Problems with AOA residencies?

[student]

I am a bit confused from reading some of the posts on this board. Is there any inherent disadvantage to doing an AOA residency instead of an allopathic residency? Should you complete an AOA residency in a specialty such as urology, ophthalmology, or orthopedics-could you run into problems when you are trying to obtain work (staff privileges) at particular hospitals in certain parts of the country?

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[spunkydoc]

good question..

let me know when you find the answer.

as far as i know, there is no inherent disadvantage..however, you might try to call up some of the places you think you might want to work and ask that very question..that is the way i have tried to go about answering this question.

 

[spunkydoc]

good question..

let me know when you find the answer.

as far as i know, there is no inherent disadvantage..however, you might try to call up some of the places you think you might want to work and ask that very question..that is the way i have tried to go about answering this question.

actually there are 5 states that require you to do the AOA internship to be licensed to practice in that state..beyond that, it is a free for all in terms of whether you resident at an MD or DO program

 

[rtk]

Student;

I think the problem assoc. with doing an AOA residency has most to do with name recognition and reputation. Most AOA programs are smaller and community based, so less known than large university programs. As the job market becomes increasingly more competitive (and it is), when a group or hospital recruits a physician they'd perfer the University of (fill in state) grad over (name of small town) General Hospital grad.

Also, an AOA graduate takes AOA boards (such as american board osteopathic internal medicine) and an ACGME grad takes ABIM boards(american board of internal medicine). Insurance companies are familiar with the later but not always the former which may present problems.

I know of several 'DO' FP and IM graduates this year from local AOA and ACGME programs. The ACGME grads had no problem getting a postition and were heavily recruited, it was a different story for the AOA grads (some still looking for work).

The sitiuation here (Kansas City) may not be representative of the rest of the country, but why take chances?

The AOA does a good job of hiding this information from 4th year students and complicates the issue with liscensing requirements, etc... I don't mean to get off on a rant here..., but the AOA is it's own worst enemy. It divides the DO community at the begining of their training by continuing the AOA internship requirement. It should support what is best for it's graduates and make every effort to place DO's in the best training programs in the country. What's the best way to get recognition for DO's: 1) A national marketing campaign (Unity) -or- 2) by having nationally recognized DO's at the forefront of their medical fields?

 

[pirulo]

For a while I have been wondering about this question and thought maybe this would be a good place to ask it. If you're a DO and complete an ACGME residency, you're not allowed to practice in those 5 states (FL, WV, PA, Mich, and i forget the other one), unless you meet some particular requirements recently specified in the new AOA resolutions right? But what if you've taken the AMA boards, and you're licensed through the AMA? I mean how can the aoa limit you from getting that license if you've completed your residency and passed your boards through the AMA??? I guess the state osteopathic assoc. has something to do with it, but i'm not sure how it works... If anyoone knows, let me know, just curious...
pirulo
UMDNJ-SOM
2004

 

[jawurheemd]

does anyone know anything about dual-accredited residencies (both AOA and AGCME)? do they exist?

 

[PCSOM2002]

The AOA doesn't prevent youo from getting a license in 5 particular states. It is the licensing board in those states that have set those requirements. Some states have one licensing body for both DOs and MDs, while some states have two separate bodies, one for MDs and one for DOs. Those five states have boards just for DOs and these boards have made it a requirement to do an osteopathic internship for licensure. Not all strictly osteopthic licensing boards require this just these five. By the way, Oklahoma is the other state.
To answer the question regarding dual accreditation, there are some programs that are like this. Most of them, if not all, are in the fields of Family Medicine and Internal Medicine.

 

[jawurheemd]

which programs have dual-accreditation -- is there any way to find out -- it seems that would be the best way to go, don't you think?

 

[student]

Originally posted by rtk:
Student;

I think the problem assoc. with doing an AOA residency has most to do with name recognition and reputation. Most AOA programs are smaller and community based, so less known than large university programs. As the job market becomes increasingly more competitive (and it is), when a group or hospital recruits a physician they'd perfer the University of (fill in state) grad over (name of small town) General Hospital grad.

Also, an AOA graduate takes AOA boards (such as american board osteopathic internal medicine) and an ACGME grad takes ABIM boards(american board of internal medicine). Insurance companies are familiar with the later but not always the former which may present problems.

I know of several 'DO' FP and IM graduates this year from local AOA and ACGME programs. The ACGME grads had no problem getting a postition and were heavily recruited, it was a different story for the AOA grads (some still looking for work).

The sitiuation here (Kansas City) may not be representative of the rest of the country, but why take chances?

The AOA does a good job of hiding this information from 4th year students and complicates the issue with liscensing requirements, etc... I don't mean to get off on a rant here..., but the AOA is it's own worst enemy. It divides the DO community at the begining of their training by continuing the AOA internship requirement. It should support what is best for it's graduates and make every effort to place DO's in the best training programs in the country. What's the best way to get recognition for DO's: 1) A national marketing campaign (Unity) -or- 2) by having nationally recognized DO's at the forefront of their medical fields?

RTK and Spunkydoc,

Thank you for your replies. Spunkydoc I don?t think that calling the individual hospitals is a simple matter. Especially, in my case - when I have no concrete plans on where I want to practice. Also, I very much doubt that the hospitals would give anyone a definitive answer. They would probably say that they try to hire the very best staff that they can.

I would like to talk to D.O.s who have recently completed AOA residencies, but I don?t know any. RTK asserts that he knows people in the KC area who have had problems finding jobs after completing AOA programs. I have heard that finding a job in California is difficult even for allopathic graduates. I definitely agree with RTK in that the future of the job market is in question. RTK, in your experience are the AOA graduates who are having problems in primary care or specialties?

Isersen (author of Getting into Medical School) seems to imply that the AOA fears that osteopathic physicians will eventually use AOA residencies exclusively for the purpose of obtaining specialty training. Given the fact that Medicare reimburses training hospitals on the average of $100,000 annually per resident, I believe this fear to be valid. My understanding, however, is that the AOA is currently able to fill all of its positions.

Does anyone have info on the plight of AOA graduates in states with relatively large osteopathic communities (e.g. Michigan)? Finally, would completing an allopathic internship after an osteopathic residency improve one?s job prospects?

Thanks again

 

[student]

RTK,

I just wanted to clarify one of my questions. You already mentioned that the problems were mostly associated with primary care AOA residencies. Do you know whether the AOA trained specialists are also having problems?

 

[abcd]

From my understanding, I have heard the following problems with AOA residencies:

1. Many are in small, Mickey Mouse hospitals that would not offer the full spectrum of experience

2. The AOA will kind of disown you if you do an allopathic residency -- ie, won't let you teach at an osteopathic institution, etc.

3. can't practice in those 5 states c/ allopathic residency if you are a DO

4. for most osteopathic residencies, you have to do a one year internship prior to the residency. Who wants to do that when you can go straight to an allopathic residency?

5. The stupid AOA doesnt even provide enough residency spots for all the osteopathic students, but yet encourages the DO schools to accept more and more applicants each year.

All in all, I think that the AOA sucks at doing its job. The advertising they have done has been piss poor, and they are screwing their own soldiers in the profession.

 

[PCSOM2002]

Jaw,

Just off the top of my head, the IM residency in Wheeling, WV; Binghampton, NY; Eaton, PA are dual accred. There are a few more, but I cannot remember where they are located. I do not know where one could find this info in one concise table. I stumbled across these by looking at AOA opportunities and FREIDA and recognizing names on both, plus some tell you in their information that they send out or on their web sites.

As far as being the way to go, I really don't think it is advantageous or disadvantageous. You should pick a program b/c it is the right fit for you whatever your criteria might be. Don't discard a program just b/c it is not dual accred.

 

[prefontaine]

The IM program in WV (OVMC) is not dual accredited. They lost the ACGME accreditation after numerous warnings and added the AOA program afterward.

It is not too difficult to find out which programs are dual, simply compare the AOA list with the greenbook. In the past, I have listed a # of these programs on this site...you will have to do the work yourself, this time.

For starters, look at NYCOM and MSU residencies. MSU has dual psych, PMR, IM and FP.
NYCOM has dual FP amd IM. Geisinger (PA) has peds.

 

[spunkydoc]

student,

1. you would be surprised at the candidness of some residency directors. most of the allopathic schools do have policies..if you look up the stats on the internet, i.e. how many DOs have historically matched, then call and ask why there is not one DO in all 4 classes, they will generally tell you why.
this is a job market.

2.as for the internship yr..there are a few ways to look at it..yes, DOs eat their young, the AOA is doing a crappy job of publicizing, promoting, etc. the whole pigeonholing into the internship thing is BS.. HOWEVER, if you look closely(in a rare moment of defense of the AOA)at the allopathics, more and more MDs are taking traditional rotatings or there are more specialties requiring it. It is in fact not a wasted year of training for most specialties (well, maybe FP,IM)..The learning curve is steep during this year and for things like EM, Surg, etc., it is a year to learn the basics and ropes and extra exposure.

3. the AOA instituted a new rule now that DO students can apply for internship and residency within the same match cycle..however, as usual, the AOA shot itself in the foot, sent info to only a few allopathic programs, and sent it out just 2 months ago barely to all the DO programs, leaving no time for any program to elect to participate and modify their admissions processes..however, when the bugs are worked out, SUPPOSEDLY this will relieve some of the anxiety and give DO students more access to more programs????!!!

4. a DO vs MD residency: i still don't have the answer and probably will not..i have been advised, GO TO THE PROGRAM WITH THE BEST TRAINING FOR YOU and forget about the rest..easier said than done with the knowledge the the AOA rules on internship evasion are so vague that they will likely bite you in the butt down the line..still, if you are in one of the 5 states, call the licensure boards and find out the policies on reciprocity and see if evasion of internship is feasable..depending on your choice of specialty, there are some very fine and very well respected residency programs..however, most are located in the midwest and many are at po-dunk hospitals..there are NOT enough residency spots for all the graduates of DO schools...for some reason the AOA is unable to comply with the laws of supply and demand--simple enough even for a 3rd grader..

5.DUally accredited programs: i found these by accident by comparing freida and the out of date and info lacking opportunities sites..i am sure i missed a few since there is no comprehensive site.. from my research i see that going with one of these programs may offer the benefit of better resources than a straight DO program due to more frequent affiliations of MD programs with major univerisities. You can sit for EITHER the osteopathic or allopathic licensing exams, in some states both (i might be wrong about part of this b/c i was looking mostly at PA)...beyond that, not many advantages i can find..you will ALWAYS be a DO no matter what and it is not really a way out of the profession, but maybe a way to protect yourself from losing the "support" of the AOA of your career.

6. what should you do? DO WHAT YOU GOTTA DO TO GET THE BEST TRAINING FOR YOU!

good luck!