Mythbusters: Educating prehealth advisers on osteopathic medicine

When Nathan D. McConkey, OMS IV, was applying to medical school in 2009, his prehealth adviser had trouble telling him the difference between DOs and MDs.

“I remember asking him one day specifically what the difference was,” says McConkey, who attended a small college in Pennsylvania and will graduate this year from the Des Moines (Iowa) University College of Osteopathic Medicine. “He shrugged and said, ‘I think DOs do something with their hands, but I’m not too sure beyond that.’ “

Lack of awareness can be a problem at big schools too. Indiana University grad Lauren A. Fetsko, OMS III, doesn’t recall any osteopathic medical schools at the preprofessional fair she attended as an undergrad. She says her prehealth adviser stressed MD schools—possibly because Indiana University had the only medical school in the state at the time.

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“Unless a student branched out and asked about osteopathic medicine specifically, the information wasn’t necessarily provided,” says Fetsko, who attends the University of Pikeville-Kentucky College of Osteopathic Medicine.

A common misconception among prehealth advisers is that applying to osteopathic medical school is a backup plan for students with subpar grades or standardized test scores, says Thomas Grawey, OMS IV, the outgoing senior director of Pre-SOMA, a branch of the Student Osteopathic Medical Association (SOMA) that focuses on premed outreach.

“I’ve heard stories from other DO students whose prehealth advisers told them, ‘You’re too good for DO school—you should go to MD school,’ ” says Grawey, who attends the Midwestern University/Chicago College of Osteopathic Medicine in Downers Grove, Ill.

A decade ago, many premeds did consider osteopathic medical school to be their backup plan, notes Gina Moses, a former prehealth adviser who now works for the American Association of Colleges of Osteopathic Medicine (AACOM).

“When I was doing premed advising, osteopathic medical schools were Plan B, pure and simple,” she says.

But in the past several years, the increased visibility of the osteopathic medical profession, along with efforts by AACOM, the AOA and groups such as Pre-SOMA to raise awareness among prehealth advisers and premeds, have led to a sea change on college campuses across the nation.

“More and more premeds in this country are saying, ‘Osteopathic medicine fits my philosophy, and it fits the way I want to practice medicine in the 21st century,’ ” Moses says. ” ‘It’s very holistic, it’s hands-on, and it’s my No. 1 choice.’ “

At Tufts University in Medford, Mass., Carol Baffi-Dugan, the school’s director of health professions advising, says she’s seen a huge increase in interest in osteopathic medical school among her students. Baffi-Dugan, who has been advising premeds since 1980, says the way she advises students on osteopathic medicine has drastically changed as well.

“Osteopathic medicine has become more and more understood and appreciated by society in general and our healthcare delivery systems,” she says. “Thirty years ago, I had to say, ‘This is a wonderful field and its philosophical approach may match your inclinations, but you are definitely going to have restrictions in terms of your career options.’ Today, there are no more restrictions in terms of career options. A student who does well is going to have all the same options as a DO as he or she would as an MD.”

AACOM’s recruiting push

In 2006, when Moses joined AACOM as associate director of application services, the organization had newly identified recruitment as one of its top priorities. Moses and her team were tasked with strategically positioning their recruiting events to reach more premeds and prehealth advisers.

“We look at places across the country where we think we need to have a more robust presence and places that are developing, such as the southern region of the country with the newer colleges of osteopathic medicine,” she says.

Moses also began giving presentations on osteopathic medical school at graduate fairs and health professions fairs on campuses around the country, where she educated prehealth advisers on the nuances of applying to osteopathic medical school.

“At some point, these advisers need to say to their students, ‘You need to have relationships with the DOs in your community, you need to have shadowing experience, and you’ll want to have letters of recommendation from DOs,’ ” she says.

Baffi-Dugan, the Tufts adviser, says she has been impressed with Moses’ presence at Boston-area schools.

“Gina does so much visiting of schools and talking directly with students,” she says. “She was just at Boston University last week. The event was for anyone in Boston, so some of my students went. That’s the way the kids get informed.”

The increased focus on recruitment has likely contributed to the growth in applicants to osteopathic medical schools. Applications via the AACOM application service (AACOMAS), which is used by all osteopathic medical schools but one, have outpaced class-size growth in the past decade. Ten years ago, 1.9 people applied for each first-year seat available. Last year, 2.4 people applied for each first-year seat.

Fetsko says she sees evidence of a change at Indiana University. At the school’s most recent preprofessional fair, osteopathic medical schools outweighed MD schools, she notes. The newly opened Marian University College of Osteopathic Medicine in Indianapolis may have helped put osteopathic medicine on the radar of Indiana educators and premeds, she says.

Reaching advisers through students

McConkey sought to raise awareness of osteopathic medicine by visiting his alma mater several times to give students demonstrations on osteopathic manipulative treatment and answer their questions.

First- and second-year medical students often do this, says Grawey, and SOMA offers students a premade presentation with information about DOs and osteopathic medical school.

Osteopathic medical students’ work with premeds can ripple up to prehealth advisers, says Devangi Patel, OMS III, the new senior director of Pre-SOMA.

“Our major goal is to utilize our medical students to be advisers and mentors,” says Patel, who attends the Rowan University School of Osteopathic Medicine in Stratford, N.J. “Then we use our Pre-SOMA chapters as our gateway to prehealth advisers. The best kind of advocacy is a student doing the advocacy because the prehealth adviser will say, ‘There are students interested in this. Maybe I should be learning more about it.’ “

Pre-SOMA helps premeds form chapters at their schools. About 60 schools have their own chapters, and in the last year, Pre-SOMA recruited 300 new members and helped establish six new chapters. The group began hosting large national Pre-SOMA conferences on college campuses two years ago, during which students from area schools can learn about osteopathic medicine.

“It’s a conference dedicated to answering the questions, ‘What is a DO?’ and ‘What is osteopathic medicine?’ ” Patel says. “We have keynote speakers and workshops, and we give students face time and inspiration.”

The events typically draw hundreds of students, and Pre-SOMA leaders tap AOA leaders to speak at them. The AOA also provides Pre-SOMA with “What is a DO?” brochures and other materials to give to premeds, such as sunglasses emblazoned with “Future DO.”

“We want premeds to understand how to get in,” says Otto Stronach Shill, OMS II, who organized a national Pre-SOMA conference in Arizona last month. “We also focus about 80% of our energy on communicating that No. 1, osteopathic medicine is on par with allopathic medicine, and No. 2, osteopathic medicine is different than allopathic medicine. And let us show you why we think it’s a better approach.”

More than 300 students attended Shill’s conference, which featured speakers Adrienne White-Faines, MPA, the executive director and CEO of the AOA, and Robert Orenstein, DO, the AOA’s editor in chief. It was jointly held by the A.T. Still University–School of Osteopathic Medicine in Arizona in Mesa and the Midwestern University/Arizona College of Osteopathic Medicine in Glendale, where Shill is a student.

Patel, who set up the first national Pre-SOMA conference in 2012 and helped start National ShaDO Week, during which premeds shadow osteopathic medical students, says that her own rough premed experience inspired her to find ways to help and encourage those who came after her.

After starting medical school, Patel began recruiting at her alma mater.

“I realized that had there been more people to tell me to just keep at it, that getting into medical school is hard, it would have made a world of difference to me,” she says.

The osteopathic difference

Working with a prehealth adviser who understands and champions osteopathic medicine can make a huge difference as well, notes Grawey, who attended Loyola University in Chicago, where his prehealth adviser encouraged students to apply to DO and MD schools.

“It’s good when you can go to a prehealth adviser who can tell you, ‘We send a lot of good people to DO schools. They’re great students, and they came out great physicians,’ ” he says.

Some MD schools are starting to transition away from focusing on test scores as a tool to select students. The new admissions process is referred to as holistic review, according to the New England Journal of Medicine.

Osteopathic medical schools have always approached their review of candidates holistically, placing more value on emotional intelligence and cultural competence than on test scores, Moses notes. As an upperclassman, McConkey has interviewed DMU-COM applicants. He says he’s realized that osteopathic medical schools aren’t any easier to get into—it’s that the criteria are different.

“We get fewer applicants, so we can pay more attention to them,” McConkey says. “And we can excuse lower test scores if applicants have other qualifying factors that make them promising as future physicians.”

Correction: This article has been updated to correct the spelling of the name of Dan Kallenberger, a recruiter with the Marian University College of Osteopathic Medicine in Indianapolis.