M.D.s and D.O.s Moving toward a Single, Unified Accreditation System for GME

[SammyJR]

Unified match will be nice, but I don't think the DO degree should be completely merged with MDs. After all, they are still different things. Should just applied to MD schools only if the DO isn't suitable.

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[Drrrrrr. Celty]

Unified match will be nice, but I don't think the DO degree should be completely merged with MDs. After all, they are still different things. Should just applied to MD schools only if the DO isn't suitable.

How are they exactly different save for one class and generally less connections to academic centers?

 

[SammyJR]

How are they exactly different save for one class and generally less connections to academic centers?

I'm not sure I follow

 

[Drrrrrr. Celty]

I'm not sure I follow

I asked you how you think the DO degree is different than the MD degree. I mentioned that the only difference is that DOs complete OMM/OMT ( To which 90% never impliment it into their practice) and that most DO schools are not connected to academic centers that conduct research. That's pretty much the only difference between MD & DO.

Inb4 the osteopathic philosophy.

 

[SammyJR]

I asked you how you think the DO degree is different than the MD degree. I mentioned that the only difference is that DOs complete OMM/OMT ( To which 90% never impliment it into their practice) and that most DO schools are not connected to academic centers that conduct research. That's pretty much the only difference between MD & DO.

Inb4 the osteopathic philosophy.

ahh

Well, you pretty much just stated the difference. Personally, I feel like some DOs don't practice OMM is because they originally wanted to go the MD route but ended up as DOs due to various reasons.

Not every physician is interested in doing research or practicing academic medicine. If that's the case, one should have gone the MD route in the first place.

IMO, its not the unification we should worry about, but the integrity of the new DO schools.

 

[Drrrrrr. Celty]

ahh

Well, you pretty much just stated the difference. Personally, I feel like some DOs don't practice OMM is because they originally wanted to go the MD route but ended up as DOs due to various reasons.

Not every physician is interested in doing research or practicing academic medicine. If that's the case, one should have gone the MD route in the first place.

IMO, its not the unification we should worry about, but the integrity of the new DO schools.

That's a minor difference. And most DOs don't practice OMM because beyond assisting lower back pain it's useless and pseudoscience ( And this isn't my opinion, this is the opinion of the vast majority of DO students). And yes, not everyone is interested in doing research, but that being said it's important to be tied to a institute that does research. It's important and for DOs who want to go onto good strong residencies they will need research to make them stand out or be in line with average applicants.

And no, don't tell me that you should have gone MD instead. You should be saying that the AOA should be aiming to have DO schools do better in these areas.

 

[GUH]

That's a minor difference. And most DOs don't practice OMM because beyond assisting lower back pain it's useless and pseudoscience ( And this isn't my opinion, this is the opinion of the vast majority of DO students). And yes, not everyone is interested in doing research, but that being said it's important to be tied to a institute that does research. It's important and for DOs who want to go onto good strong residencies they will need research to make them stand out or be in line with average applicants.

And no, don't tell me that you should have gone MD instead. You should be saying that the AOA should be aiming to have DO schools do better in these areas.

Not all of us are interested in doing research. I don't feel the need to go to a school that is renowned for research. If I wanted to go to a prestigious research-oriented school, I would have applied to one. The fact that there is a famous scientist at a school does not necessarily improve the quality of education.

If you wanted to be an MD, you should've gone to an MD school.

P.S. I think you meant to use the word "deluded" instead of "diluted" in your other post.

 

[SammyJR]

That's a minor difference. And most DOs don't practice OMM because beyond assisting lower back pain it's useless and pseudoscience ( And this isn't my opinion, this is the opinion of the vast majority of DO students). And yes, not everyone is interested in doing research, but that being said it's important to be tied to a institute that does research. It's important and for DOs who want to go onto good strong residencies they will need research to make them stand out or be in line with average applicants.

And no, don't tell me that you should have gone MD instead. You should be saying that the AOA should be aiming to have DO schools do better in these areas.

If OMM can be used in assisting lower back pain, how is it useless?

I guess this is where we differ in opinions. I don't think it's the AOA's mission to satisfy students' wishes to be more MD-like. Instead, you can make the argument that MD schools should increase their class size or open up new MD schools instead of DO schools

 

[Drrrrrr. Celty]

Not all of us are interested in doing research. I don't feel the need to go to a school that is renowned for research. If I wanted to go to a prestigious research-oriented school, I would have applied to one.

If you wanted to be an MD, you should've gone to an MD school.

P.S. I think you meant to use the word "deluded" instead of "diluted" in your other post.

Right, I did mean deluded. My bad.

And no, MD or DO it's frankly irrelevant to me. However I do believe it is asinine that we have two organizations when we could do so much better with having a single one. And you're missing the point of why a medical school's capacity to pump out research is important. And it's not only because of the fact that research is relevant to a good amount of residencies, but because it is the model of medicine we have chosen, i.e evidence based medicine.

 

[Drrrrrr. Celty]

If OMM can be used in assisting lower back pain, how is it useless?

I guess this is where we differ in opinions. I don't think it's the AOA's mission to satisfy students' wishes to be more MD-like. Instead, you can make the argument that MD schools should increase their class size or open up new MD schools instead of DO schools

"beyond lower backpain"

No, but it is the AOA's mission to promote and better the situation for DOs. This includes listening to DO students such as when SOMA had enormous support for revamping the OMM curriculum and they rejected it. And many more things.

And I'm pretty sure you gave up half way into that "argument." MD schools are expanding and increasing their class sizes as well, they are also on average a lot stronger institutes than most of the new DO schools.

 

[SammyJR]

Right, I did mean deluded. My bad.

And no, MD or DO it's frankly irrelevant to me. However I do believe it is asinine that we have two organizations when we could do so much better with having a single one. And you're missing the point of why a medical school's capacity to pump out research is important. And it's not only because of the fact that research is relevant to a good amount of residencies, but because it is the model of medicine we have chosen, i.e evidence based medicine.

I agree with the last part. It's important for all physicians to be updated with the latest research, but that doesn't mean DO schools should start affiliating themselves with research centers so their students can have a shot at research oriented residencies. If you are doing a joint degree with PhD, that's a different discussion.

"beyond lower backpain"

No, but it is the AOA's mission to promote and better the situation for DOs. This includes listening to DO students such as when SOMA had enormous support for revamping the OMM curriculum and they rejected it. And many more things.

And I'm pretty sure you gave up half way into that "argument." MD schools are expanding and increasing their class sizes as well, they are also on average a lot stronger institutes than most of the new DO schools.

DO students are only a portion of DOs.

I just stating my opinion that the DO degree shouldn't be changed just because students wants to be MDs.

 

[Drrrrrr. Celty]

I agree with the last part. It's important for all physicians to be updated with the latest research, but that doesn't mean DO schools should start affiliating themselves with research centers so their students can have a shot at research oriented residencies. If you are doing a joint degree with PhD, that's a different discussion.

Many big and established DO schools have tried strongly for establishing connections to research schools in their areas. While they themselves are not usually connected to a school they have directly won support from schools in their area. And many others have direct connections to research, i,e the public DO schools ( i.e the Jewels of Osteopathic medicine). But regardless, this is fundamentally my opinion of the matter. I believe research is an important component of all medicine and that all schools should offer their students the capacity to do it in an unobstructed manner.

Which is in majority part 1 one my explanation to why I think a good amount of new DO schools are bad. Unless you're connected to a strong hospital ( MUCOM, ACOM) or connected to an institute with an enormous OPTI ( LECOM-SH) or connected to research schools, then you're doing your students a misdeed.

Anyway, end rant. I'm going to go study.

DO students are only a portion of DOs.

I just stating my opinion that the DO degree shouldn't be changed just because students wants to be MDs.

In 10 years they'll be the majority of practicing DOs.

 

[SammyJR]

Many big and established DO schools have tried strongly for establishing connections to research schools in their areas. While they themselves are not usually connected to a school they have directly won support from schools in their area. And many others have direct connections to research, i,e the public DO schools ( i.e the Jewels of Osteopathic medicine). But regardless, this is fundamentally my opinion of the matter. I believe research is an important component of all medicine and that all schools should offer their students the capacity to do it in an unobstructed manner.

Which is in majority part 1 one my explanation to why I think a good amount of new DO schools are bad. Unless you're connected to a strong hospital ( MUCOM, ACOM) or connected to an institute with an enormous OPTI ( LECOM-SH) or connected to research schools, then you're doing your students a misdeed.

Anyway, end rant. I'm going to go study.




In 10 years they'll be the majority of practicing DOs.

Your points are very valid. I was referring more to the fact that DO schools should not be pressured into removing OMM from their curriculum and become research heavy schools to compete with the top MD schools.

Good luck.

 

[YouWithTheHair]

I'm sorry, but this is more than a fit. It's a disgusting display of old men unwilling to give up power and change for the better.

I totally agree. I have no problem starting at a DO school this year (class of 2017!), and i do believe that OMM can have its place, but I think it's a detriment to the future of osteopathic students when you have a few diehard legacies clinging to their power and ideals just because that's the way it's been done. Honestly I think it'd be more effective at improving the uniformity and quality control of medical education if they went beyond GME and just made a joint board exam as well. How hard would it be to have everyone take the USMLE exams and just have an extra section for osteopathic certification? Speaking with friends who have already taken both, they are relatively the same material with the exception of OMM.

 

[Drrrrrr. Celty]

I totally agree. I have no problem starting at a DO school this year (class of 2017!), and i do believe that OMM can have its place, but I think it's a detriment to the future of osteopathic students when you have a few diehard legacies clinging to their power and ideals just because that's the way it's been done. Honestly I think it'd be more effective at improving the uniformity and quality control of medical education if they went beyond GME and just made a joint board exam as well. How hard would it be to have everyone take the USMLE exams and just have an extra section for osteopathic certification? Speaking with friends who have already taken both, they are relatively the same material with the exception of OMM.

I think OMM has it's place too, albeit with a good amount needing to be cut out. I personally am interested in OMM as a method of preparing students for clinical interactions ( And in my opinion this would be a nice study) since many claim it is helpful in that regard.
But yes, having two exams given the combined match is idiotic. It only hurts DO students who need to spend more time and effort on another exam.

 

[NeuroLAX]

i think OMM and the DO title should stay, but COMLEX and DO boards should be gone. they create nothing but extra expenditure and confusion to the public. unifying MD and DO boards will improve public and international recognition of DO and OMM.

How would board unification lead to improved public recognition when many people simply don't know what a DO is altogether?

 

[Drrrrrr. Celty]

i think OMM and the DO title should stay, but COMLEX and DO boards should be gone. they create nothing but extra expenditure and confusion to the public. unifying MD and DO boards will improve public and international recognition of DO and OMM.

Unifying things more closely will likely lead to increased international rights. But that's about it. Public perception probably won't change too much and OMM will always be scrutinized as a methodology that is in majority useless. OMM needs to be researched, reduce it to the techniques that work and make it a 1 year course. Either the Comlex to a OMM exam and let all DO's use the USMLE as their standardized test sequence and add an OMM component to the end of it.

 

[HalfListic]

How would board unification lead to improved public recognition when many people simply don't know what a DO is altogether?

exactly, let alone how would you include OPP and OMM in a test that everyone takes, but only DO students learn/study.

Not that I wouldnt rather have only one test to worry about, but its problematic in a number of ways

 

[SpecterGT260]

How would board unification lead to improved public recognition when many people simply don't know what a DO is altogether?

Because average people totally keep up on what medical boards are up to.

 

[NeuroLAX]

Because average people totally keep up on what medical boards are up to.

Of course. What was I thinking? Mea culpa.

exactly, let alone how would you include OPP and OMM in a test that everyone takes, but only DO students learn/study.

Not that I wouldnt rather have only one test to worry about, but its problematic in a number of ways

I've said it before and I'll keep saying it. Solid OMT research needs to continue and the researchers need to shout it from the mountaintops. The biggest problem is well-designed double-blind studies, but even that is beginning to be worked out... finally. If the research is there to support it, I think everyone should be required to learn it.

 

[HalfListic]

I've said it before and I'll keep saying it. Solid OMT research needs to continue and the researchers need to shout it from the mountaintops. The biggest problem is well-designed double-blind studies, but even that is beginning to be worked out... finally. If the research is there to support it, I think everyone should be required to learn it.

Exactly. I hope this becomes more of a priority. The results are pretty amazing, but they need to be quantified and verified by the standard double-blind studies, like you pointed out, to gain the traction it deserves.

 

[Drrrrrr. Celty]

Exactly. I hope this becomes more of a priority. The results are pretty amazing, but they need to be quantified and verified by the standard double-blind studies, like you pointed out, to gain the traction it deserves.

It realistically wouldn't be any harder than the psychologists who compare paradigms in relation to patient outcomes. But it's unlikely we will see a lot of good OMM research for many reasons, but generally because they are either so false that they're difficult to disprove, to being invasive i.e chapman and been proven low effect in dogs.

Generally I want a study that looks at OMM as a model of education. Whether or not teaching OMM may be related to better preparedness in clinical settings or feeling more comfortable working with patients.

 

[gyngyn]

Exactly. I hope this becomes more of a priority. The results are pretty amazing, but they need to be quantified and verified by the standard double-blind studies, like you pointed out, to gain the traction it deserves.

Well designed studies with reproducible outcomes would get everyone's attention.

 

[HalfListic]

It realistically wouldn't be any harder than the psychologists who compare paradigms in relation to patient outcomes. But it's unlikely we will see a lot of good OMM research for many reasons, but generally because they are either so false that they're difficult to disprove, to being invasive i.e chapman and been proven low effect in dogs.

Generally I want a study that looks at OMM as a model of education. Whether or not teaching OMM may be related to better preparedness in clinical settings or feeling more comfortable working with patients.

Well designed studies with reproducible outcomes would get everyone's attention.

Im sure you are right! Hopefully I (we) students can spur some of it along.

Even though I don't see myself specializing in OMM, I do plan on utilizing it.

 

[babdoc]

Exactly. I hope this becomes more of a priority. The results are pretty amazing, but they need to be quantified and verified by the standard double-blind studies, like you pointed out, to gain the traction it deserves.

1. Solid research is what is needed because I don't see any (much) of it. Most of the OMT studies that are done are on small patient groups and are poorly designed. And their effects are, frankly, not that convincing to me. Two years ago, as a second year, the president of the AOA stood in front of my class and asked how many patients were in the study that found that 4th ventricle compression induces labor. The answer? 6. How far along were these ladies? All were past-due. For all we know, watching a scary movie would have been as likely to induce labor. Her point was, lets be smart about this. OMT, like you said, isn't going to get any cred until it has better designed studies to back it up (a la, the LBP studies that are so often quoted). The JAOA isn't helping this much by publishing small preliminary studies that don't show much effect or statistical significance. Where are the follow up studies with big study groups?

2. You can't double blind OMT studies. Sure, the patients can be "blinded"...though I'd love to see a study of how many subjects know they got the "sham-OMT". It wouldn't be that hard, and I bet the results would be damning for the idea that sham-OMT elucidates much of a difference between the real thing. For double blinding, the doctor would have to be ignorant that they're giving OMT or not. This isn't possible, just like you can't double blind surgery.

 

[NurWollen]

Looks like the merger is off, at least for now.

http://www.osteopathic.org/inside-aoa/Pages/ACGME-single-accreditation-system.aspx

 

[darklabel]

The osteopathic medicine licensing examination (COMLEX-USA) remains in place and viable.

So basically, Osteo wants to keep the "separate but equal" mentality?

 

[NontradCA]

Looks like the merger is off, at least for now.

http://www.osteopathic.org/inside-aoa/Pages/ACGME-single-accreditation-system.aspx

 

[gmcguitar4]

They are being stupid about this. It is just delaying the inevitable and costing more time, money, and frustration to everyone because some old guys don't want to budge.

 

[Back 5]

Are the AOA unwilling to increase their standards to that of the ACGME (if their standards are lower) ,of residencies, and this is the hang up?

 

[Dr.TurkandJD]

Are the AOA unwilling to increase their standards to that of the ACGME (if their standards are lower) ,of residencies, and this is the hang up?

I don't think so, I think the hang up comes from allowing MD students into DO residencies without OMM.

 

[sylvanthus]

The biggest hang-up is that people in power want to stay in power. It has absolutely nothing to do with our "distinctiveness" that is just what they are using as a shield for the true reason. I guarantee it.

 

[Dr Dazzle]

It's so ridiculous how slowly they are going about this. More DOs are in ACGME programs than are in AOA programs! So frustrating for DO students.

 

[Drrrrrr. Celty]

The AOA doesn't want to lose their money and power. Instead of just letting to and let everything be handled by a central organization they want to maintain "osteopathy" I.e their salaries.


Too bad we can't vote any of them out or even create alternative organizations.

 

[darklabel]

It's so ridiculous how slowly they are going about this. More DOs are in ACGME programs than are in AOA programs! So frustrating for DO students.

Thats also out of necessity, despite what the article says there aren't enough residencies from the AOA to cover all graduates.

 

[Dr.TurkandJD]

The dean talked to us today, and said there is a good and exciting announcement coming out next week!

 

[Anicetus]

The dean talked to us today, and said there is a good and exciting announcement coming out next week!

New food station opening up in the cafeteria.

 

[guylewis]

The dean talked to us today, and said there is a good and exciting announcement coming out next week!

Ugh I am not good at waiting for surprises. First Comet Ison, then Elon Musk's hyperloop announcement, and now this?? Please tell me you have a hint or even a hypothesis of what this good news could be!! Anyone??

 

[sylvanthus]

Ugh I am not good at waiting for surprises. First Comet Ison, then Elon Musk's hyperloop announcement, and now this?? Please tell me you have a hint or even a hypothesis of what this good news could be!! Anyone??

Everyone at the AOA is canned?

 

[salutations]

1. ... The JAOA isn't helping this much by publishing small preliminary studies that don't show much effect or statistical significance. Where are the follow up studies with big study groups?

2. You can't double blind OMT studies. ... For double blinding, the doctor would have to be ignorant that they're giving OMT or not. This isn't possible, just like you can't double blind surgery.

First, I agree with your general sentiments. But you can't go from casually observing objects always fall to having evidence to substantiate a law of gravitation in just a (figurative) day. Especially without the funding. And, for one, I believe the MD heads of surgery at St Johns and Staten Island Univ Hospital are making rotating do students carry out treatment for post-op ileus as they felt a previous study (Crow 2009) didn't go far enough. I don't know where that's at or even if it's true, just remember reading it soemwhere.

Second, as I understand it, blinding isn't implemented for the sake not knowing what you're doing. It's about minimizing biases. Even with pharmaceutical trials there can be strange tastes or bizarre side effects which can clue in both patient and physician as to what group they've been randomized to. The fact is that in *any* study there will *always* be error and bias; it's the extent to which it's minimized that is important. Even surgical intervention studies have been called "double-blinded" because of their awesome design eliminates placebo (sham surgery) and observer-expectancy (dont let the surgeon be the observer of results) effects. Of course, like you said, it's impossible for the surgeon to know whether or not a surgery was performed (unless it was, like, done by a LASIK robot?). This is why it's being recommended more and more to acknowledge *who* in the study was blind. The patient? The doctor? The researcher? The data collector?

I mean the High Dose flu shot didn't even undergo a trial testing the solely important clinical end-point of, oh , say... PREVENTING THE FLU. There are more adverse reactions with it. It costs about twice as much (60 vs 30 retail) and as it's for those 65+, that's a lot of medicare money. Yet I haven't seen anyone make a fuss about mass-injecting the geriatric population with a vaccine that hasn't undergone the rigors of a double-blind trial but is instead based solely on the whim that it'll work (higher antibody titer). edit: i should probably /rant before bed

 

[user3]

The dean talked to us today, and said there is a good and exciting announcement coming out next week!

town hall meeting with AOA leadership regarding merger

anti climactic

 

[guylewis]

town hall meeting with AOA leadership regarding merger

anti climactic

You have got to be kidding me! A town hall meeting with the AOA??? that's the big "exciting announcement"??? yeah lots of great things get changed and fixed because of townhall meetings <sarcasm font>

 

[Ost3oclast]

This isn't even a thing anymore is it? Last I heard...AOA said "nope!" Lol

 

[jayoh]

Haha, actually the AOA said "nope, the ACGME are trying to be bullies and force an evil agreement on us"

Then the ACGME said "what? You guys were literally writing this entire thing with us."

Comedy. I guess the town hall thing should be entertaining.

 

[SpecterGT260]

Haha, actually the AOA said "nope, the ACGME are trying to be bullies and force an evil agreement on us"

Then the ACGME said "what? You guys were literally writing this entire thing with us."

Comedy. I guess the town hall thing should be entertaining.

Weird... I wonder if anyone said something like this would happen several pages ago...