MS-III
Thursday, June 02, 2005
Opening up AOA programs
I'm about to mention something considered faux-pas in the osteopathic community: Opening up AOA residency programs to allopathic physicians.
Since the mid 20th century, osteopathic and allopathic physicians have been training in parallel - allopaths go to school in LCME-accredited medical schools and train at ACGME accredited residencies, osteopaths go to AOA accredited medical schools and train in AOA accredited residencies. However, in recent years, more and more osteopathic students have fled to ACGME training institutions. Something like 50% of osteopathic medical students matched into ACGME residencies in the 2005 match, leaving the other 50% in AOA programs.
There are many arguments as to why this is so: Many students quote their desire to escape the clutches of the "dogmatic" AOA. Others mention more practical reasons - hospital size, patient volume, location, perceived superiority of training at ACGME residencies, or increased opportunity for fellowship training. Whatever the reason, the AOA (and AOA accredited postgraduate training institutions) have been left with the reality that students are not applying to, nor matching at, their training programs. This has left many hospitals in a pinch, and the AOA wondering what the hell happened - while they were busy trying to push a superfluous exam and convince every student that a change in the initials after their name would make them more "osteopathic," they seem to have lost their audience. Every year, over 3000 osteopathic students graduate, and nearly 50 per cent do not match into their own postgraduate training programs. This should send a blaring message to the AOA that they are doing something horribly, horribly wrong. Unfortunately for us all, they have not been listening. They only seem to blame the medical students, rather than their own poorly designed system for the exodus that has occurred in recent years.
Many reforms must be made to osteopathic postgraduate education: better teaching, more volume, more consistency between programs. As it stands now, there are a few high-quality training programs, and many more low-to-poor quality training programs. This situation leaves the medical student in a hard place - face professional exile from their accrediting body or complete poor training. No surprise many students are choosing the former.
In recent years, there has been a huge push from the osteopathic student body for a combined AOA-ACGME match. The AOA (in true AOA-form) is firmly set against the proposition, fearing that a combined match (rather than the high-pressure roulette system they have in place now) will lead to more students abandoning osteopathic residencies in favor of ACGME training programs. I understand their argument, even if I do not agree with it. They are afraid osteopathic GME will cease to exist if the doors are opened for osteopathic medical students to enter ACGME programs without fear of excommunication. I don't see how this is necessarily a bad thing. The good programs will stay, the poor programs will die off - as well they should. Competition is only good for the system.
One of the complaints I have seen from allopathic students is something to the effect of, "why should we support a joint match when we won't get any benefit from it?" As it stands now, AOA GME programs only allow DO students to matriculate, meaning that allopathic students cannot enter into osteopathic residency programs. Allopathic residency programs are more "open" (for the most part), allowing DOs, USMDs, IMGs, and FMGs to apply and train at their programs.
What I am proposing, is for osteopathic GME to reciprocate and allow any and all-comers to apply and match at their programs (in conjunction with a combined match system). This would serve several purposes. First, it would provide those allopathic students interested in osteopathy the opportunity to train in a program where OMT and other osteopathic modalities are emphasized. It would also eliminate the inequities in the current combined-match scenario. It would enable those programs the opportunity to stay open, since the pool of potential applicants would increase roughly 400% or more. Another benefit would be increased exposure to and acceptance of osteopathy, since MDs training in osteopathic postgraduate medical institutions would be less likely to slight the profession than those with no exposure and only hear-say upon which to base their opinions.
I'll be adding more to this at a later time - I've been working on this post for a week now, so I figured it was time to publish and get the rough draft out...
Another half-baked idea, brought to you by the letter K and the number 14... ¶ 2:16 AM 1 comments
Since the mid 20th century, osteopathic and allopathic physicians have been training in parallel - allopaths go to school in LCME-accredited medical schools and train at ACGME accredited residencies, osteopaths go to AOA accredited medical schools and train in AOA accredited residencies. However, in recent years, more and more osteopathic students have fled to ACGME training institutions. Something like 50% of osteopathic medical students matched into ACGME residencies in the 2005 match, leaving the other 50% in AOA programs.
There are many arguments as to why this is so: Many students quote their desire to escape the clutches of the "dogmatic" AOA. Others mention more practical reasons - hospital size, patient volume, location, perceived superiority of training at ACGME residencies, or increased opportunity for fellowship training. Whatever the reason, the AOA (and AOA accredited postgraduate training institutions) have been left with the reality that students are not applying to, nor matching at, their training programs. This has left many hospitals in a pinch, and the AOA wondering what the hell happened - while they were busy trying to push a superfluous exam and convince every student that a change in the initials after their name would make them more "osteopathic," they seem to have lost their audience. Every year, over 3000 osteopathic students graduate, and nearly 50 per cent do not match into their own postgraduate training programs. This should send a blaring message to the AOA that they are doing something horribly, horribly wrong. Unfortunately for us all, they have not been listening. They only seem to blame the medical students, rather than their own poorly designed system for the exodus that has occurred in recent years.
Many reforms must be made to osteopathic postgraduate education: better teaching, more volume, more consistency between programs. As it stands now, there are a few high-quality training programs, and many more low-to-poor quality training programs. This situation leaves the medical student in a hard place - face professional exile from their accrediting body or complete poor training. No surprise many students are choosing the former.
In recent years, there has been a huge push from the osteopathic student body for a combined AOA-ACGME match. The AOA (in true AOA-form) is firmly set against the proposition, fearing that a combined match (rather than the high-pressure roulette system they have in place now) will lead to more students abandoning osteopathic residencies in favor of ACGME training programs. I understand their argument, even if I do not agree with it. They are afraid osteopathic GME will cease to exist if the doors are opened for osteopathic medical students to enter ACGME programs without fear of excommunication. I don't see how this is necessarily a bad thing. The good programs will stay, the poor programs will die off - as well they should. Competition is only good for the system.
One of the complaints I have seen from allopathic students is something to the effect of, "why should we support a joint match when we won't get any benefit from it?" As it stands now, AOA GME programs only allow DO students to matriculate, meaning that allopathic students cannot enter into osteopathic residency programs. Allopathic residency programs are more "open" (for the most part), allowing DOs, USMDs, IMGs, and FMGs to apply and train at their programs.
What I am proposing, is for osteopathic GME to reciprocate and allow any and all-comers to apply and match at their programs (in conjunction with a combined match system). This would serve several purposes. First, it would provide those allopathic students interested in osteopathy the opportunity to train in a program where OMT and other osteopathic modalities are emphasized. It would also eliminate the inequities in the current combined-match scenario. It would enable those programs the opportunity to stay open, since the pool of potential applicants would increase roughly 400% or more. Another benefit would be increased exposure to and acceptance of osteopathy, since MDs training in osteopathic postgraduate medical institutions would be less likely to slight the profession than those with no exposure and only hear-say upon which to base their opinions.
I'll be adding more to this at a later time - I've been working on this post for a week now, so I figured it was time to publish and get the rough draft out...
Another half-baked idea, brought to you by the letter K and the number 14... ¶ 2:16 AM 1 comments
