Moving forward

Video: Next steps in proposed ACGME agreement to unify residency programs

Memorandum of understanding is expected to be drafted this spring, says AOA Executive Director John B. Crosby, JD.

AOA Executive Director John B. Crosby, JD, lays out the next steps in negotiations with the Accreditation Council for Graduate Medical Education and the American Association of Colleges of Osteopathic Medicine to create a single, unified accreditation system for graduate medical education.


  1. John- thanks for your excellent service over the years. We appreciate you keeping us up to date on this EXTREMELY important subject.

  2. Dear Mr. Crosby:

    Thank you very much for this update, which is critical to the future of all graduate medical education–allopathic and osteopathic.
    I am proud of our association in being so proactive in this endeavor.
    Sincerely yours,


  3. Sounded like three minutes of saying we don’t know when this is going to happen instead of actually informing us of the reasons why the merger was pushed back and what is being done to rectify said issues other then just saying when the groups are meeting. Please please please get this done.

  4. Sounds like politics and egos are getting in the way of better and more unified graduate medical education. I thought this was about patient care….

  5. I think it’s time we started to be honest with ourselves. We have allowed hundreds of GME spots to go unfilled for years and by this we have committed inexcusable misconduct in the name of preserving an outdated treatment modality. It is not the time for political posturing nor self preservation semantics. It is time to roll up or sleeves, acknowledge and apologize for our betrayal of our responsibility to public health. We failed as a profession to do what was in the best interest of our communities by not training licensed physicians that they paid for with their tax dollars (i.e. empty GME seats).

    We are a major contributor to the physician shortage in the US.

    In a misguided effort to manifest a distinctness, in the staunch opposition to any logical thought, our leadership has truly proven despicable.

    There is no excuse for this continued mismanagement and retention through intimidation.

    Students, residents, young and old physicians have shown time and time again that if given the opportunity to distance themselves from the world of osteopathy it is in great majority taken.

    This process of merging the professions is slow and will involve many strong egos but I ask that we worry less about the politics and political correctness and more about what is right for our patients and for the physician community as a whole. I do not appreciate empty words nor do I appreciate the emotionally based rhetoric that have been the mainstay of the ACGME debate. Speak with meaning, honesty, and logic, I accept nothing less.

  6. The Realist comments cuts to the root of the problem which is a egocentric approach by the Realist and wannabee MD students that have utilized the osteopathic system as a means to get a degree to practice medicine. Instead of heaping on the garbage, why not try to advocate for changes within the system??? A 3-5 year approach is incrementalism and will prevent a knee jerk merger which undoubtedly will have orders of secondary consequence.

  7. First, kudos for getting this far, It could not have been easy. I think our distinction should be in the way we practice, not in the wording of our inter-professional agreements. “maintaining our distinctiveness” seems like code for “us vs them.” The profession is still feeling a hangover from anti-DO practices of the past/over reacting to current covert discrimination (real and perceived). We need to lick our wounds and do what is right for patients, students, and both branches medicine. Students and physician alike will benefit from less isolation and less distinction by decree.

  8. Just got my AOA renewal today $700 dollars for what?Chance to take the 4 th leg of the osteopathic biracial family car ride?-Delusional Get real.

  9. So lets cut through through all the BS…This will lead to annihilation of the osteopathic profession as we know it. All this talk about “preserving distinctiveness” is only lip-service.

  10. I think those of us who want to preserve our distinctiveness can and should continue to do so in practice, regardless of what things say we’re supposed to cover on paper. No one can tell me not to work on someone’s pelvis when they’ve got low back pain even if this merger ends with most AOA residencies becoming much more ACGME-like (whatever that means). My point is this: Anyone’s “distinctiveness” won’t really matter with the merger. Those of us who still enjoy doing OMM will learn it and still have easy access to do so if we join the right training program, and it wont be forced on those who don’t want to learn it. This seems no different from any other medical specialty in my eyes. Some DOs will be “distinct” in their practice, and most will not, regardless of what the top-down definitions are.

  11. I am a transfer student from a US-MD school to a US-DO school. Being in a DO school I have learned that the curriculum is the EXACT SAME THING. The 1st and second years take an extra 2hrs a week to learn the Osteopathic portion. Which I had to learn in 6 months time. Since I’ve transferred I have felt the discrimination. It is ridiculous, for that a year prior to my transfer I was held with higher respect. The merger should hopefully abolish this discrimination.

  12. Dear realist and others: If you think that AOA positions have been left unfilled, you should be aware that the percentage of first year funded AOA training slots were 92% filled in 2012. We expect it to be higher this year. In a year or two they will be 100% filled. It is likely that DOs who do not match in either the AOA or NRMP Match will no longer have the ability to scramble into unfilled AOA training slots once we unify with ACGME. Our greatest need is to have a sufficient number of slots for the evergrowing number of graduating DO students looking for residency training slots now and in the future. We will continue to recruit and approve new AOA programs and training slots to meet this need.

    Diane Burkhart, PhD
    AOA Director of Education

  13. Dr. Burkhart,

    I am pleased to be proven wrong on your point. That being said, you will have to forgive me for being skeptical of your claim. Previous years’ GME reports do not represent anywhere near the percent filled that you speak of. If the AOA has managed such a turn around then I applaud you. However, I am unsure as to why there is such a discrepancy between years past and the 2012 match and likewise if there truly has been such success filling GME spots then why is this not being heavily advertised / disseminated? In short Dr. Burkhart, I’d like some proof. I would also like to state very clearly that any statistical manipulation to pretty up the match outcome data will not go without notice.

  14. As a DO neurosurgical resident being trained by about 60% of allopathic physicians, it is appalling to me that DOs are not permitted to join the neurosurgical societies, such as CNS and AANS. The most common statements I hear from my MD trainers is that they view our DO residencies as being disorganized with no valid measures of comparing our competancy to that of MDs as we do not take the same board exams as our allopathic counterparts.

    I have always been proud of my osteopathic training, however I cannot help but feel a sense of shame at not being able to join my specialty’s academic societies. As a resident, I have had the opportunity to work with many allopathic medical students from large well-known institutions, and have been surprised to see the glaring lack of exposure to procedures and overall weak fund of clinical knowledge exhibited by many. This has further reinforced my pride in my medical school training, which I believe has always fostered strong clinical and academic experiences. Additionally, I find that the majority of my osteopathic attendings have similar experiences. Yet we are not regarded with the same respect as our allopathic counterparts, despite our individual strong performance surgically and academically. Furthermore, many neurosurgical residents feel that being a DO makes it more difficult to get published in many of the more reputable neurosurgical journals. I’m sure DOs in other specialties have similar experiences.
    Despite the position of wanting to maintain distinctiveness, there needs to be some valid measures of demonstrating professional EQUALITY established by the AOA/ACGME/ACOS, whether this is via merging of residencies or at least standardizing board exams.
    Gone are the days of purely DO or MD hospital systems, and I find it very disappointing that I may finish an osteopathic residency to join an integrated profession as one of the red-headed stepchildren of neurosurgery-unable to become a member of academic societies, viewed as one with “questionable training.”

    My sense of pride over the years is disappointingly being replaced by a sense of defensiveness and shame.

  15. If we feel shame and defensiveness regarding our profession it is because we have allowed “outside” forces to affect us. Allowing ourselves to be bullied by any organization, will provoke defensiveness and shame.
    As for any merger with allopathic medicine…hasn’t that been the trend for years? It was attempted in California, and we haven’t learned from that lesson yet. Out distinctiveness as Osteopaths is just empty words with leadership. Why have AOA anymore when there is the AMA? Will that be the next “merger”?
    Problems within with medical education need to be solved by Osteopaths, for Osteopaths.

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