Turbulent times for DOs ahead

[Drrrrrr. Celty]

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Today the ACGME posted a response/rebuttal to the AOA's Dr. Buscher's claim that the ACGME tried to push their MOU on the Osteopathic Community/ AOA. Dr. Bsucher claimed that the ACGME had disrespected the AOA's osteopathic characteristics and as such they couldn't agree to the MOU. But it appears that Dr. Buscher and the AOA have lied to us, they have opted out of the merger simply based on self interest. Instead of representing the Osteopathic Community the AOA has made it clear they want DOs to pay dues to their organization and do not want the ACGME butting in on it.

http://www.acgme.org/acgmeweb/Portals/0/PDFs/Nasca-Community/NascaLetterGMECommunityJuly232013.pdf

But my question is this now, what is the full scale of the damage here? I believe the AOA has effectively harmed DO prospects in ACGME residencies extensively. I mean why take residencies associated with an organization that opted to paint you out as a bunch of blood suckers?

But what are your opinions?

 

[NeuroLAX]

Dude, enough with multiple threads on the same topic.... especially in a pre-med forum of all places.

All are free to join/contribute to any of the 4 current discussions going on in the Osteo forum:

http://forums.studentdoctor.net/showthread.php?t=862903

http://forums.studentdoctor.net/showthread.php?t=1022313

http://forums.studentdoctor.net/showthread.php?t=1021332

http://forums.studentdoctor.net/showthread.php?t=1021290

 

[Drrrrrr. Celty]

Dude, enough with multiple threads on the same topic.... especially in a pre-med forum of all places.

All are free to join/contribute to any of the 4 current discussions going on in the Osteo forum:

http://forums.studentdoctor.net/showthread.php?t=862903

http://forums.studentdoctor.net/showthread.php?t=1022313

http://forums.studentdoctor.net/showthread.php?t=1021332

http://forums.studentdoctor.net/showthread.php?t=1021290

Right, but a lot of pre-osteos don't go to Osteo. So I felt like spreading the umm.. bad news?

 

[gmcguitar4]

Are you saying it hurts the individual DO student in applying to ACGME residencies? I don't think it will for the most part. Most people know it isn't the students making these choices, so why screw them over. If a student is a good student, performs very well, has great board scores, and seems like they would make a good doctor, I think that student would have the same chances at a residency regardless of this decision. I think all this has done is delay the inevitable merger another 5-10 years.

 

[SoulinNeed]

I have to say that you are really exaggerating this. Outside of DO student circles, no one seems to really be talking about this, especially since any talks of a merger were very preliminary, and there wouldn't have been one for another 5 years, at the least, anyway. The truth is that DO's are matching to ACGME residencies at a higher rate than ever before, despite growing numbers of applicants. The AOA recently added 1,100 new AOA residency spots, and this keeps them exclusive to DO's.

Essentially, what I'm saying is. . . . . . RELAX!

 

[Drrrrrr. Celty]

Are you saying it hurts the individual DO student in applying to ACGME residencies? I don't think it will for the most part. Most people know it isn't the students making these choices, so why screw them over. If a student is a good student, performs very well, has great board scores, and seems like they would make a good doctor, I think that student would have the same chances at a residency regardless of this decision. I think all this has done is delay the inevitable merger another 5-10 years.

Most people know it's the American government bombing places, doesn't stop them form associating them with Americans. But regardless, who knows what will happen. But I think it's a frightening time and hey, some extra anti-aoa sentiment is always nice eh?

 

[Drrrrrr. Celty]

I have to say that you are really exaggerating this. Outside of DO student circles, no one seems to really be talking about this, especially since any talks of a merger were very preliminary, and there wouldn't have been one for another 5 years, at the least, anyway. The truth is that DO's are matching to ACGME residencies at a higher rate than ever before, despite growing numbers of applicants. The AOA recently added 1,100 new AOA residency spots, and this keeps them exclusive to DO's.

Essentially, what I'm saying is. . . . . . RELAX!

Aren't most of these TRI and good luck getting into fellowships I mean.

 

[NeuroLAX]

Aren't most of these TRI and good luck getting into fellowships I mean.

http://www.osteopathic.org/inside-aoa/Education/Pages/new-aoa-approved-ogme-programs.aspx

 

[Drrrrrr. Celty]

http://www.osteopathic.org/inside-aoa/Education/Pages/new-aoa-approved-ogme-programs.aspx

Oh, some of those are pretty good fields.

 

[darklabel]

I'll be more worried if the ACGME decided to bar DO applicants from MD residencies as a retaliation for the AOA being stubborn. Unlikely, but could happen and send the message that "they need us more than we need them". Fellowship may also be a concern.

I just want a unified match, but keep the AOA residencies for DOs. Ideally, students can apply to both and have AOA as a backup in case they match no where in the ACGME (for instance, someone gunning for rads).

This is of course in an ideal world; I doubt that'll ever happen.

 

[SoulinNeed]

I'll be more worried if the ACGME decided to bar DO applicants from MD residencies as a retaliation for the AOA being stubborn. Unlikely, but could happen and send the message that "they need us more than we need them". Fellowship may also be a concern.

I just want a unified match, but keep the AOA residencies for DOs. Ideally, students can apply to both and have AOA as a backup in case they match no where in the ACGME (for instance, someone gunning for rads).

This is of course in an ideal world; I doubt that'll ever happen.

That shouldn't happen. It would be absolutely unfair to MD students. Hell, the current situation is unfair to MD students.

 

[SoulinNeed]

Oh, some of those are pretty good fields.

Seriously, dude, it's going to be fine. Don't worry about some theoretical changes that may happen. This country needs more doctors, and the government would come down on ACGME if they tried to bar qualified doctors from getting residency positions, which medicare is paying for. PD's would rebel, if the ACGME forced them to take Carib grads over DO's.

It's not going to happen. As far as fellowships go, who knows?

 

[HoboCommander]

The current situation actually benefits DO students. We can apply to either AOA or ACGME residencies, whereas MDs can only apply to ACGME.

 

[WonderBoy]

The current situation actually benefits DO students. We can apply to either AOA or ACGME residencies, whereas MDs can only apply to ACGME.

👍

 

[TheFuture_22]

The current situation actually benefits DO students. We can apply to either AOA or ACGME residencies, whereas MDs can only apply to ACGME.

I agree. Let them stay separate until I graduate and then merge them. The merge is great for the long term but bad for the short term.

 

[darklabel]

That shouldn't happen. It would be absolutely unfair to MD students. Hell, the current situation is unfair to MD students.

Current situation is beneficial for MDs since it will always be easier to place into a top ACGME program for an MD as opposed to a DO. The only reason I am against unified accreditation is that the bias will always be there. Removing the two letters behind your name and comparing the relevant stuff (USMLE scores, grades, rank, etc) would be the fairest way to compete but the bias is very real (especially in the top programs), but oh well.

If I were an MD student I would worry more about the increase in # of MD schools and class size and stagnant number of residencies since I doubt all of them will be going for primary care. Same can be said for DOs.

The current situation actually benefits DO students. We can apply to either AOA or ACGME residencies, whereas MDs can only apply to ACGME.

True, but sometimes people forgo the AOA match and risk it in the ACGME match. I definitely think those people are brave (Unless they are going for FM or IM)

 

[TheFuture_22]

Current situation is beneficial for MDs since it will always be easier to place into a top ACGME program for an MD as opposed to a DO. The only reason I am against unified accreditation is that the bias will always be there. Removing the two letters behind your name and comparing the relevant stuff (USMLE scores, grades, rank, etc) would be the fairest way to compete but the bias is very real (especially in the top programs), but oh well.

If I were an MD student I would worry more about the increase in # of MD schools and class size and stagnant number of residencies since I doubt all of them will be going for primary care. Same can be said for DOs.





True, but sometimes people forgo the AOA match and risk it in the ACGME match. I definitely think those people are brave (Unless they are going for FM or IM)

Could you not apply to competitive specialties only through AOA as a reach then apply FM, IM, etc. through ACGME if unsuccessful?

 

[darklabel]

Could you not apply to competitive specialties only through AOA as a reach then apply FM, IM, etc. through ACGME if unsuccessful?

I'm premed such as yourself, but yes. I just assumed if someone wants Ortho, didn't get it from the AOA match, then they'd try again in ACGME.

 

[Drrrrrr. Celty]

The current situation actually benefits DO students. We can apply to either AOA or ACGME residencies, whereas MDs can only apply to ACGME.

Chances are AOA residencies would have been 95% populated by DOs regardless. We also lose heavily in fellowships and we lose heavily in mid tier students being forced into AOA residencies for specialties like Gen Surgery that otherwise may have opened up fully in the merger situation.

 

[TheFuture_22]

I'm premed such as yourself, but yes. I just assumed if someone wants Ortho, didn't get it from the AOA match, then they'd try again in ACGME.

True, but if I was gunning for Ortho my strategy would be to apply Ortho in the AOA match then Ortho/backup plan specialties in the ACGME match. This is assuming I have stats good enough for Ortho.

 

[SoulinNeed]

Chances are AOA residencies would have been 95% populated by DOs regardless. We also lose heavily in fellowships and we lose heavily in mid tier students being forced into AOA residencies for specialties like Gen Surgery that otherwise may have opened up fully in the merger situation.

You're making far too many assumptions here. Why would Gen Surgery programs that currently don't take DO's, due to a DO bias start taking DO applicants, just because a merger occurred? And why would previously DO exclusive residencies still be "95% DO filled"? The only way that would occur is if DO PD's were biased against MD applicants, and if that were the case, then MD PD's would have more reason than ever to be biased against DO applicants.

All we know is that DO match rates have been going pretty well over the past few years, and things look to be continuing to improve. No reason to panic now.

 

[TheFuture_22]

You're making far too many assumptions here. Why would Gen Surgery programs that currently don't take DO's, due to a DO bias start taking DO applicants, just because a merger occurred? And would previously DO exclusive residencies still be "95% DO filled"? The only way that would occur is if DO PD's were biased against MD applicants, and if that were the case, then MD PD's would have more reason than ever to be biased against DO applicants.

All we know is that DO match rates have been going pretty well over the past few years, and things look to be continuing to improve. No reason to panic now.

Yep, I think people fail to see the silver lining to this. We get exclusive access to AOA residencies for now, and in the future this merger is inevitable anyway.

 

[Drrrrrr. Celty]

You're making far too many assumptions here. Why would Gen Surgery programs that currently don't take DO's, due to a DO bias start taking DO applicants, just because a merger occurred? And why would previously DO exclusive residencies still be "95% DO filled"? The only way that would occur is if DO PD's were biased against MD applicants, and if that were the case, then MD PD's would have more reason than ever to be biased against DO applicants.

All we know is that DO match rates have been going pretty well over the past few years, and things look to be continuing to improve. No reason to panic now.

And you're reading into my statements. Why would students opt out of the AOA match where they can be sure to match gen surgery risk it all for ACGME gen surgery? That is the issue here. A combined match offers people a chance to maximize where they end up.

 

[Drrrrrr. Celty]

Yep, I think people fail to see the silver lining to this. We get exclusive access to AOA residencies for now, and in the future this merger is inevitable anyway.

It's off for the forseeable future. The ACGME isn't going to want to spend time and money for the AOA to reject it last minute.

 

[SoulinNeed]

And you're reading into my statements. Why would students opt out of the AOA match where they can be sure to match gen surgery risk it all for ACGME gen surgery? That is the issue here. A combined match offers people a chance to maximize where they end up.

But any benefit is negated by more competition coming from MD students now having access to previously AOA residencies.

I don't understand why you think previously DO only residencies would still be 95% DO filled? What evidence do you have to back that up?

I think we could wind up in a situation where DO's could get locked out of Gen Surgery residency programs that continue to maintain a bias (and I don't see a reason why they would stop all of a sudden), and increased competition from MD's, when there wasn't any before.

 

[TheFuture_22]

And you're reading into my statements. Why would students opt out of the AOA match where they can be sure to match gen surgery risk it all for ACGME gen surgery? That is the issue here. A combined match offers people a chance to maximize where they end up.

That's a good point, but you have to at least agree that it is not as doom and gloom as you presented it earlier. Settle for an AOA match is you are risk averse, and go for the ACGME if you want to roll the dice. Either way you will end up doing the job you desire in this scenario.

 

[GypsyHummus]

About the AOA:

You either die a hero or you live long enough to see yourself become the villain

 

[Temperature101]

Today the ACGME posted a response/rebuttal to the AOA's Dr. Buscher's claim that the ACGME tried to push their MOU on the Osteopathic Community/ AOA. Dr. Bsucher claimed that the ACGME had disrespected the AOA's osteopathic characteristics and as such they couldn't agree to the MOU. But it appears that Dr. Buscher and the AOA have lied to us, they have opted out of the merger simply based on self interest. Instead of representing the Osteopathic Community the AOA has made it clear they want DOs to pay dues to their organization and do not want the ACGME butting in on it.

http://www.acgme.org/acgmeweb/Portals/0/PDFs/Nasca-Community/NascaLetterGMECommunityJuly232013.pdf

But my question is this now, what is the full scale of the damage here? I believe the AOA has effectively harmed DO prospects in ACGME residencies extensively. I mean why take residencies associated with an organization that opted to paint you out as a bunch of blood suckers?

But what are your opinions?

I am sure the discussion will resume again... AOA and ACGME are like two kids who are arguing about the size of their..... (you know what).

 

[DocMC]

AOA is ridiculous. Stay away from the DO route with the current leaders of the AOA. And yes, I agree 100% with OP that this will affect future DO's significantly. It has undoubtedly created tension between the AOA and ACGME (read the link in the OP, clearly the ACGME has tried to mold the MOU to fit with the AOA, and it STILL gets rejected?! How frustrating for the ACGME!!!), and because the AOA has made the "osteopathic community" look bad (you can't even argue this), ACGME programs, IMO, will be less willing to take DOs in the future. Unreal. The AOA is absolutely absurd. .

 

[gmcguitar4]

Most people know it's the American government bombing places, doesn't stop them form associating them with Americans. But regardless, who knows what will happen. But I think it's a frightening time and hey, some extra anti-aoa sentiment is always nice eh?

I mean.. that is a litttttle extreme. We are talking about doctors here..not the masses from a developing nation.

 

[Drrrrrr. Celty]

But any benefit is negated by more competition coming from MD students now having access to previously AOA residencies.

I don't understand why you think previously DO only residencies would still be 95% DO filled? What evidence do you have to back that up?

I think we could wind up in a situation where DO's could get locked out of Gen Surgery residency programs that continue to maintain a bias (and I don't see a reason why they would stop all of a sudden), and increased competition from MD's, when there wasn't any before.

Again, DO residencies aren't going to suddenly be accepting all MD students. Same way that MGH will not be accepting DO students after the merger.

And there's not a bias per say. But for many applicants its a hard specialty to get into and they feel like they risk more by not doing AOA match.

Furthermore, I believe we have more to gain because we had the chance to normalize by simply being present.

 

[Drrrrrr. Celty]

I am sure the discussion will resume again... AOA and ACGME are like two kids who are arguing about the size of their..... (you know what).

Actually no, the ACGME has been cordial and patient in accommodating the AOA. Their statement today really sends a message of them generally having no intention in the near future of having a merger.

 

[Drrrrrr. Celty]

AOA is ridiculous. Stay away from the DO route with the current leaders of the AOA. And yes, I agree 100% with OP that this will affect future DO's significantly. It has undoubtedly created tension between the AOA and ACGME (read the link in the OP, clearly the ACGME has tried to mold the MOU to fit with the AOA, and it STILL gets rejected?! How frustrating for the ACGME!!!), and because the AOA has made the "osteopathic community" look bad (you can't even argue this), ACGME programs, IMO, will be less willing to take DOs in the future. Unreal. The AOA is absolutely absurd. .

This is more or less my point of view. No matter which way you look at it the DO prospects in the ACGME aren't leaving unscathed.

 

[gc91]

because the AOA has made the "osteopathic community" look bad (you can't even argue this), ACGME programs, IMO, will be less willing to take DOs in the future. Unreal. The AOA is absolutely absurd. .

It will depend on the program. Sure, someone who wants a high-tier competitive residency and eventual fellowship may be affected, but for someone (like me) who is looking to practice rural FP any impact at all will go unnoticed.

 

[Drrrrrr. Celty]

It will depend on the program. Sure, someone who wants a high-tier competitive residency and eventual fellowship may be affected, but for someone (like me) who is looking to practice rural FP any impact at all will go unnoticed.

And when you decide that you want to better serve the rural community by being a surgeon?

 

[gc91]

And when you decide that you want to better serve the rural community by being a surgeon?

When that happens you have my permission to say "I told you so." 😉

 

[NontradCA]

This is more or less my point of view. No matter which way you look at it the DO prospects in the ACGME aren't leaving unscathed.

I think it's too soon to jump to conclusions, and yea this looks pretty bad from the AOA AACOM side. Don't be too serenade, and just wait this out. I wouldn't withdraw your apps or anything over politics; that's all this is.

 

[Drrrrrr. Celty]

I think it's too soon to jump to conclusions, and yea this looks pretty bad from the AOA AACOM side. Don't be too serenade, and just wait this out. I wouldn't withdraw your apps or anything over politics; that's all this is.

Meh, I find solace is panic.

 

[csx]

About the AOA:

You either die a hero or you live long enough to see yourself become the villain

And when you decide that you want to better serve the rural community by being a surgeon?

Sometimes, the truth isn’t good enough. Sometimes people deserve more. Sometimes people deserve to have their faith rewarded.

 

[wjs010]

It's not really a bad thing. ACGME fellowships are only out of reach if you don't do an ACGME residency. It will be allllright. I honestly don't get what is so bad about doing an AOA residency. Can someone please tell me? If I was going into ENT and could only get into AOA, should I not go into that residency and choose FP MD residency? I know there are less DO residencies and spots, but do they just suck? I just want to be a doctor. Lol

 

[Drrrrrr. Celty]

It's not really a bad thing. ACGME fellowships are only out of reach if you don't do an ACGME residency. It will be allllright. I honestly don't get what is so bad about doing an AOA residency. Can someone please tell me? If I was going into ENT and could only get into AOA, should I not go into that residency and choose FP MD residency? I know there are less DO residencies and spots, but do they just suck? I just want to be a doctor. Lol

It's awful actually, and we risk far more than just residencies after having spit in their faces.

 

[sylvanthus]

If you do an AOA residency you get the joy of being a member of the AOA every single time you recertify your boards. There is no such stipulation on the MD side.

 

[jayoh]

I don't think this is cause for panic so to speak, but like I was saying in my other thread, it makes me not want to apply to DO schools at all.

It's about more than fellowships and whatnot. It's about the bigger picture, and the future of the profession. I don't care about protected aoa residencies, because I have no interest in them (especially now).

I was already sad to see the merger was off, and now that the ACGME has posted their response, it makes me really question the motives and the leadership in the AOA. Not an organization I want to be associated with.

 

[GypsyHummus]

When that happens you have my permission to say "I told you so." 😉

When Primary Care is in Ashes, you have my permission to cry

 

[SoulinNeed]

Again, DO residencies aren't going to suddenly be accepting all MD students. Same way that MGH will not be accepting DO students after the merger.

And there's not a bias per say. But for many applicants its a hard specialty to get into and they feel like they risk more by not doing AOA match.

Furthermore, I believe we have more to gain because we had the chance to normalize by simply being present.

DO residencies may not all of a sudden start accepting MD students, but they eventually will, especially since a true merger would allow MD's to become PD's of formerly DO only residencies. And there is a bias against DO's in surgery specialties in ACGME programs. There just is, and a merger would not change that. Currently, a DO student's best chance at surgery is in the AOA match, and I don't see that changing even after a merger.

Once again, I really think you're exaggerating this whole "AOA spat in ACGME's face!". Most PD's have no idea that this is happening. A close friend of mine is a PD at a ACGME program (and he's a DO), and he had no idea that a merger was even being talked about. If you look at NRMP data, DO match rate in the ACGME has been going up and up, and the AOA has added a bunch of new spots in desirable fields. This likely wouldn't have taken affect until after you graduated, anyway.

 

[hallowmann]

...It's about more than fellowships and whatnot. It's about the bigger picture, and the future of the profession. I dont care about protected aoa residencies, because I have no interest in them (especially now).

I was already sad to see the merger was off, and now that the ACGME has posted their response, it makes me really question the motives and the leadership in the AOA. Not an organization I want to be associated with.

I'm a little concerned about the AOA/AACOM response, but is it really a surprise? It seems obvious what their motives were. Honestly, I'm sure the ACGME tried to accommodate them (keeping their own interests as a priority of course), but the people in power and the people getting the money didn't want it. Its simple politics.

I just hope when we see drops in DO applicants in the coming years the AOA will get the message. Enough of this "separate, but equal" stuff.

I for one would be glad to pay the AOA/AACOM some ridiculous fee to participate as a DO in a combined match. At least it would save me the choice between a risky chance of even getting a mediocre ACGME residency and a good chance at an AOA residency with significant limits on whether I'm able to subspecialize in the future.

 

[Radon XP]

Can somebody explain in a tl;dr fashion the opening post? I'm not quite sure I understand what this means

 

[SoulinNeed]

I'm a little concerned about the AOA/AACOM response, but is it really a surprise? It seems obvious what their motives were. Honestly, I'm sure the ACGME tried to accommodate them (keeping their own interests as a priority of course), but the people in power and the people getting the money didn't want it. Its simple politics.

I just hope when we see drops in DO applicants in the coming years the AOA will get the message. Enough of this "separate, but equal" stuff.

I for one would be glad to pay the AOA/AACOM some ridiculous fee to participate as a DO in a combined match. At least it would save me the choice between a risky chance of even getting a mediocre ACGME residency and a good chance at an AOA residency with significant limits on whether I'm able to subspecialize in the future.

You really think they'll be a drop in DO applicants in the coming years? Seriously? All indications are that numbers are skyrocketing.

 

[Drrrrrr. Celty]

I don't think this is cause for panic so to speak, but like I was saying in my other thread, it makes me not want to apply to DO schools at all.

It's about more than fellowships and whatnot. It's about the bigger picture, and the future of the profession. I don't care about protected aoa residencies, because I have no interest in them (especially now).

I was already sad to see the merger was off, and now that the ACGME has posted their response, it makes me really question the motives and the leadership in the AOA. Not an organization I want to be associated with.

I've always seen the AOA as an organization doing worse for us, but yah same. If I can't get into an MD program this cycle I will sincerely debate taking a year off ( deferring an acceptance) and retaking the mcat.

 

[hallowmann]

You really think they'll be a drop in DO applicants in the coming years? Seriously? All indications are that numbers are skyrocketing.

Honestly I expect at very least some stagnation or a significant drop in the rate of increase. By skyrocketing, you mean a increase of 7-8% per year? Having any growth is necessary in order to maintain the applicants to seats ratio. Don't forget that 500 new DO seats were just added.

I'm sure at least some of the remaining additional applicants applied due to the belief that the merger would take place. In general more people are applying to med schools because of the economic instability of the country and job security in medicine, a peak that regularly happens and then declines or stops. Besides that, people have been applying to DO schools more not because of OMM, but because culturally pre-meds have been fed this DO = MD stuff. Now with this decision, I'm pretty certain that many people will question that idea when it seems like the DO leadership themselves don't believe they are equals or that their programs are solid enough to stand up to ACGME accreditation requirements.

Don't get me wrong. I'm sure there will still be tons of applicants, especially from the bastions of Osteopathic Medicine in the midwest and east. I just wouldn't be surprised if we saw a slow or stop in total DO applicant numbers in a few years.

But who knows. Maybe negotiations will continue and we'll have a merger set for 2020. Or maybe Congress will finally come through and allocate money for a ton of new ACGME residencies and fellowships so that all these new DO graduates will be able to secure ACGME residencies and it won't be as risky with more residencies to go around, so anyone who thinks they might subspecialize could just go ACGME with less fear. All of these would continue applicant growth, so its really up in the air.