Forget board scores. Postdoc training once required guile, pluck, ‘subterfuge’

At a time when the AOA and the Accreditation Council for Graduate Medical Education are considering unifying their GME accreditation systems, 93-year-old Arnold Melnick, DO, reminds the profession of when there were hardly any specialty training opportunities for osteopathic physicians.

In his new autobiographical collection of essays, Osteopathic Tales, Dr. Melnick recounts that when he graduated from the Philadelphia College of Osteopathic Medicine in 1945, fewer than one-third of his classmates managed to snare osteopathic internships. Most went straight into general practice. The few specialty residency programs open to DOs were minuscule and mostly surgical.

Determined to become a highly skilled and knowledgeable pediatrician, Dr. Melnick designed his own training program by taking short courses in pediatrics offered by medical schools and hospitals in the Northeast.

“I—and many of my colleagues—kept our eyes open for such opportunities, even though we knew that rarely was a DO welcome to attend,” he writes. “We took our chances.”

With humor, Dr. Melnick describes “the major subterfuge used by many DOs at the time” to further their training. “I registered as Arnold Melnick, MD,” he writes, explaining how he gained admission to a 10-week course given by a world-renowned researcher and clinician in pediatrics. Every Monday when he arrived at the course site at Yale University, he avoided signing in.

“I didn’t want to get caught. Imagine having that panicky feeling when all I wanted to do was learn,” he remembers in his book. “But it was worth the suffering.”

The founding dean of what is now the Nova Southeastern University College of Osteopathic Medicine in Fort Lauderdale, Fla., Dr. Melnick also faced professional discrimination early on because he is Jewish.

As a premedical student at Temple University in Philadelphia, Dr. Melnick was dismayed that he didn’t get accepted into Temple’s or any other MD school. Perplexed, Dr. Melnick’s father spoke with the school’s dean and described his son’s competitive credentials.

“ ‘Mr. Melnick, even if your son were everything you say he is, I could not admit him,’ ” the dean told his father, Dr. Melnick writes. “ ‘You see, we already have our quota of Jews for this year.’ ”

Osteopathic medical schools, on the other hand, needed students and were more likely to accept Jews and other often quota-restricted minorities.

“Luckily for me, I discovered osteopathic medicine,” Dr. Melnick writes. “I became a doctor—proudly an osteopathic one—and started my medical career. It went far beyond my dreams.”

In reading Osteopathic Tales, Martin A. Finkel, DO, recalled anecdotes shared by his father, the late Harold Finkel, DO, a close friend and contemporary of Dr. Melnick’s.

“These doctors were passionate about what they did, passionate about providing the best care, passionate about getting the best education and knowledge, and wanting to be as knowledgeable and skillful and competent as anybody else,” says Dr. Finkel, a pediatrician in Stratford, N.J. “You can see in Arnold’s book how they had to struggle to get recognition, to get access to graduate medical education.

“In spite of all the challenges, they didn’t give up. They worked hard to be the best doctors and serve their patients and their community. And they were leaders and role models and really exceptional physicians.”

Dr. Melnick wrote Osteopathic Tales to make sure the profession’s history is remembered.

“I had come to realize that newer osteopathic physicians and students had no idea what the profession went through to get where we are today,” says Dr. Melnick, a former columnist for The DO.

“With his easy-to-read writing style,” says Dr. Finkel, “Arnold captures a bygone era that none of us should forget.”