new osteo school

[monte]

Has anyone heard anything about Virginia opening a new osteopathic school?

Take care.

---

Members don't see this ad.

 

[dieselkid]

Call the AOA to find out for sure. There's one in West Virginia already...Is that what you are thinking of?

 

[Pikevillemedstudent]

Actually, I have heard this. I was told this by two different dependable sources. It is going to be in Blacksburg, VA at Virginia Tech University. I do not know when it is supposed to start.

 

[Hskermdic]

One of our dean's will be the new dean there. She starts there in August and said she will be there for two years setting up the program before the first class gets there. So the first class will start there in 2003 and should then graduate in 2007. She said it was at Blackburg (Va Tech) as well.

I guess it is a done deal. I personally don't think we need to be starting anymore medical school in this country (MD or DO).

 

[alperaar]

hi...do you have reasons for not wanting another med school? Or do you just love spouting off stupid opinions without backing them up!! With the critical shortage of doctors that we're facing in this country, especially in so many specialities, we could use all the med schools we can get.

 

[healthydawg]

how interesting...

i contacted the AOA and AACOM not too long ago asking whether or not any new schools were coming aboard and they said no. i specifically asked about the Florida COM, in Tarpon Springs that some folks were trying to start up a few years back. That effort apparently went nowhere.

but i also specifically asked whether other schools were starting up and they said no. Maybe it was too early... Anyway, does anyone know what the rationale is behind opening another one in Virginia? i mean, i think opening another school might not be a bad idea but i always thought the intermountain west or perhaps a little school in Alaska would make a better choice. just my $0.02.

 

[Hskermdic]

alperaar,
If I wasn't so tired from studying for finals I might be offeneded at your question if I like spouting off stupid comments without backing them.
I am against creation or more medical schools because of the freeze put on creating residency programs by the balanced budget act of 1987 (I am not sure this is the exact year) The osteopathic profession is several hundred (or thousand) internships and residencies short to have space for all of its graduates. The only thing that saves us is that a large number of DO graduates go into MD residencies. As schools and the number of graduates increase there will still be that fixed number of residency slots and residencies will be harder to come by.
I know that the balanced budget act does allow for creation of residencies in underserved hospitals that have not had a residency in them. Right now it seems like a lot of those programs are in smaller and more rural programs. Parden another spout of un-backed up information but I am leary of the type of experience we will get in the smaller hospitals especially if you want to do something like OB, cardiology etc where small hospitals may not have the volume you need.

Just my 2 cents. If you don't like it don't read it.

 

[roughgod]

From what I know, they will not open another school again.....I heard from a friend who's spoken to the AOA president in a seminar. The reason is mostly what Carrie had mentioned up there.

P.S. Carrie, where does the hostility come from? You have a rude anger in your tone....why is that? Relax a bit; we all have finals and more.

 

[Billie]

I don't think she has a rude tone. If someone told me that I was spouting off "stupid opinions", I would be a little perturbed too!

 

[Pikevillemedstudent]

Originally posted by healthydawg:
•how interesting...

i contacted the AOA and AACOM not too long ago asking whether or not any new schools were coming aboard and they said no. i specifically asked about the Florida COM, in Tarpon Springs that some folks were trying to start up a few years back. That effort apparently went nowhere.

but i also specifically asked whether other schools were starting up and they said no. Maybe it was too early... Anyway, does anyone know what the rationale is behind opening another one in Virginia? i mean, i think opening another school might not be a bad idea but i always thought the intermountain west or perhaps a little school in Alaska would make a better choice. just my $0.02.•

Perhaps even more interesting is the fact that at this year's SOMA convention in Washington, DC, an AOA board member, I think it was Boyd Bowden, spoke to the SOMA house of delegates and said that no new schools or new seats in existing schools would be added until enough AOA approved residencies were present for every DO student. With the obvious opening of the new school in Virginia, I feel this was an out right lie. I have also heard that a new school in Montana may open up. I was told this by one of my dependable sources I mentioned earlier and I also heard it from a woman who was actually making the preparations in Montana. It was a small college I think.

 

[JS-UNMC]

I have found, to much disapointment, that the AOA is the worst source of information for any medical student. If you know someone (prof or DO) who says they are starting up a new school... I would go with what they say... not what the AOA says. Sorry, but the AOA is incredible dissorganized.

 

[DrQuinn]

hm, wow a DO school at Tech? Damn, I knew I shoulda waited so I could get in-state tuition. Just kidding.

Actually, the DO profession has many MORE slots than it does graduates. Like, several hundred... only 800 or so DO graduates went to the MD programs (this statistic was just released, I think I read it in the last issue of the "New Physician."). Opening another school wouldnt' hurt anyone, and all it would do is to increase the # of DOs which is only a good thing.

I went to JMU in Harrisonburg, VA for undergrad, about 2-3 hours from V.Tech. V.Tech is in NOWHERE, and the SW part of VA (appalachians) is in desperate need of physicians. Read: RURAL. Not like my much loved NSU-COM which is in Ft. Lauderdale, or PCOM in the heart of Philly, but VT is rural and I think that would be an excellent place to train students who actually want to go into underserved populations, and not just hte people who put that on their application.


Q

 

[muonwhiz]

Think of it this way: the more osteopathic medical schools, the more DO's in the population. The more DO's, the greater the influence in the overall profession

 

[healthydawg]

let me add a little intrigue...

i shot off an e-mail today to the folks at VTech's Development office in administration. the nice lady who responded had no idea what i was talking about. now, this DOES NOT mean that plans aren't in the works for a new school. i believe they are. and based on a previous poster's description of the locale, it may be a really good thing. it's a good school, that much i know and to the extent that the DO program could benefit from their academic strength, even better. anyway, apparently word hasn't spread much over there...

now what's this about a school in montana?

 

[MSUCOM2003]

Guys,


Lighten up a little! If true this is actually great news. Vtech is a major public university and will bring needed credibility and exposure for Osteopathic medicine in the research and academic arena. Not to mention the fact that the Hokies are a football powerhouse. Who knows, in a few years there might be some intercollegiate rivalries worth getting excited about (when was the last time MSU played Vtech???)

 

[ebola95]

well, let me just add some fuel to the fire....the new people at Central Michigan University want to add a DO school as well...in fact, i guess they have just started construction on a new building for it too....i don;t get it...why at CMU of all places and especially when MSUCOM is just 1 hour south?
the world will never know!

 

[healthydawg]

ok, this is turning into a very interesting thread indeed...

i shot an e-mail off to a DO in montana asking about this. and the answer was...drumroll please... there has indeed been talk about adding a DO school to a small college up there. so pikesville, your sources are damn good! the DO told me where to go for an update which i'll do today. sniffing this stuff out is kinda fun - but then i am a dawg right?

now what's this about a school at central mich?

dawg

 

[Bigk9s]

Virginia is the birthplace of Dr. Still, so why shouldn't it have some DO representation?

 

[Kent Ray]

I cannot believe what I am reading. Why open new schools. In this thread there have been so many factual errors. First there aren NOT enough graduate spots for all the undergraduates. Second the spots that we have now are at small community hospitals where your lucky if you learn anything. Someone said in this thread that the more DO's the better. Well, did you know that if you look at research dollars and add them up for all the DO schools we would rank 125th on the list. We have to improve upon what we have before we try to grow.

 

[ebola95]

kent, i hear what you are saying and i understand, butyou have to see the incentive for the universities to open a medical school (for example CMU)...they are trying to shift the emphasis of the campus to health care (new PA program 4 years ago, increased PT and OT schools) because of the ..... that's right, MONEY that it brings in! especially in the midwest where there is a major boom in DO's....do you really think that a university cares about post-grad? they get the first 4 done and ship you off...they leave all the residencies up to the AOA to figure out...they don;t give a !@$%.....

but, as someone mentioned earlier in this thread, a big-wig at DO Day on the Hill mentioned that they are trying to focus on getting more residencies opened up for DO's...that is where the DO's are loosing people, b/c we have to go do an allopathic residency....

good topic for discussion

 

[healthydawg]

a lot to mull over so far...

i guess the question is how do you balance what's good for the population at large versus what's good for the profession. from the rumors (or maybe facts?) we've heard so far, it seems that two of the schools may actually be in locations that serve their surrounding populations well. those are Vtech and the little school in Montana. Vtech also offers a good benefit for the profession since it's a well known school with a substantial amount of research going on. (they are part of a new biomedical research consortium with other Va schools.) now as for central mich, well that one i would question as the state already has a high proportion of DOs, a DO school is close by, and the school is not, as far as i know, a research powerhouse.

in the end, i would say dismissing new schools off hand is not wise but neither is opening new schools willy-nilly. planned growth is not bad. to read more on this (for those who've read this far) check out the osteopathic reformation book.

 

[R. Dale Jackson]

I just wanted to address some of the factual aspects of this thread.

-The Balanced Budget Act of 1997 did a number of things. First, it limited the number of IMG slots in the US. This was to save money and to stop the US taxpayer from having to fund the education of many foreign graduates. Second, it froze the number of current residency slots in existing programs. The general purpose for this was to help fix the imbalance of specialty to primary care physicians (more than 2:1). The wording of the law was written so that if a medical school wants to open up new programs, it is very easy to do so IF it is a primary care residency and IF it is in an area where a residency did not already exist.

-This helped re-ignite the debate about whether it is a bad thing that osteopathic schools have the majority of their clinical rotations in community hospitals. I did a review of health policy books and journals on this topic; many experts tend to think that this is the best way to train community-oriented and competent primary care physicians. The claim is that learning primary care in a tertiary care facility (a.k.a a large academic facility) does not prepare one as well for practicing in a community environment. If you look at some of the allopathic schools that have made a shift toward primary care (e.g. U of Wash, U of Minn-Diluth, some of the schools in Texas, etc), they have reformed their clinicals and now send many medical students out to community hospitals and clinics for many of their rotations. These sites often rely heavily on volunteer faculty and preceptors. This is controversial for some, but only a review later in the future will tell. Many point out that this is allopathic schools doing what many in the past have bashed osteopathic schools for doing.

-There are nearly enough D.O. residency slots for all the graduates. However, many students choose to go to allopathic programs because they perceive them as better. I have heard this effectively argued both ways. The AOA is currently working to expand residency programs in states where they do not already exist. They are doing so in accordance with the BB Act of 1997. Also, it is important to remember the new OPTI requirements only took effect a few years ago. It established new rules and regulations for all osteopathic post-graduate programs to go by. The effect has been very positive and will only get better, especially as the new programs are opened. For more on the new programs read here, as well as check out what ?OPTI?s? are all about: http://www.aoa-net.org/Publications/DO/train201.pdf

-Research is expanding, there are now several DO-PhD programs and the number is supposed to grow. Most are located in the state D.O. schools. However, the private schools, e.g. UHS, NSU and PCOM are supposedly working to bring programs online in the next few years. The NIH is also expanding the number of grants it is giving out to study OMT, acupuncture, etc. This is all part of the efforts of the Center for Complementary and Alternative Medicine. http://altmed.nccam.nih.gov/nccam/fi/concepts/pa/chiro.html

-There has been a swell of support for osteopathic principles and philosophies dating back to 1970 (after the failed CMA attempt to wipe out D.O.s.) Shifts in government policy and toward manage care have tended to favor much of it. Many of the tenets of the philosophy that were bashed in the past are now accepted and taught in many medical schools---I am talking about the primary and preventative emphasis, as well as the concepts of holistic and humanistic medicine. This has been one of the causes of the blurring line between the two professions. That combined by with the fact that over 50% of D.O.?s are doing allopathic residencies is what caused the osteopathic profession to regroup over the past few years.
D.O.?s spent many years proving they were equal. Now that that has been accomplished, they have to make sure they remain SEPERATE but EQUAL, or face absorption. That is why the AOA is trying so hard to increase the number of quality residency programs. IT IS IMPORTANT FOR D.O.?s TO CONTINUE TO BE TRAINED IN OP&P. If not, the profession will become too diluted and lose its sense of uniqueness. For more on this read: Osteopathic Medicine: A Reformation in Progress (2000), http://www.amazon.com/exec/obidos/ASIN/0443079919/qid%3D990144733/103-5778643-0223029

Well, I could go on, but I will stop here. My final point is this--osteopathic medical schools have come a long way and are now known for producing quality physicians, especially in primary care. However, like in allopathic schools, there are needed improvements. These are well defined and many of the fixes are in progress. However, because of the system works change comes slow. It is important that all osteopathic physicians and students do their part by continuing to build on the constantly improving reputation of the profession. Moreover, it is time that we make sure that everyone knows we are proud to be D.O.?s and pre-D.O.?s. In the past many have tried to hide this by not putting the ?osteopathic? in front of ?medical school? or ?medicine? when talking to others about what they do and where they come from. Many physicians would not practice OMT for fear of not being accepted. They would put ?Dr.? in front of their name on their coat, but leave the D.O. part off. We need to continue to work hard at providing top-quality healthcare for our patients, while at the same time letting everyone know how proud we are to be called D.O.

Dale Jackson
MSU-COM 2005


A quick side note: MedTech1.com recently interviewed Dr. Blank, D.O. from UNTHSC-TCOM. It was pretty interesting, check it out: http://www.medtech1.com/hero/medtech_hero.cfm?Article=7

 

[drusso]

Originally posted by R. Dale Jackson:
•I

-This help re-ignite the debate about whether it is a bad thing that osteopathic schools have the majority of their clinical rotations in community hospitals. I did a review of health policy books and journals on this topic; many experts tend to think that this is the best way to train community-oriented and competent primary care physicians. The claim is that learning primary care in a tertiary care facility (a.k.a a large academic facility) does not prepare one as well for practicing in a community environment. If you look at some of the allopathic schools that have made a shift toward primary care (e.g. U of Wash, U of Minn-Diluth, some of the schools in Texas, etc), they have reformed their clinicals and now send many medical students out to community hospitals and clinics for many of their rotations. These sites often rely heavily on volunteer faculty and preceptors. This is controversial for some, but only a review later in the future will tell. Many point out that this is allopathic schools doing what many in the past have bashed osteopathic schools for doing.


-Research is expanding, there are now several DO-PhD programs and the number is supposed to grow. Most are located in the state D.O. schools. However, the private schools, e.g. UHS, NSU and PCOM are supposedly working to bring programs online in the next few years. The NIH is also expanding the number of grants it is giving out to study OMT, acupuncture, etc. This is all part of the efforts of the Center for Complementary and Alternative Medicine. http://altmed.nccam.nih.gov/nccam/fi/concepts/pa/chiro.html •

More D.O. schools is an interesting proposition. There is some thought that we are not currently training enough physicians:
http://www.nejm.com/content/2000/0343/0003/0213.asp


"Given the large and consistent shortfall in the supply of medical school graduates available to fill residency positions and a pool of qualified applicants eager to enter medical school, it might be appropriate once again to expand enrollment in U.S. medical schools. There are a number of reasons why such a change in policy merits the attention of leaders in medical education and the public. The first reason is to close the gap between the need for trained physicians in the United States and the capacity of U.S. medical schools to educate them. This gap has persisted for two decades, as has the possibility of closing it with qualified applicants to U.S. medical schools. A second reason for increasing the number of medical school positions is to expand career opportunities. Over the years and despite recent perturbations in medical practice, careers in medicine have been eagerly sought by bright, capable young people. Medicine remains a respected and well-remunerated profession. U.S. labor and educational policies should be designed to offer as many U.S. students as possible the opportunity to study and practice medicine...Creative ways of expanding medical education are well under way all around the borders of U.S. allopathic medical education. The number of graduates of osteopathic medical schools has doubled in recent years, with half the graduates entering allopathic residency programs. In addition, there is a sophisticated new generation of programs in other countries, including a Columbia University-affiliated, four-year curriculum for English-speaking students at Ben-Gurion University of the Negev, in Beer-Sheva, Israel. (12) Increasing numbers of U.S. students are enrolling in well-established medical schools in countries such as Ireland, with the intention of returning to the United States for residency training. (13)"

The New England Journal of Medicine -- July 20, 2000 -- Vol. 343, No. 3


But what troubles me about more D.O. schools is that, to my knowledge, the osteopathic profession has never articulated a strategic plan for growth. If we are to have more D.O. schools, I'd like to see that they are public, university-affiliated ones.

With respect to training venues I think that a mix is needed. As a medical student I've rotated in both smaller community hospitals as well as large tertiary care settings. I think that exposure to both is needed. They each offer unique advantages and disadvantages.

 

[R. Dale Jackson]

Originally posted by drusso:

But what troubles me about more D.O. schools is that, to my knowledge, the osteopathic profession has never articulated a strategic plan for growth. If we are to have more D.O. schools, I'd like to see that they are public, university-affiliated ones.

With respect to training venues I think that a mix is needed. As a medical student I've rotated in both smaller community hospitals as well as large tertiary care settings. I think that exposure to both is needed. They each offer unique advantages and disadvantages.[/QB]

This is a good point that I touched on in past posts. It is also something I looked very hard at when choosing which D.O. school I wanted to attend.

 

[Kent Ray]

R. Dale Jackson,
Your thoughts are clear and I agree with almost everything you said except.. I know from experience that training in community hospitals compared to large teaching hospitals is a far cry from the quality that should be expected from post. grad. programs. My internship is split evenly between a large research/teaching hospital and a small community hospital. At the community hospital I am basicaly working for a private physician. This person has to be in his/her office most of the day and will round for 30-45min. All year I have recieved less than an hour of teaching during rounds. Now at the teaching hospital I have teaching rounds that last for two hours each day. We also have 4.5 hours per week of non service teaching. There is a huge difference in attitude between the two facilities. To sum it up, at the community hospital we are there to make the attendings life easier, and at the teaching hospital we are there to learn.

 

[DaNugget79]

It's great to hear that Virginia is getting a DO school. Personally, I now wish I was 2 years younger so I could apply there and go there at a cheaper price. My only complaint is WHY TECH? Of all the schools in Va, WHY TECH? The only reason they have a football powerhouse is because all the recruits from a couple of years of ago (including a guy named Vick) realized they couldn't hack it academically at UVa because Tech is the only place you can major in "University Studies". Pretty cool huh?

Now, back to WHY TECH? There's William and Mary, JMU, in addition to UVa. I don't see why those schools couldn't get the DO school. Granted, UVa already has an MD school, but I don't see why they can't pull a Michigan State and have both. Shoot, Northern Va needs a school - George Mason is good. Or a compromise - UVa has a small independent school (UVa College at Wise) which is in rural Va. Why not let them have it? But ideally, W&M or JMU should get it to give them more national recognition because they are great schools. For the love of God, anywhere but TECH!!!

Nugget

 

[Pikevillemedstudent]

danugget,
University studies is major at several schools, not just Va. Tech. I have heard of people getting accepted into dental and pharmacy school then dropping there bio major and graduating with a degree in university studies. It is done at several places and is allowed by the grad schools. Also, I am sure you know more about VA schools than I do but I will have to eliminate one school off your list: UVA@Wise. It less than an hour from PCSOM and we have FP and IM residencies opening up at the hospital there. Probably not a good idea to put the two newest DO schools so close together.

BTW, I think MSU has both DO and MD schools because both were pursued at the same time. Having an already established MD school add a DO program would be very doubtful to occur.

Also, it is Pikeville, not PikeSville. I think that may be my pet peeve.

 

[DrQuinn]

Wow. 'nuff said.

Danugget: I am from the DC area and went to undergrad at JMU... I believe out of all the schools, VT would be best suited for the medical school. Its a large school, far away from any of the other medical schools (JMU is 1.5 hrs from UVA)... Mason would be a bad choice because how many medical schools are there in DC? 3? And you have U of MD not too far away too. I think Fairfax Hospital is associated with GW too...

Tech is out there in Blackburg... RURAL. Which is what most osteopathic schools "want"... who knows if the students will practice there, but we definately don't need another urban medical school around DC. William and Mary is next to EVMS, plus I doubt the second or i can't remember if its the oldest, medical school would want a DO program there.

 

[DaNugget79]

QuinnNSU: I see your point, but I still have to ask WHY TECH? Why not Radford, they're close to Tech. Or if all else fails, couldn't we associate it with a community college or something? Anything but Tech. Do we really want to dumby down the reputation of this new school by slapping Virginia Tech's name in front of it? Do we really want our doctors to be "Hokies"? What the heck is a hokie anyway? I don't know what the world is coming to.

Nugget

 

[DrQuinn]

DaNugget...

Someone doesn't like Tech. I think Tech is also a good choice because they (I'm pretty sure) have a veterinary program. So that helps too, I would think. Ok, so maybe the patient population of vets doesnt' care, but I'm sure they can share some of the same facilities. i.e. put the ICU in the kennel, spread a little toxo.

Radford? No way. Why not move it to Longwood?

JMU would be a decent choice, but its too close to UVA, the hospital (Rockingham Memorial) is growing but I definately don't think its anything spectacular... especially since we used to ship all our patients out to UVA for any reason we could... JMU does have a PA program that they started (BS degree, I don't know how its working out as I left right when they started it).

I'm not a Tech fan (especially since I learned the cup rule at the parties) but I think its the best choice for a DO program in VA. btw, I don't like it just because they ahve a good football program, and both schools i've gone to don't have any great fb program (JMU and NSU).
Q

 

[DaNugget79]

QuinnNSU: First, glad to hear you're not a Tech fan. One (definitely not the only) reason for my (slight?) dislike is because they think they are so big and bad because of football. "We don't know our left hand from our right, but we have a great football program, so we're better than you, YES!"

Now, back to the school. Yes, yes, all your points are correct and make the most sense. But still, come on...Tech? Radford, Longwood, Lynchburg, Blacksburg Community College, all better choices than Tech. Or how about not affiliating it with any school, like LECOM does? We can call is VCOM. You can have it in the Blacksburg area, that's fine with me. Just don't put Tech's name anywhere around it, and I'm happy. Just my thoughts...

Nugget

 

[healthydawg]

a little more to add to the mix...

the college in montana MAY or MAY NOT be opening a DO school. they are considering it but it sounds like they are still quite a distance off from making a decision. they still have to undertake a feasibility study and that MAY or MAY NOT happen next year. having said that, it looks like the model they would emulate (if they do this) is pikeville. montana does not currently have a med school and neither do idaho, wyoming, or alaska. i think their goal is to attract folks who would practice in those states. so things are still pretty tentative...

all of this came from a very, very reliable source.

as i said before, IMHO this is one model of school that is worth pursuing because the clear purpose is to serve a population that is likely underserved right now. there will be a clear benefit to the population.

dawg

 

[Liljoe2002]

Allright, I hate myself for getting in this discussion, but here is my opinion on the matter. I would love to see a school in the Pacific Northwest-Oregon, Wash., Idaho, Montana and I'll throw Alaska in there. There is a definite need for it. All other parts of the country have a representative Osteopathic school. I'm shocked that there is no push for a school in this part of the country. I do agree with some points made about too many medical schools and not enough spots for us:I'm ignorant when it comes to the exact numbers so I can't back up this claim. Well enough said.

Liljoe

 

[dieselkid]

My vote is for Hawaii.

 

[groundhog]

Why not University of Alaska in Fairbanks AK?


R.Dale Jackson,

U Wash Med School is rated #1 for training of primary care physicians by USNWR.

Go Dawgs. Woof Woof.

 

[R. Dale Jackson]

Sorry about the length of this post, but a few of us opened a can of worms here and I can not resist the opportunity to expound. However, much of it cannot be adequately addressed in a forum such as this. But, I have some serious time on my hands, so I am would like to add some ideas to think about. Just maybe someone is bored enough to read it.

To start, assuming this information about opening a new school is true, VA Tech and Blacksburg is a great place. ...And that is assuming it is going to have a mission statement similar to the West Virginia and Pikeville School...not quite as focused though. I doubt their Appalachian requirement will be as strict...being associated with a major university they will be able to attract a larger applicant pool with other interests. The location is prime though...for many reasons already stated.

Danugget: I think you are being a little VA TECH. It might not be UVA, but it is a solid, nationally ranked, second tier school.

Liljoe2002: I agree with this point. Wyoming, Alaska, Montana and Idaho do not have their own medical schools per se. Although, they are part of the WWAMI program through the University of Washington. The program was designed to recruit students from these states and then have them return to underserved areas. The students attend basic science classes at their perspective state schools, eg. U of Alaska, Wyoming, Montana, etc. They then move to U of Wash for MS II and then go on to do MS III and IV training in community settings throughout the Northwest and Alaska. An Osteopathic School would do wonders for the region as well. Especially if it was modeled after Pikeville and had a regional orientation.

Groundhog: Your damn straight it is . It has an awesome programs, which is very regionally structured to recruit from certain states (aka WWHAMI, see above). It has done wonders for primary care in the Northwest and Alaska.

Regarding PGY2?s comments, I have a few of my own. Since my opinions are always a work in progress, I welcome any responses.

As medical students, you are not looking further into the future regarding what your work environment is going to be like by the time you graduate from residency. Right now, you are only focused on passing your classes and board exams.

For the sake of argument, lets just agree to disagree on this point. That description does not fit everyone. I am a very forward thinker and have put much thought into this; my experience and personal relationships have helped to refine my plans to this point. For the record, even with all of the controversy that goes into doing so, I did choose D.O. first. With that said, even though I get a little boisterous on this site, I doubt I will ever fit into the ?diehard osteopath? category. My whole personality, in addition to many thoughts, does not even come close to coming out in my posts.

I am now in my 2nd year of residency and the future is looking pretty bleak regarding working conditions for most docs coming out of residency. Much of this can be attributed to managed care but another factor fueling this is that the supply of physicians in and around large cities outweighs the demand.... Most people, especially young physicians want to live in areas close to family and in places that offer entertainment suitable for younger people (larger cities).... When you're in your final year of residency and looking for a job, you'll wish there was a shortage of physicians because the job opportunities, especially in primary care are not that inviting at this time.... Then you'll be wishing they would stop opening all these new medical schools.... You may think I am being selfish, but when you try to raise a family, buy a house, and pay off your med school loans you'll wish you never became a doctor. Picture yourself at the end of residency, 11 years of post high school education, with $200k in student loans, a mortgage, and a kid on the way, and the best offer you get is working 80 hours per week for $90,000/year. No thanks! And to avoid this, what do most medical students end up doing? They stray away from primary care and end up subspecializing.

Correct me if I am wrong, but many of the things you point out in this quote as well as the ones below, personify what is wrong with our health care system and past medical education models. The worst thing that ever happened to healthcare in this country is it became a BUSINESS. From physicians, to hospitals to pharmaceutical and equipment companies, everyone saw it as a way to make the big bucks and be in a prestigious profession. Policy for most of the century drove the price of health care beyond the reach of many and lead to disparities in care, as well as this seriously mucked up imbalance of physicians we have. We are the only industrialized country on the planet that does not have enough primary care physicians. Why is this? Because, of many of the reasons you already pointed out...as well as fifty years of bad government policy, misguided lobbying of the AMA and the way that medical schools trained doctors, among others. It is a nasty uphill battle we have to climb to fix the mess.

Although managed care is a broken solution to a huge problem, it is rooted in good theory. We need to get back to the basics and find a balance between preventative, primary, emergency and specialty care. This is tough though. Our system has evolved to favor the production of specialty physicians. To make matters worse, we have to overcome the ?primary care physicians are lesser physicians? stigma that exists in this country. Moreover, we need to close the salary gap in order to recruit more physicians into primary care. IMHO, there are only a few organizations that have a clear grasp on the subject. Among them are the American Medical Student Association, the American Public Health Association and the authors of Healthy People 2010. Our health care system is seriously dysfunctional. Everyone is clearly in agreement with this. The knife-fight is in the details of how best to fix it. I am a big fan of some of the recent proposals for National Health Insurance (see www.apha.org or www.congress.gov for a concise summary). For this to work though, most insurance companies will have to die and there will be a painful transition for the highest paid physicians, as well as the pharmaceutical and equipment companies.... basically all the powerful ones getting rich off of the business of medicine and those very well represented by lobbyist groups.

And not to open a new debate, how many osteopathic physicians end up practicing osteopathy in their practices? How about less than 10%! Why is this? First, it is very difficult to be reimbursed for this and second, it takes too much time! Half of my residency class is from osteopathic schools, none of them incorporate or are even interested in utilizing these skills.

Your percentages and anecdotal evidence is not well supported. The most recent survey I saw in a JAOA article that quoted a survey taken by an independent agency stated that 89% of D.O.s incorporate OMT into their practice (National study of the impact of managed care on osteopathic physicians, http://www.aoa-net.org/Publications/JAOA/jaoa.htm). I will assume that this is to different degrees. Of the hand full of D.O.?s I know, they all use it.... except for the ER DOCS and a few other subspecialists...only on occasion. However, when I asked them about it they usually say something like ?my style of practice incorporates many other aspects of OP&P.?

As far as having it paid for, the article, in addition to my own anecdotal evidence states that it is much easier to get insurance to pay for it, or collect a fee-for-service payment, than it is to get an MCO to do so. My response to that is ?no big surprise.? I am in an HMO--which is supposed to be a good one; after all, it is the one used by University Health System employees--and it sucks. When my appendix ruptured, I went through an 8-month nut-roll to get them to pay for my treatment. It was missed on my initial visit to the emergency room--which meant I had to pay the $50 copay/fine for going to the ER and not be admitted-- and when I went back I was too sick to call my PCP to get ?authorization? to be there.

As far as OMT goes, it is hard to get it approved. To make matters worse, my HMO does not recognize SPORTS MEDICINE as a specialty. I had a plaguing injury that I wanted a referral for but could not get it. My HMO does not allow fellowship-trained physicians to list themselves as sports medicine specialists; they must either be Orthopedic and Family Practice. To make matters worse, my PCP is not allowed to make referrals to FP-Sports medicine guys and sense there are no Ortho-Sports Medicine Docs on the plan, it is not an option. As far as PM&R goes, if you do not have a ?disabling injury? that causes you to miss work, it is tough to get a referral approved. My point is that HMO?s suck...it is not that they are anti-DO, that is certainly not the case, it is that they are excessively frugal and profit driven.

In fact, most of them are seeking allopathic fellowships in cardiology, gastroenterology, and heme/onc. Goodbye primary care! Most of them whom I've spoken with all admitted that the only reason they went to osteopathic school is because they didnt get into the allopathic schools they applied to. I can already see the onslaught of rebuttals that statement is going to generate, but I am only speaking from my own experience. And those of you who say you were accepted to allopathic schools and decided to go to osteopathic schools, well, the more power to you. Most people say that they just felt better, had a better "fit" at the osteopathic schools. But remember, medschool is only four years long, it may have been more advantageous to go to the allopathic school and suck it up for those four years than to have to put up with the bias so many complain of for the rest of their lives.... The whole DO/MD thing is a moot point to me because from my experience, they all end up practicing allopathic medicine in the end. Hey, how many of you who are already in practice (not including students) would voluntarily give up your DO title if they were offered the MD title like they did in california all those years back? The reason I exclude students from the question is because you havent been out there yet and experienced what the actual practice of medicine is like as a doctor. I am not intending to insult anyone by my post. We all went to medical school for the same reason, to become doctors and practice medicine. DO vs. MD route will still get you to the same place. Personally I wish they would give you the option to which degree you would prefer, that way all the die hard osteopaths would be satisfied and all the others who really wanted to MDs could have their wish too.

As far as this goes, I am going to respectively dismiss much of this as your opinion and agree to disagree. We all know people who would wait in line to debate your comments.
This does bring up another point that I have been surprised to learn over the last few years. ...We all know that many students ?settle? for their 2nd, 3rd, 4th...8th.... etc, choice when going to medical school. Whether it be MD or DO, medical school is very competitive and hard to get into. Being a little older and a tad more worldly, this topic makes me chuckle a bit. I compare it to someone making comments or complaining about the fact that they made it to the Olympics, competed with the best in the world and ONLY came away with a Bronze Medal. From my perspective, I would say a bronze medal is quite an outstanding accomplishment and something to be revered. ...Not everyone can go to Harvard (I personally would never want to) and in most cases, unless you have very specific career goals, it does not matter in the ?big picture? we call life; although for some, the ego/prestige factor is an almost overwhelming force.

This leads into my point, I was very surprised at all the unhappy medical students and residents I have come across the last few years. It is not uncommon at all for me to run into medical students who say their training sucks, etc, etc. Medical students can certainly B*tch with the best of them. In addition, a sizable minority of Residents I have met, have stated that if they had it to do all over again they would have done something else other than medicine. Allopathic students have repeated to me many of the complaints I see from D.O. students on this board, especially concerning clinicals. It is quite common to hear entirely different stories from people who did the same clinical rotation. I have come to think it is much like any training. Depending upon who your professor, preceptor or senior resident is, your training will vary greatly. With that said, there are improvements needed in osteopathic clinical and GME training and they are being arduously worked on. However, many of the same, as well as other unique problems exist in allopathic programs as well. Some hospitals have closed leaving students and residents scrambling for positions. MCP came very close to going bankrupt. UCSF went through a tough time in the late 90's as they were transitioning toward their goal of having 50% of their class enter a primary care field. As they shifted around clinicals and reallocated residency positions the backlash on students and residents got ugly. And let us not forget Stanford, who missed by one vote having the LCME place them in probationary status because of shortcomings in their labs, library etc.
The point I am taking away from this is, whether it be D.O. or M.D., you best work hard to find the best training opportunities you can and be prepared to be flexible. All programs have areas that need work or are going through growing pains. In clinicals some rotations will suck, some will be great...and that pretty much goes for any place with varying degrees of course. I guess as students, residents and physicians we must always continue to strive for improvement and reform. After all, many of the problems are a result of the ?system.? With that said, let us not forget the main purpose of everyone?s existence--the PATIENT.

So to summarize, you may want to increase the osteopathic exposure by opening more schools, but by fueling the unbalanced distribution of physicians around large cities, it may come back and bite you in the ass when it comes time to look for a job. I know it, I'm there going through it now.... Personally, I think medical schools are becoming like law schools, they are everywhere, based upon profits for the schools, and cranking out grads irrespective of the damage it is doing to the job market. One solution to the problem may be opening schools whose graduates are admitted based upon their commitment to provide services where they are needed (rural areas). This would only be successful if the financial burden was lifted from the shoulders of these students in the form of free education funded by Medicare or by the communities that will employ them.

Your points again highlight some of the fundamental problems with our health care system, as well as fallacies in our policies over much of this century. I agree with your proposal about ?looking for a certain type of applicant,? in addition to lifting the financial burden. Osteopathic schools and the allopathic schools that have made shifts toward primary care are doing the first part of this. It will have to accompany a lot of other serious health care reform though...and that is way too much to get into in any detail on this board.

 

[R. Dale Jackson]

I just went back and saw how long my post was...excuse me, why I go and find a life.

 

[JS-UNMC]

Although I cannot disagree that we need more DO representation in medicine, I do feel that we need to fix our problems with GME before we start adding anymore schools to the situation. I am sad to say that there has not been one AOA-approved GME program that I have looked into that I feel will meet all of my needs at this moment. I have already had MD programs (GME) that are trying to recruit me into their programs, even though it is still a long ways off, and their facilities thus far have blown the DO programs that I have contacted out of the water. This disapoints me and this is why I feel that we need to fix what we have... and soon! There are many good reasons that DO students are going into MD GME's at record numbers.
One of these (especially for me) is location. I would like to do my GME in either omaha, NE or Denver, CO for personal reasons. The AOA, to my knowledge, has nothing in these areas... as well as many others. I am not going to play down geography in my deciding where to do GME. Sorry, just a few (frustrated) thoughts.
Josh Smith

 

[FamilyDO2BE]

I think we do need a new school, but my only concern is that West Virginia School Of Osteopathic Medicine is only about an hour and a half from VA tech. Shouldn't we try to enter a population we are not in. In our class we have some VA Tech grads. I don't see having two schools so close together

Later

MSI WVSOM

 

[OldManDave]

Yes, the new school will be in Blacksburg, VA and affiliated/run-by VA Tech. Last I heard, the first actual class is to enter in the fall of 2003.

Our [KCOM] interim Academic Dean has won the job as permanent Dean of the new school. Of course, now I am wondering whose gonna be our Dean. I think Dean Rawlins has done a hell of job around and here...VA Tech should consider themselves lucky.

Originally posted by Pikevillemedstudent:
•Actually, I have heard this. I was told this by two different dependable sources. It is going to be in Blacksburg, VA at Virginia Tech University. I do not know when it is supposed to start.•

 

[OldManDave]

Originally posted by Liljoe2002:
•Allright, I hate myself for getting in this discussion, but here is my opinion on the matter. I would love to see a school in the Pacific Northwest-Oregon, Wash., Idaho, Montana and I'll throw Alaska in there. There is a definite need for it. All other parts of the country have a representative Osteopathic school. I'm shocked that there is no push for a school in this part of the country. I do agree with some points made about too many medical schools and not enough spots for us:I'm ignorant when it comes to the exact numbers so I can't back up this claim. Well enough said.

Liljoe•

Actually, a group of investors is currently trying to organize (at least according to the rumor mill) a school in Montana. IF it comes on line, it will maybe begin taking students the year after the VA Tech program opens.

This was talked about while I was attending "DO Day on the Hill" & the SOMA Spring Leadership Conference in Washington, DC last month.

 

[R. Dale Jackson]

All-Righty then...if Old Man Dave said it is true, now I will believe it. Putting aside all the debate for a moment about whether or not we need another medical school, I am actually very happy to hear about this. I have always thought VA should have a D.O. school. It seems somewhat poetic since it is where A.T. Still hales from. Moreover, I would very much like to return home to practice. If I ever decide to teach or be a clinical associate, I will be able to do so through VA TECH-COM.

Peace

 

[gower]

A small, maybe irrelevant point, but I believe one of the offshore allopathic Caribbaean schools was trying to establish a basic sciences campus only campus in Montana. The proposal ran into so much flak that the idea seems to have been dropped for the time being. Perhaps or perhaps not, that episode is being confused with the possible establishment of a DO school in Montana.

 

[R. Dale Jackson]

Originally posted by gower:
•A small, maybe irrelevant point, but I believe one of the offshore allopathic Caribbaean schools was trying to establish a basic sciences campus only campus in Montana. The proposal ran into so much flak that the idea seems to have been dropped for the time being. Perhaps or perhaps not, that episode is being confused with the possible establishment of a DO school in Montana.•

I do not think so. The school you are referring to is Ross University in Dominica. They were trying to establish a school in Casper, Wyoming. The AAMC/LCME politicked the idea to death...the effort was abandoned.
http://www.rossmed.edu/Medical_School/Medical_School_News_Updates/Letter_to_the_NEJM/letter_to_the_nejm.html

 

[JS-UNMC]

As I have come to love the city of Des Moines so much... here is one small suggestion. We close down DMU, Relocate it to Colorado Springs, CO which is DO friendly and in a city whose population is booming... unlike des moines, whos population is simply aging. We could affiliate the school with CSU and service colorado springs, pueblo, and all other cities south of denver. Any thoughts?
-jsdmu (sick of the midwest)

 

[LisaB]

I like the fact that we are opening a new DO school, especially at a big university. I think that we should only open new DO schools if they are supported by large undergraduate programs.

 

[hankhill]

I'd rather see DMU sell out to Iowa State University and remain in Iowa granting the DO degree. Its not likely to happen, but the state support would make DMU a much much better school IMO. I agree with Drusso though. State support of DO programs is a significant asset in many ways.

 

[Brennan]

If they were to open more medical schools, i think they should be Osteopathic...we need more good doctors lol

 

[KCOM2005]

jsdmu,
This is the best idea I have heard in a long time! Colo Spgs is the perfect place for a DO school. Colorado is quickly growing and in need of another med school. One thing that would make it particularly nice is that there are plenty of rural areas around as well as the city (C. Springs just surpassed the half million mark). The area is a beautiful setting as well. I would like to see it associated with my alma mater, Colorado College (but I doubt it would ever happen).
Anyway, you have my vote!

 

[go GOP]

This is just to confirm that there will be an osteopathic medical school at Virginia Tech. I spoke with the Virginia Osteopathic Medicine Association yesterday. The charter class will begin in the summer of 2003. I am excited about this move as I plan to return to Virginia to practice medicine.

I graduated from the University of Virginia and I can understand some of the pain expressed earlier. I like to poke fun at the Hokies!!! However, VA Tech has a huge reputation for scientific research and engineering, not to mention that it is a Big East school. As for the other universities, most Virginians don't even know that Radford University exists! George Mason doesn't have the national reputation that Tech does and the other schools either have a medical school or are too close to schools that do. Osteopathic medicine will get a lot of exposure here. More importantly, Southwestern Virginia is desperate for more physicians.

By the way, UVa will beat Tech this year in football and life will be happy in Hooville once again.
GO HOOS!!