Question about the merger

[letmein1992]

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Hello,

I will be attending an Osteopathic school this fall. I know that there is a merger between the DO and the MD residencies, and that the merger is supposed to be completed by 2020, which is when I would be graduating.

I have a quick question about the timeline. When can students from allopathic schools start applying to osteopathic residencies? Also, when the merger is complete, will the residencies that were previously under AOA have any preference for Osteopathic students?

Thank you!

 

[Drrrrrr. Celty]

2020. Probably.

 

[LemurLux]

search bar is your friend, my friend.

 

[IslandStyle808]

It will most likely be sooner than 2020. Once they are ACGME accredited and are able to enter the NRMP match (some are already accredited), they are up for grabs by any allo student (including FMGs/IMGs).

The topics has been mentioned a ton on here, probably on a weekly basis. Read all the threads you can.

 

[Drrrrrr. Celty]

It will most likely be sooner than 2020. Once they are ACGME accredited and are able to enter the NRMP match (some are already accredited), they are up for grabs by any allo student (including FMGs/IMGs).

The topics has been mentioned a ton on here, probably on a weekly basis. Read all the threads you can.

Right, in all truth the AOA match will be over around 2018-2019. You can't be accepted by an AOA program that won't be ACGME approved by the time you finish.

 

[DrDreams]

Right, in all truth the AOA match will be over around 2018-2019. You can't be accepted by an AOA program that won't be ACGME approved by the time you finish.

I asked Dr. Buser about this (2 weeks ago), he told me that basically by 2019 (when I graduate) most if not ALL of the residencies will be ACGME accredited.

 

[gamerEMdoc]

Hello,

I will be attending an Osteopathic school this fall. I know that there is a merger between the DO and the MD residencies, and that the merger is supposed to be completed by 2020, which is when I would be graduating.

I have a quick question about the timeline. When can students from allopathic schools start applying to osteopathic residencies? Also, when the merger is complete, will the residencies that were previously under AOA have any preference for Osteopathic students?

Thank you!

For many of the programs, it will be this next match class (2017). Because this year there are a ton of programs likely to get ACGME accreditation.

Once an AOA program becomes ACGME accredited, they can begin taking MD students. Many will be accreditted this year actually. Most aren't waiting until 2020. A huge number of programs filed for preaccreditation in 2015 and had their site visit. They are awaiting decision of accreditation this spring (RRC meets in April). There are going to be a ton of programs switching over very soon. Over the next few years, AOA residencies will become ACGME or they will close their doors. Noone is going to wait until the last second to apply, in fact, they actually can't. If they don't apply I think by 2018 or something, they can't participate in the match anymore anyways.

As for whether former AOA programs will still have an osteopathic preference, my gut feeling is they will. All residency programs must have an affiliation with a medical school, and all these current AOA programs have affiliations with Osteopathic schools. Most if not all the students they have rotating with them are osteopaths. It will take years for these programs to get a foothold amongst the allopathic student community. I'd be very surprised if my institution's match classes aren't almost entirely DO for the first 3-4 years after we get accredited.

 

[IslandStyle808]

For many of the programs, it will be this next match class (2017). Because this year there are a ton of programs likely to get ACGME accreditation.

Once an AOA program becomes ACGME accredited, they can begin taking MD students. Many will be accreditted this year actually. Most aren't waiting until 2020. A huge number of programs filed for preaccreditation in 2015 and had their site visit. They are awaiting decision of accreditation this spring (RRC meets in April). There are going to be a ton of programs switching over very soon. Over the next few years, AOA residencies will become ACGME or they will close their doors. Noone is going to wait until the last second to apply, in fact, they actually can't. If they don't apply I think by 2018 or something, they can't participate in the match anymore anyways.

As for whether former AOA programs will still have an osteopathic preference, my gut feeling is they will. All residency programs must have an affiliation with a medical school, and all these current AOA programs have affiliations with Osteopathic schools. Most if not all the students they have rotating with them are osteopaths. It will take years for these programs to get a foothold amongst the allopathic student community. I'd be very surprised if my institution's match classes aren't almost entirely DO for the first 3-4 years after we get accredited.

What about in the case of a hospital being the sponsoring institution? Do you think the preference will still be as strong as if the sponsoring institution were instead an osteopathic medical school?

What I mean to say is how strong are these affiliations for certain schools? There are hospitals systems that have stopped taking certain students for rotations in the past for other schools. Like in the case of the hospital systems in Alabama when ACOM was made (mainly due to a locality thing). I don't doubt residency programs whose sponsors are medical schools. However, I feel uncertain for those sponsors who are hospitals instead. I think there is some reassurance if they applied for osteopathic recognition. However, what about those hospitals who are sponsors, but are not applying for this recognition?

 

[gamerEMdoc]

What about in the case of a hospital being the sponsoring institution? Do you think the preference will still be as strong as if the sponsoring institution were instead an osteopathic medical school?

What I mean to say is how strong are these affiliations for certain schools? There are hospitals systems that have stopped taking certain students for rotations in the past for other schools. Like in the case of the hospital systems in Alabama when ACOM was made (mainly due to a locality thing). I don't doubt residency programs whose sponsors are medical schools. However, I feel uncertain for those sponsors who are hospitals instead. I think there is some reassurance if they applied for osteopathic recognition. However, what about those hospitals who are sponsors, but are not applying for this recognition?

I'm in EM, and to my knowledge, we were told by our site reviewer that no programs had applied for osteopathic accreditation. Its an insane amount of busywork, and almost no DO students want to do OMM anyways once they are in residency in EM.

As for how strong a school affiliation is in terms of how it will affect match chances, I'd say the affiliation is basically meaningless. DO schools give us literally no money to take there students on rotation. Thats very different from a University based residency with a medical school where the 3/4th year student tuition helps offset the cost of training. We take students, house them, train them, grade them, and get no money for it while the DO schools collect the tuition for two years and sit back and do nothing. There is a reason DO schools are popping up everywhere, its a great money making business. Charge students tuition, collect tuition for four years, but then pass the cost off on training those students on other places for 1/2 of their time in school.
I'm not saying programs won't want to match DO students, I think many will still target almost all DO students in their match. But I don't think you'll see alot of allegences to any single one school, unless the programs are in close geographic proximity to one another.

 

[IslandStyle808]

I'm in EM, and to my knowledge, we were told by our site reviewer that no programs had applied for osteopathic accreditation. Its an insane amount of busywork, and almost no DO students want to do OMM anyways once they are in residency in EM.

As for how strong a school affiliation is in terms of how it will affect match chances, I'd say the affiliation is basically meaningless. DO schools give us literally no money to take there students on rotation. Thats very different from a University based residency with a medical school where the 3/4th year student tuition helps offset the cost of training. We take students, house them, train them, grade them, and get no money for it while the DO schools collect the tuition for two years and sit back and do nothing. There is a reason DO schools are popping up everywhere, its a great money making business. Charge students tuition, collect tuition for four years, but then pass the cost off on training those students on other places for 1/2 of their time in school.
I'm not saying programs won't want to match DO students, I think many will still target almost all DO students in their match. But I don't think you'll see alot of allegences to any single one school, unless the programs are in close geographic proximity to one another.

Thank you for the reply. I really appreciate the honesty in your response. It is sad that allopathic schools are still cheaper as a whole and yet they still pay hospitals for their students. I do think there are some schools that are paying for rotations, but we have no idea where the money is going and how much?

 

[WalterDonnie]

I'm in EM, and to my knowledge, we were told by our site reviewer that no programs had applied for osteopathic accreditation. Its an insane amount of busywork, and almost no DO students want to do OMM anyways once they are in residency in EM.

As for how strong a school affiliation is in terms of how it will affect match chances, I'd say the affiliation is basically meaningless. DO schools give us literally no money to take there students on rotation. Thats very different from a University based residency with a medical school where the 3/4th year student tuition helps offset the cost of training. We take students, house them, train them, grade them, and get no money for it while the DO schools collect the tuition for two years and sit back and do nothing. There is a reason DO schools are popping up everywhere, its a great money making business. Charge students tuition, collect tuition for four years, but then pass the cost off on training those students on other places for 1/2 of their time in school.
I'm not saying programs won't want to match DO students, I think many will still target almost all DO students in their match. But I don't think you'll see alot of allegences to any single one school, unless the programs are in close geographic proximity to one another.

why is it that hospitals take DO students then? I've been aware of the fact that our school pays very little to the places we rotate. But, I don't understand why the hospitals are ok with it.

 

[WalterDonnie]

Hello,

I will be attending an Osteopathic school this fall. I know that there is a merger between the DO and the MD residencies, and that the merger is supposed to be completed by 2020, which is when I would be graduating.

I have a quick question about the timeline. When can students from allopathic schools start applying to osteopathic residencies? Also, when the merger is complete, will the residencies that were previously under AOA have any preference for Osteopathic students?

Thank you!

I doubt there will be any change in terms of the type of students programs will prefer. Programs that mainly filled MD still will, and likewise for DOs and the former AOA programs. The main advantage is you will be able to rank everywhere you interview in order of actual preference. the way it is now some people interview AOA and ACGME and are kind of forced to choose between matching at an AOA program that is not their #1 vs risking not matching at all in the ACGME match.

 

[BinderClip]

Hello,

I will be attending an Osteopathic school this fall. I know that there is a merger between the DO and the MD residencies, and that the merger is supposed to be completed by 2020, which is when I would be graduating.

I have a quick question about the timeline. When can students from allopathic schools start applying to osteopathic residencies? Also, when the merger is complete, will the residencies that were previously under AOA have any preference for Osteopathic students?

Difficult to say for certain with respect to the timeline. However, I would argue that AOA residencies will still have a preference for DO students because they're a known quantity. The program directors will understand the scoring system of the COMLEX moreso than the USMLE. The DO students understand the "game", that is, the need for audition rotations, especially at the well-regarded institutions. That would include the letters of recommendation and student activism in particular conferences. In addition, there may just be plain old preference toward DO applicants. However, that's not to say that PD's will automatically exclude MD students, especially competitive ones with a compelling application.

why is it that hospitals take DO students then? I've been aware of the fact that our school pays very little to the places we rotate. But, I don't understand why the hospitals are ok with it.

Thank you![/QUOTE]

While I've never spoken to hospital administrators about it, it would be prudent to divide the programs who take students into residency-affiliated and non-residency-affiliated. For those with residencies, I'd wager they're looking to draw in medical students to the program and find people who meet their desired resident profile early. In a way, it would be easier marketing. For those without residencies, it could be that individual attendings have taken on students in the past and have had enjoyable experiences with students early on, and so the administration is content to allow it to continue.

 

[gamerEMdoc]

why is it that hospitals take DO students then? I've been aware of the fact that our school pays very little to the places we rotate. But, I don't understand why the hospitals are ok with it.

Because you need students to rotate at your hospital to want to match at your hospital. And to be an accreditted residency, you have to have a medical school affiliation, its an aoa and acgme requirement.

Why do non-residency attendings take on students? Id assume its because they just like teaching and like the company. Being a community doctor out on your own can actually be a very isolating experience. I can see how taking on a medical student every month would give some docs better career satisfaction.

 

[AlteredScale]

I'm in EM, and to my knowledge, we were told by our site reviewer that no programs had applied for osteopathic accreditation. Its an insane amount of busywork, and almost no DO students want to do OMM anyways once they are in residency in EM.

As for how strong a school affiliation is in terms of how it will affect match chances, I'd say the affiliation is basically meaningless. DO schools give us literally no money to take there students on rotation. Thats very different from a University based residency with a medical school where the 3/4th year student tuition helps offset the cost of training. We take students, house them, train them, grade them, and get no money for it while the DO schools collect the tuition for two years and sit back and do nothing. There is a reason DO schools are popping up everywhere, its a great money making business. Charge students tuition, collect tuition for four years, but then pass the cost off on training those students on other places for 1/2 of their time in school.
I'm not saying programs won't want to match DO students, I think many will still target almost all DO students in their match. But I don't think you'll see alot of allegences to any single one school, unless the programs are in close geographic proximity to one another.

I have a quick question about this. Would you say this effect of DO schools not providing compensation for clerkship training to guys affects the perception at your hospital about having DO's match into your program at all?

I was never actually aware that this was the case and it's quite sad. It does fortify some of the reasons why my DO school is so quiet when it comes to clinical rotations....

 

[kenjixshadow]

Because you need students to rotate at your hospital to want to match at your hospital. And to be an accreditted residency, you have to have a medical school affiliation, its an aoa and acgme requirement.

With the current rising of competition in EM, there are surely students from non-affiliated institutions would love to match at your shop when it is pre-accredited by ACGME and is available for MD students. How is your shop going to rank these students vs. DO students? Let's presume that these students are likable, more competitive on papers, and have good SLOEs and they will rank your shop b/c they want to match into EM or d/t the location. I understand that your shop has a history with DO students and will still be DO friendly. Nevertheless, the affiliated DO school(s) does not provide any resource or support to your shop. Hence, I don't see why your shop have any obligation to give preference to DO students or will not highly rank the top students out there, even if this means ranked to match the MD students over DO students.

 

[IslandStyle808]

With the current rising of competition in EM, there are surely students from non-affiliated institutions would love to match at your shop when it is pre-accredited by ACGME and is available for MD students. How is your shop going to rank these students vs. DO students? Let's presume that these students are likable, more competitive on papers, and have good SLOEs and they will rank your shop b/c they want to match into EM or d/t the location. I understand that your shop has a history with DO students and will still be DO friendly. Nevertheless, the affiliated DO school(s) does not provide any resource or support to your shop. Hence, I don't see why your shop have any obligation to give preference to DO students or will not highly rank the top students out there, even if this means ranked to match the MD students over DO students.

This also gets at the heart of my former question. If the sponsoring institution is an osteopathic school, then it would make sense that it would prefer its own students and at the same time osteopathic students. However, with the hospital being the sponsoring institution, there is no real assurance that it will take osteopathic students if a nearby MD school has students wanting to apply. These osteopathic schools don't pay for the rotations so there is no incentive to take their students as residents. The residency program could even make affiliations with nearby MD schools just as easily, if the MD school uses a preceptor based model. Now with former AOA residencies become ACGME ones (without osteopathic recognition) there is nothing to tie them to osteopathic students. From the applicants side, how much trust can we place on such residencies preferring osteopathic candidates when they could have excellent MD candidates.

 

[TheOther]

This also gets at the heart of my former question. If the sponsoring institution is an osteopathic school, then it would make sense that it would prefer its own students and at the same time osteopathic students. However, with the hospital being the sponsoring institution, there is no real assurance that it will take osteopathic students if a nearby MD school has students wanting to apply. These osteopathic schools don't pay for the rotations so there is no incentive to take their students as residents. The residency program could even make affiliations with nearby MD schools just as easily, if the MD school uses a preceptor based model. Now with former AOA residencies become ACGME ones (without osteopathic recognition) there is nothing to tie them to osteopathic students. From the applicants side, how much trust can we place on such residencies preferring osteopathic candidates when they could have excellent MD candidates.

We can only count on osteopathic PDs, DO residents and the current system of landing AOA residencies (eg. auditions) for now, I suppose. Who knows, maybe this will force the hand of DO schools to start allocating funding toward hospitals where their students can rotate.

 

[hallowmann]

Wait, since when did we get to the conclusion in this thread that paying hospitals for rotations is inherently a good thing? It can be, and some good programs need funding and actually use it for the rotating students and attendings, but I'm very familiar with a program that charges thousands per student per month, offers students nothing but an id badge and parking, and gives most attendings nothing or ~$100-$150 at most to the director. A lot of MD schools also don't pay for rotations, is just built into the affiliation agreement that's required by the ACGME.

This is a money making endeavor for big hospital systems, and the attendings are not always the ones who benefit. For example I have a relative that used to get $500/month to the department to take on a student, then the health system changed policies, made a formal inter-institutional contract with the school, where the system gets over a thousand per student and the department doesn't see any of it.

In any case, programs like people they know. They have to work in generally difficult conditions with the person for years. They have to rely on them to make reasonable medical decisions in their absence, and they have to cover them if they don't show up. And most likely they'll be hanging out with those people during at least part of their free time. It's for that reason that programs almost universally prefer people they know over someone with slightly better scores that they only met for one day. That may in and of itself make it worth it to take rotating students.

 

[gamerEMdoc]

With the current rising of competition in EM, there are surely students from non-affiliated institutions would love to match at your shop when it is pre-accredited by ACGME and is available for MD students. How is your shop going to rank these students vs. DO students? Let's presume that these students are likable, more competitive on papers, and have good SLOEs and they will rank your shop b/c they want to match into EM or d/t the location. I understand that your shop has a history with DO students and will still be DO friendly. Nevertheless, the affiliated DO school(s) does not provide any resource or support to your shop. Hence, I don't see why your shop have any obligation to give preference to DO students or will not highly rank the top students out there, even if this means ranked to match the MD students over DO students.

We don't bias our rank list in favor of a hospital affiliation. I mean, there is ZERO bias, at all. We match people from all over the place, and have students requesting rotations from osteopathic schools from all over the country that we have no affiliation with. We rank the best students, in order of how we want to match them, regardless of what school they come from.

 

[gamerEMdoc]

Wait, since when did we get to the conclusion in this thread that paying hospitals for rotations is inherently a good thing? It can be, and some good programs need funding and actually use it for the rotating students and attendings, but I'm very familiar with a program that charges thousands per student per month, offers students nothing but an id badge and parking, and gives most attendings nothing or ~$100-$150 at most to the director. A lot of MD schools also don't pay for rotations, is just built into the affiliation agreement that's required by the ACGME.

The system should be fair. I'm not saying hospitals should be profiting off of medical students, but they shouldn't be expected to house and train them for free while a school is charging crazy tuition and providing none of the training or expense after the 2nd year of medical school. My hospital has to pay me as a clerkship director for the academic time it takes to evaluate and grade all the students that come through. That money is coming from my hospitals budget, not the schools that send their students here. It seems a little unfair that the schools are profiting and not funding the educators on the ground, and expecting private hospitals to basically just pick up the tab while they are raking in money.

Look at how fast DO schools are expanding and opening up. Compare that to how often a new allopathic school in a University Hospital pops up. There is a reason the number of DO schools are exploding in number. Its because its a good business model. Charge a ton of money for tuition and don't pay anyone to train the students for 2 of the 4 years you collect tuition. That model will only work for so long though, I'm not sure when the tipping point will be, but as the number of students continue to rise, and residency spots remain stagnant, then eventually rotation sites will get more and more competitive and will be able to tell schools that expect free training while they make all the money and share none of the cost that the hospitals can no longer accept their students.

I don't see that happening anytime soon though, but I can definitely imagine a future where that is the case.

 

[hallowmann]

The system should be fair. I'm not saying hospitals should be profiting off of medical students, but they shouldn't be expected to house and train them for free while a school is charging crazy tuition and providing none of the training or expense after the 2nd year of medical school. My hospital has to pay me as a clerkship director for the academic time it takes to evaluate and grade all the students that come through. That money is coming from my hospitals budget, not the schools that send their students here. It seems a little unfair that the schools are profiting and not funding the educators on the ground, and expecting private hospitals to basically just pick up the tab while they are raking in money.

Look at how fast DO schools are expanding and opening up. Compare that to how often a new allopathic school in a University Hospital pops up. There is a reason the number of DO schools are exploding in number. Its because its a good business model. Charge a ton of money for tuition and don't pay anyone to train the students for 2 of the 4 years you collect tuition. That model will only work for so long though, I'm not sure when the tipping point will be, but as the number of students continue to rise, and residency spots remain stagnant, then eventually rotation sites will get more and more competitive and will be able to tell schools that expect free training while they make all the money and share none of the cost that the hospitals can no longer accept their students.

I don't see that happening anytime soon though, but I can definitely imagine a future where that is the case.

To be fair the MD schools have opened practically as many new schools as osteopathic schools in the last decade. For us it means more because we only had 20-some schools a decade ago and they had 120+, but in terms of raw number of new schools, they're practically the same. Our class sizes are bigger and tuition greater, however, so ultimately new DO schools are making more with less effort as you said.

I have no problem with the idea of paying to cover the expense of students for rotations, but my point is more that the measure of fairness and good rotations isn't really based on how much a med school pays to send their students on rotations. Like I said, plenty of MD schools don't inherently pay for rotations. It's one of the reasons MD schools in NYC were up in arms about the contract St. George's had with the NYC hospitals, paying them over a million for their students to rotate, in turn displacing US MD (and DO for that matter) students. That doesn't mean those MD school's rotations are inherently worse.

Our rotations are worse, not simply because we don't pay sites, but because our schools don't put money and effort in to creating a standardized and effective curriculum in 3rd and 4th year. We are basically sent off to preceptors or hospitals, some of which have barely any experience teaching, with very little guidance as to our objectives, requirements, etc. On top of that our clinical departments consist of less than a handful of administrators covering hundreds of us. Sure we're going to smaller sites, but I've rotated with a bunch of MD students even at some of these smaller sites, and the main difference is that they actually have school-provided study resources and an outlined curriculum that we generally lack.

Also, I will say that direct payment for students isn't the only way schools can "reimburse" hospitals for their rotations. My school doesn't pay sites for rotations, but they put money and resources towards establishing affiliated residencies at those sites, which end up bringing in ~$150k/yr/resident. Now most of that is used up in the residency, but the non-allocated institutional money and a bit of that allocated money makes the effort valuable or in many cases lucrative for a program that didn't previously have residencies. They also save on hospitalists once the residents are established and further along.

 

[gamerEMdoc]

To be fair the MD schools have opened practically as many new schools as osteopathic schools in the last decade. For us it means more because we only had 20-some schools a decade ago and they had 120+, but in terms of raw number of new schools, they're practically the same. Our class sizes are bigger and tuition greater, however, so ultimately new DO schools are making more with less effort as you said.

I have no problem with the idea of paying to cover the expense of students for rotations, but my point is more that the measure of fairness and good rotations isn't really based on how much a med school pays to send their students on rotations. Like I said, plenty of MD schools don't inherently pay for rotations. It's one of the reasons MD schools in NYC were up in arms about the contract St. George's had with the NYC hospitals, paying them over a million for their students to rotate, in turn displacing US MD (and DO for that matter) students. That doesn't mean those MD school's rotations are inherently worse.

Our rotations are worse, not simply because we don't pay sites, but because our schools don't put money and effort in to creating a standardized and effective curriculum in 3rd and 4th year. We are basically sent off to preceptors or hospitals, some of which have barely any experience teaching, with very little guidance as to our objectives, requirements, etc. On top of that our clinical departments consist of less than a handful of administrators covering hundreds of us. Sure we're going to smaller sites, but I've rotated with a bunch of MD students even at some of these smaller sites, and the main difference is that they actually have school-provided study resources and an outlined curriculum that we generally lack.

Also, I will say that direct payment for students isn't the only way schools can "reimburse" hospitals for their rotations. My school doesn't pay sites for rotations, but they put money and resources towards establishing affiliated residencies at those sites, which end up bringing in ~$150k/yr/resident. Now most of that is used up in the residency, but the non-allocated institutional money and a bit of that allocated money makes the effort valuable or in many cases lucrative for a program that didn't previously have residencies. They also save on hospitalists once the residents are established and further along.

Totally agree. I don't think a system where basically you pay some flat amount per student is the perfect solution. But I do think they need to have a skin in the game especially when they are charging so much in tuition and putting no resources into supporting their clinical faculty. The school we are "affiliated" with offers no faculty advancement in their institution for clinical faculty (you can't go from assistant to associate to full professor no matter how much you publish, get grants, etc). They offer almost zero faculty development. They don't help us fund our private residency spots (our residency spots are only partially funded by federal dollars, the rest of fully funded by department budget). Eventually you realize that they are gaining everything from the affiliation, and you are gaining nothing other than a name on a piece of paper. That is absolutely great for them, but eventually bigger community hospitals who no longer will need their affiliation to be with a DO school will have every right to just align with an MD residency as a community training site. Our other residencies are duel accreditted and already have an MD affiliation as well as an AOA one. I can absolutely see a day when bigger community programs reevaluate their DO school affiliations if they have other options. Money is only a part of the equation, but faculty development resources and opportunity, or lack there of, is also a big deal.

 

[hallowmann]

Totally agree. I don't think a system where basically you pay some flat amount per student is the perfect solution. But I do think they need to have a skin in the game especially when they are charging so much in tuition and putting no resources into supporting their clinical faculty. The school we are "affiliated" with offers no faculty advancement in their institution for clinical faculty (you can't go from assistant to associate to full professor no matter how much you publish, get grants, etc). They offer almost zero faculty development. They don't help us fund our private residency spots (our residency spots are only partially funded by federal dollars, the rest of fully funded by department budget). Eventually you realize that they are gaining everything from the affiliation, and you are gaining nothing other than a name on a piece of paper. That is absolutely great for them, but eventually bigger community hospitals who no longer will need their affiliation to be with a DO school will have every right to just align with an MD residency as a community training site. Our other residencies are duel accreditted and already have an MD affiliation as well as an AOA one. I can absolutely see a day when bigger community programs reevaluate their DO school affiliations if they have other options. Money is only a part of the equation, but faculty development resources and opportunity, or lack there of, is also a big deal.

It really does seem like your program is not getting much out of the deal, especially the bolded (I thought this was at least present to some degree at most schools), and in reality, I think with expansion of both MD and DO schools, departments and hospital systems will be reevaluating their contracts more frequently. There will be plenty of schools to choose from, and the ones that don't offer more to their affiliates will have to adapt, start their own health systems, or close down for lack of rotations.

 

[NurWollen]

Do you guys at other schools have assignments and meetings and lectures from your school for different rotations? Or do you just say goodbye to your school for 3rd and 4th years? Rotations at my school are of varying quality but overall I do still feel very connected and very much a part of my school.

I think rotations could be improved if schools would pay preceptors and hospital sites a significant amount (enough to make it worth their while) in exchange for the preceptors fulfilling certain requirements. Attending training session and what not. This would help preceptors and hospital programs feel more invested in the educational process, and we students wouldn't seem like an afterthought as can sometimes happen.

 

[uworldrelay]

Do you guys at other schools have assignments and meetings and lectures from your school for different rotations? Or do you just say goodbye to your school for 3rd and 4th years? Rotations at my school are of varying quality but overall I do still feel very connected and very much a part of my school.

I think rotations could be improved if schools would pay preceptors and hospital sites a significant amount (enough to make it worth their while) in exchange for the preceptors fulfilling certain requirements. Attending training session and what not. This would help preceptors and hospital programs feel more invested in the educational process, and we students wouldn't seem like an afterthought as can sometimes happen.

This will never happen, osteopathic schools are a business model. Also, if you told preceptors for osteopathic schools that they had to fulfill requirements, they would quit! ....They are private physicians...

 

[GUH]

So, if the merge is completed in July 2020 (like the website says), DO Class of 2020 could still possibly match into AOA-slotted residencies? It's for the Class of 2021 that there will be no more AOA residencies?

But regardless, some AOA programs will become ACGME before 2020?

The short answer is that there will most likely be very few, if any AOA-accredited programs participating in the 2020 NMS (osteopathic) match. Almost every program (or maybe every program) which survives the transition will have already shifted over by then, assuming that the timeline does not change.

Long answer:
Every program has to have initial accreditation by June 30, 2020. However, the AOA has now said that a residency program is not allowed to accept residents who would graduate after the deadline if the program has not applied for ACGME accreditation (which is called pre-accreditation). The last graduating resident class under AOA accreditation will be those who finish on June 30, 2020. For IM or FM, this means that they would have to match in 2017 at the latest. After that, any programs of three or more years in length will need to have at least applied for ACGME accreditation in order to continue matching residents in the NMS (AOA) match. According to the ACGME, the time from pre-accreditation to initial accreditation is 4-12 months if all goes well. So if a 3-year program applies right before the match in February of 2018, they would likely obtain initial accreditation by April of 2019. At that point, the program can participate in the NRMP (ACGME) match. Now while I am not aware of a hard requirement that programs participate in the NRMP match after obtaining initial accreditation, it is widely believed that most programs will. Which means that the three-year programs that pass initial accreditation will likely not participate in the 2020 NMS (AOA) match. There may be a few one-year programs left, but those would be risky since they would only have a few months between match day and the initial accreditation deadline.

 

[GUH]

Do you guys at other schools have assignments and meetings and lectures from your school for different rotations? Or do you just say goodbye to your school for 3rd and 4th years? Rotations at my school are of varying quality but overall I do still feel very connected and very much a part of my school.

I think rotations could be improved if schools would pay preceptors and hospital sites a significant amount (enough to make it worth their while) in exchange for the preceptors fulfilling certain requirements. Attending training session and what not. This would help preceptors and hospital programs feel more invested in the educational process, and we students wouldn't seem like an afterthought as can sometimes happen.

We have online assignments for each third-year rotation, and return to campus one week out of every three months for shelf exams, OSCEs, and didactics sessions.

Most preceptors, even the good ones, would not want to attend a training session if it took any amount of time or travel. I think we may lose a lot that way. I have heard that core preceptors do receive site visits from my school's clinical education staff as a way of vetting them, however. It is unfortunate that you've had experiences where you were more of an afterthought. That sucks. Why do they even take students?

On top of that our clinical departments consist of less than a handful of administrators covering hundreds of us.

Huge issue at our school as well. At one point there were only 4 administrators handling rotation stuff for about 700 students spread among three classes. It's better right now but when it comes to things like VSAS, anything which requires the school to submit or sign a document or release an application is still likely to get delayed. Which is unfortunate because ideally the school's involvement should support a student, not hold him back.

 

[Ioannes Paulus]

I know that CCOM students spend between 4 to 8 hours per week during year 3 for "didactics" depending on what rotation they are on. They usually include a lecture or clinical case presentation or both.

 

[deleted564680]

The short answer is that there will most likely be very few, if any AOA-accredited programs participating in the 2020 NMS (osteopathic) match. Almost every program (or maybe every program) which survives the transition will have already shifted over by then, assuming that the timeline does not change.

Long answer:
Every program has to have initial accreditation by June 30, 2020. However, the AOA has now said that a residency program is not allowed to accept residents who would graduate after the deadline if the program has not applied for ACGME accreditation (which is called pre-accreditation). The last graduating resident class under AOA accreditation will be those who finish on June 30, 2020. For IM or FM, this means that they would have to match in 2017 at the latest. After that, any programs of three or more years in length will need to have at least applied for ACGME accreditation in order to continue matching residents in the NMS (AOA) match. According to the ACGME, the time from pre-accreditation to initial accreditation is 4-12 months if all goes well. So if a 3-year program applies right before the match in February of 2018, they would likely obtain initial accreditation by April of 2019. At that point, the program can participate in the NRMP (ACGME) match. Now while I am not aware of a hard requirement that programs participate in the NRMP match after obtaining initial accreditation, it is widely believed that most programs will. Which means that the three-year programs that pass initial accreditation will likely not participate in the 2020 NMS (AOA) match. There may be a few one-year programs left, but those would be risky since they would only have a few months between match day and the initial accreditation deadline.

Deadlines are June 30th, 2016 for 5 year programs, Dec. 31st, 2016 for 4 year programs, and Dec. 31st, 2017 for 3 year programs. If any program does not apply for pre-accreditation by those dates then they cannot accept any new residents. However, it's the AOA so this could change 🙂

I know that CCOM students spend between 4 to 8 hours per week during year 3 for "didactics" depending on what rotation they are on. They usually include a lecture or clinical case presentation or both.

KCOM students have noon didactics at their rotation sites also.

 

[GUH]

@GUH Thanks, does the merger put DOs at a greater handicap b/c MDs will match into what had initially been AOA-only (the stigma thing)? Will the merge make it more plausible for IMGs to match optho & derm?

I'd think programs that were originally AOA (esp. ROAD) will still favor DOs, but others disagree.

Not sure about ophtho or derm but yes, programs which previously were for DOs only will now be forced to accept applications from MDs, including IMGs. Inevitably, some of those MDs will match to those programs.
Some AOA programs might still take more DOs than MDs, but even if they take just a small number of MDs it cuts down on the number of seats for DOs. In competitive specialties, a small number of seats may represent a large portion of the DOs who match into that specialty.
But even assuming that all former AOA programs will favor DOs over MDs is still optimistic thinking not based on any actual data that I'm aware of.

 

[TheaterOfTheme]

W

Not sure about ophtho or derm but yes, programs which previously were for DOs only will now be forced to accept applications from MDs, including IMGs. Inevitably, some of those MDs will match to those programs.
Some AOA programs might still take more DOs than MDs, but even if they take just a small number of MDs it cuts down on the number of seats for DOs. In competitive specialties, a small number of seats may represent a large portion of the DOs who match into that specialty.
But even assuming that all former AOA programs will favor DOs over MDs is still optimistic thinking not based on any actual data that I'm aware of.

So how should DOs compete? Audition rotations?

 

[GUH]

W

So how should DOs compete? Audition rotations?

The same as always - doing as well as we can on boards, earning high grades, and to a lesser extent, building a solid resume, getting strong letters, and doing well on auditons. The merger does not chamge this.

 

[cassis_Cake]

So everyone in DO schools will be required to take USMLE in future to apply for residency? If so, what's the purpose of comlex then?

 

[AlteredScale]

So everyone in DO schools will be required to take USMLE in future to apply for residency? If so, what's the purpose of comlex then?

No that is not a requirement. DO schools require the comlex. The only way usmle would be required is if there was an acquisition of DO schools by the LCME.


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[IslandStyle808]

So everyone in DO schools will be required to take USMLE in future to apply for residency? If so, what's the purpose of comlex then?

COMLEX I and II are the requirement to graduate from all osteopathic medical schools (RVU is the only school I know of that requires USMLE step I also for graduation). You need COMLEX III to get licensed in all 50 states.

It is up to the PDs whether the USMLE is either required or recommend to match in their programs. There will still be PDs who will look at the COMLEX none the less. So you want to take the USMLE to give them an 'apples to apples' comparison to their MD applicants.

 

[jw3600]

So everyone in DO schools will be required to take USMLE in future to apply for residency? If so, what's the purpose of comlex then?

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