Historic Decision

House supports profession’s entry into a single GME accreditation system

The action caps more than two years of deliberations, negotiations and soul-searching. “I am elated,” student says.


On Saturday morning, capping more than two years of deliberations, negotiations and soul-searching, the AOA House of Delegates voted to support the osteopathic medical profession’s landmark entry into a single graduate medical education accreditation system. Both the AOA and the American Association of Colleges of Osteopathic Medicine (AACOM) called the decision historic.

The vote follows the February announcement that the AOA, AACOM and the Accreditation Council for Graduate Medical Education (ACGME) had agreed to pursue a system in which the DO and MD professions will develop a single standard for residency training.

The new system optimizes “the use of GME resources provided by the public to the profession, and maximizes opportunities for the residents of today and tomorrow,” the ACGME said in a statement.

Throughout the spring and into the summer, AOA leaders redoubled their efforts to travel the country to meet with osteopathic physicians and medical students to listen to their opinions and concerns and answer their questions.

Their efforts and the language in the resulting resolution pleased Ohio delegate Robert L. Hunter, DO, for one, who said it appropriately and satisfactorily reflects the profession’s hopes and concerns for the single GME system.

During a hearing the day before the House voted on the single GME accreditation system, Carisa R. Champion-Lippmann, OMS IV, was one of dozens who lined up to voice their opinions.

“This resolution is one of the best resolutions I have ever seen in this House,” said Dr. Hunter, who had an inside view as a member of the AOA Special Reference Committee on the Single GME Accreditation System. “If you look at it, it incorporates everybody. … We really tried to incorporate everybody’s wants in this House.”

The resolution calls for the AOA to provide annual progress reports to the House of Delegates on osteopathic board certification, the state of rural training programs and other pertinent issues. The resolution also emphasizes the importance of maintaining osteopathic licensing exams, osteopathic divisional and specialty societies, and the distinctiveness of osteopathic medicine as the AOA moves forward with the single accreditation system. And it encourages the AOA to advocate for fair evaluation of currently AOA-accredited programs as they transition into the next accreditation system.

Students thrilled

In a single GME accreditation system, osteopathic medical students will have greater options for their residency and fellowship training, many delegates noted. Moreover, students will not be hindered by the ACGME’s previously planned changes to its common program requirements, which would have barred DOs who served AOA residencies from entering ACGME fellowships. Therefore, a single system will allow students greater freedom to pursue specialty and subspecialty fellowships, some of which are not currently offered in AOA programs.

“Our students will get to compete on a level playing field with the allopathic students,” Illinois delegate Richard A. Feely, DO, told The DO. “They have the opportunity to achieve great things in the new single GME system. We will be challenged to come forward and show [the nation] the unique characteristics an osteopathic physician can have. It’s incumbent upon the colleges and the students to grab the bull by the horns and move forward with osteopathic medicine in the 21st century.”

Justin Michael Penny, OMS II, is excited about more fellowships potentially being within his reach, he told The DO.

“I have an interest in bioethics, and I’m hoping to pursue hospice and palliative care,” said Penny, who attends the Kansas City (Missouri) University of Medicine and Biosciences College of Osteopathic Medicine. “There are a lot of hospice and palliative care fellowships in the ACGME system that I hope to have access to no matter which residency I go into. There are many more hospice and palliative care fellowships in the ACGME system than there are in the AOA system.”

Students on the whole were overwhelmingly in favor of a single GME accreditation system, Penny noted.

“I am elated for myself, for my school and for osteopathic medical students on the whole,” he said. “We’re passionate about our identity as future osteopathic physicians, and we’re excited for future opportunities.”

Speaking on behalf of the Student Osteopathic Medical Association, John M. Carlson, OMS III, addressed the House to thank AOA leaders for incorporating student opinion into the resolution.

“The SOMA national leaders, local chapter leaders at our schools and colleges of osteopathic medicine, and our student members across the country wish to join their voices in support and recognition of the AOA leaders and their tireless work put forth during the single accreditation negotiations,” said Carlson, who attends the Lincoln Memorial University-DeBusk College of Osteopathic Medicine in Harrogate, Tennessee. “Again, we express appreciation for their efforts in reaching out to students, providing formative resources, answering our questions, addressing our concerns, truly listening to and acknowledging our opinions, and above all giving us the opportunity to have our collective voice heard.”


  1. This stinks

    Unfortunately, this is going to be a detriment to our students. This is going to funnel all of our students into primary care specialties. No longer will our students have protected slots in specialties like ophthalmology, dermatology, orthopedic surgery, radiology, gastroenterology, etc. They will be put out into the ranks of all of the allopathic and IMG students.

    Not to mention the long term health of our specialty societies and boards. I hope the AOA has a resuscitation plan for these societies and itself.

  2. hank

    GOOD!!! that is VERY GOOD!
    spots should not be open because im a DO it should be open because I belong there (bc iam a good candidate)!!! if your scared your not competitive….go study more!!

  3. Tre

    I agree with This Stinks….. It is the death knoll for The DO profession specialist, and after that the DO in General. The society’s will certantly never survive. Is this what is best for healthcare in the US…. maybe, but it for sure is not what is best for DOs.

  4. Skeptical

    I agree with “this stinks”. With the new accredidation system only MD’s can be program directors or faculty members. Why would they pick a DO for their competitive subspecialty residencies when there are four times as many MD’s. No matter how high your scores are, you are still a DO in their eyes. I hate to break it to you but unfortunately many of them discriminate.

  5. ?

    I agree with Tre. This is the best call for healthcare in the US, so I support it. I just don’t see how we can maintain our uniqueness (especially OMT) with MD’s in DO residencies.

  6. JB Skeptical

    As a proud DO subspecialist (GME trained through military/ACGME) who applied only to osteopathic medical schools with the intention of receiving the most comprehensive training inline with the tenets, I have the following thoughts. While I think a unified system portends to display an equal standing among current AOA programs, the future evolution of the residents/fellows or the de-accreditation of those same programs 5 years in will be the proof of this latest move. I ask why the AOA supports this unified system to join as part of the ACGME today when many (DO leaders) floundered and were opposed to it over the past 2 years. Are some AOA programs cutting corners and not living up to the public expectation of competency and accountability for self righteous reasons? Time will tell. Don’t get me wrong, I know of several ACGME programs that are pulling the same shady antics, and in this way, regulation is a good thing. If AOA programs start accepting MDs to train, they should hold those MDs to the same standards of osteopathic principles as there counterparts as this only helps the public better (though it would blend the philosophical lines of DO distinctiveness). Otherwise I agree that this will only serve as a stepping stone for the ACGME to gain more leverage over the entire DO profession at the GME level.

    My second question to the AOA leadership is why are you supporting this when the very mission of the recent rapid growth of osteopathic medical schools and satellite campus medical schools have taken a footing in underserved areas under the auspices of providing primary care to that community, not subspecialty care?

  7. M H Rosenthal

    As a now retired DO who did MD port-grad training, I feel this is a positive step. Locked out of a first rate DO internship, I received one of the best MD, med-surg internships (University of Rochester) in the country and equally fine residency training (UCSD). Never was my back turned on my profession and I wore my DO proudly in geographical areas where we were very sparse. Give our DO students the opportunities they deserve to have the very best. This is a free market society. The best training programs will rise to the top and the poor ones will be under-enrolled. Support the students that take this course and the profession will be repaid with loyalty. As a board certified psychiatrist (AMA) and Fellow in the Academy, I continued to use my DO training and DO principles to the very end of my career. It’s rather a Zen concept; let them go and they will return all the stronger.

  8. Michael

    Over recent years there has been a dramatic proliferation of osteopathic schools, without any increase in osteopathic hospitals. In this way, the osteopathic profession has had no choice but to rely on allopathic institutions. So this move is not surprising. Osteopathic training institutions will survive initially because the profession needs them for their students, but will these osteopathic institutions survive long term within the ACGME standards?
    This may be a revisit to California in 1961, and a merger of the osteopathic and allopathic professions. Perhaps osteopathy will become a subspecialty, e.g. neuromuscular and manipulative medicine.

  9. Robert Fedor DO

    The hard work begins now. Our AOA leaders need to continue the distinctive autonomy of the Osteopathic Profession in its continued negotiations with the ACGME.
    Our representatives need to present a unified effort to not surrender our profession to those who would take the opportunity to amalgamate all physicians and cause the de facto demise of the Osteopathic Physician.

  10. Tre' Landrum

    I hate to say it Robert… but I think this move is surrender.
    Think about what you do every day… how much of it is what you learned in school, vs how much did you learn in residency. The VAST majority of what I do every day I learned in residency. Sure there there is the occasional OMT (but if we want to be honest how I use that I learned from on my of the MD’s attending’s who learned it form his DC).
    Med school does start a future physician with a certain philosophy, and it teaches OMT, but you all know the real learning takes place after the DO. And we are now giving all of that teaching we are giving up control on?
    As I said before… it MAT be best for American medicine in general, but it certainly isn’t best for DO’s.
    As a final note… I was trained in a residency that was very much a hybrid of MD and DO residency styles… and I saw the good and the bad of both. But, don’t mistake it, there is a difference. And for the large population centers the MD model works. But do not think for a second that it is the same for small town America. And it is in my little small town that the DO model really shines. It isn’t just the philosophy difference, it is the training. The residency programs are much better at producing a small town physician. They may not be as good an making a big name researcher, or an ultra sub-specialist… but you come to my little neck of the woods and you can see what an ultra sub-specialist will do for you.

  11. Ray Seifert

    500 Allopathic graduates did NOT match after the scramble. This dramatically limited their options for the following year. I am sure the AMA switchboards were clogged with outraged calls from students, faculty and parents. Afterwards, ACGME unilaterally barred us from programs until this agreement was made. I see short term relief, most noticably from students who see how this might impact them. This arrangement was not made on the basis of how wonderful our graduates are or how much the allopaths respect their osteopathic colleagues. I believe this was out of want of control of our training process, and in effect, our future. A famous quote, ” those who do not learn from history are doomed to repeat it.” Homeopathy was an accepted school of medicine at one time. They were then incorporated into organized medicine, soon told to remove “Homeopathy” from their diplomas. Now, anyone identifying themselves as a “homeopathic” physician is considered a “fringe” practitioner. How long will it take for D.O’s who practice like D.O.’s today to become fringe practitioners? I categorically reject the notion that OUR primary care programs must meet their bloated standards and that their programs are better! This short term solution will take the spotlight away from the incompetence of our AOA leadership for not addressing the looming residency shortfall. I believe it also spells the end of osteopathic specialty societies. AS for now being able to compete on a level playing field with all medical school graduates, ….REALLY? I competed on a level playing field for my allopathic residencey and fellowship 30 years ago. ACGME barred D.O.’s from training, only to force us into agreement so they might control our futures. Anyone who sees this merger as a good thing is short sighted or running for cover to hide their incompetence in maintaining appropriate residencey slots for their graduates.

  12. 4th year DO

    This merger from my perspective was an inevitability. Our profession or more specifically the DO schools have gotten there hands caught in the proverbial honey jar…charging thousands of students HUNDREDS of thousands of dollars and essentially doubling class sizes in 10 years without an equivalent increase in GME…what did we expect? There are way too many old guard DOs at my school harping on what the “MDs have done to us”-the only fingers that should be pointed are ones at each other, COCA and the AOA. Without his merger DO students would have essentially been locked out of residencies, we did not have enough spots to sustain the graduates from our schools and we’re relying on50-60% of students to enter the MD match…with there own students starting to feel the residency crunch did we honestly think they would just standby and do nothing?

  13. JB

    Keep in mind, while GME has not expanded to the same degree as undergraduate DO enrollment, the chances of competing for a highly selective specialty is still in your favor when compared to only other DOs and excluding the rest of the MDs and MBBSs (foreign medical grads). Perhaps the advantage of the unified system for the US is that it will be able to fill more GME training spots with US grads over foreign doctors.

  14. Tre

    There have always been more residency spots than US med school grads… Up until a few years ago. Up till then the MDs were glad to have DOs fill those spots rather than give them to FMGs. But now that we have increased med school grads to the point we have (mostly in DO)…. Well 4th year DO nailed it… And we have not even fought for it. Like many minorities we as DOs just caved to the majority…. Because them must do it better. See California in the early 60s…. But is is nation wide.

  15. william faber

    so perhaps more residencies shall be available. I do not see how the uniform standards teach the osteopathic principles and practices. The shadowing a dr. who pecks on a laptop during 99% of the patient visit and does a 30 to 60 second examination makes for the uniform allopathic standard of care. author – THE OSTEOPATHIC MEDICINE ADVANTAGE.

  16. Michael E. Fitzgerald at the American Academy of Osteopathy

    From the perspective of the American Academy of Osteopathy, the vote on the single accreditation system for graduate medical education was the most important decision made by the AOA House of Delegates at its 2014 meeting.
    The second most important decision was adopting the policy titled “Patient Safety and Use of Osteopathic Manipulative Treatment for Patients With Pain Conditions.” This policy proclaims that OMT is a safe intervention and that it should be considered first-line treatment for patients with pain associated with somatic dysfunction and for patients with other appropriate pain conditions.
    For more on the American Academy of Osteopathy’s perspective on the 2014 AOA House, see the lead article in the latest issue of “AAO Member News” at http://files.academyofosteopathy.org/MbrNews/2014/AugustNews2014.pdf and the YouTube video at https://www.academyofosteopathy.org/eweb/DynamicPage.aspx?Site=AAO&WebCode=AOAHouse2014.

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