This is pessimistic, but most likely the realistic scenario. This is exactly why I firmly believe that borderline MD applicants get shafted the most when it comes to medical school admissions.
No arguments there
Exactly. This is what I have been telling the optimists with fairy dust in their eyes for the entirety of this thread. It comes down to the fact that MDs are on average better candidates. Hence DOs did nothing but harm themselves by giving up exclusive residencies which were ensuring them a greater presence in competitive specialties.
They literally built up all these programs over decades and tore down all of that work with this one decision.
I would, however, come in with only point of contention: some former AOA programs may still keep a strong DO presence. De facto exclusivity may not even be out of the question, though I'm not sure what kind of quotas the merger will impose. i.e. all programs must have at least X% MDs and X% DOs. It seems like PDs are kind of feudal lords of their own domains, and I don't know if the bureaucratic oversight will even reach far enough to force them to change their practices, nor do I know if the ACGME even cares to micromanage in that fashion.
Apologies in advance for the ensuing diatribe.....
Unless there's some grand scheme at play that I'm not seeing, the people who decided this was a good idea for DOs have shot the entirety of osteopathic medicine in the foot. I feel like this decision had to have been forced upon the AOA by not only ACGME leadership but by others who see the issue of limited residency expansion. The overflow had to go somewhere. I see the conversation going something like this - bureaucrat making decisions, "Instead of creating enough new residency positions to keep up with the increasing number of graduates (who are needed given the physician shortage we're facing), let's just open all of the existing OGME spots to MD graduates too. They have plenty of spots." Other bureaucrat responds, "Brilliant! Who cares about the future osteopathic physicians when this option saves $$$$ and the effort of creating new residency spots?"
I haven't fact-checked this, but this quote is taken from a presentation by Norman Gevitz (
http://www.oucom.ohiou.edu/hpf/pdf/...intended Consequences of the ACGME Merger.pdf)
"Under our current system, unfilled OGME slots provide an excellent safety net for osteopathic students who do not secure slots in either the osteopathic or allopathic match. Last year, 500 US MD graduates did not find residency positions after their scramble. By contrast, all DO graduates who wanted a residency position found a residency position because we have a safety net."
I think we can all connect the dots. Hilariously, they don't even admit that this would benefit the residency shortage (probably because they realize this is a band-aid fix to the issue and don't want to bring any attention to it). In the FAQ about the merger (
http://www.acgme.org/acgmeweb/Portals/0/PDFs/Nasca-Community/FAQs.pdf) they list these as the benefits of single accreditation:
1. Establish and maintain consistent evaluation and accountability for the competency of resident physicians across all accredited graduate medical education (GME) programs.
2. Eliminate duplication in GME accreditation.
3. Achieve efficiencies and cost savings for institutions currently sponsoring “dually” or “parallel” accredited allopathic and osteopathic programs.
4. Ensure all residency and fellowship applicants are eligible to enter all accredited programs in the United States, and can transfer from one accredited program to another without repeating training, and without causing the sponsoring institutions to lose Medicare funding. (See Appendix 1: Eligibility for Residency and Fellowship for additional detailed information.)
