Recent advocacy wins combat professional discrimination against DO trainees

Despite record-breaking growth in the osteopathic profession during the past decade, DOs and osteopathic medical students still, on occasion, encounter professional barriers related to training, credentialing, licensure and payment. The AOA views each instance of professional discrimination as a call to action and an opportunity for legal advocacy and support to ensure all DO physicians and osteopathic medical students enjoy the rights, privileges and respect they have earned.

“Protecting and defending the osteopathic profession is one of the most basic, yet essential functions the AOA can provide in service of its members and our profession,” says AOA CEO Kevin M. Klauer, DO, EJD. “I look forward to the day when these interventions are no longer needed because everyone will understand the distinctive philosophy and practice of osteopathic medicine, but the AOA will continue to fiercely champion the rights of DOs and osteopathic medical students until that time comes.”

The AOA recently launched a new Professional Advocacy landing page, where you can track the AOA’s ongoing professional and legal work to protect and defend the rights of DOs and osteopathic medical students. You can also stay updated with #AOAinAction on social media.

In recent months, the AOA’s legal team has worked to address several reports of audition rotation sites and residency programs that limit eligibility to only MD students, reports Josh Prober, JD, AOA senior vice president and general counsel.

“Discrimination against DOs, DO students and DO residents on the basis of their education is unacceptable,” he says. “When the AOA learns about it, we look into it and advocate on behalf of our DOs and DO trainees.”

As a result of the AOA’s advocacy, two institutions recently updated their applicant specifications to remove exclusions to DO students or DO candidates. Also, the AOA successfully intervened when it learned that the San Francisco Plastic Surgery Match did not include a pathway for some DOs.

San Francisco Plastic Surgery Match

The AOA recently learned that the San Francisco Plastic Surgery Residency Matching Program required applicants to prove that they are eligible to obtain board certification from the American Board of Plastic Surgery (ABPS). However, DOs who trained in AOA residencies are not eligible for ABPS board certification. The AOA worked with the plastic surgery match, the ABPS, the ACGME and the American Council of Academic Plastic Surgeons to get the requirement updated so that ABPS or AOA board eligibility is acceptable.

“We learned about this issue because a DO resident whose AOA-accredited general surgery program achieved ACGME accreditation during his third year wanted to enter the plastic surgery match but wasn’t sure if he would be accepted because of the ABPS board eligibility requirement,” says Maura Biszewski, AOA vice president of graduate medical education. “After we advocated for him, he was able to enter the Match since he is eligible for AOA board certification. We’re thrilled that our advocacy not only helped him, but also will make it easier for other DOs in the same position to enter the plastic surgery match.”

Washington University

Earlier last year, the AOA learned that Washington University in St. Louis’ visiting student rotation information stated that the institution was only interested in MD students. The AOA’s legal team connected with Jennie Kwon, DO, MS, a former AOA board member who is an assistant professor of medicine at Washington University.

“Dr. Kwon was able to intervene directly and promptly. We heard quickly back from the school that the omission of DO students was an inadvertent error,” Prober says. “Washington University’s visiting student rotation slots are open for application from DO and MD students, once Washington University begins accepting visiting student rotations, pending COVID-19 concerns.”

University of Virginia

A DO student recently alerted the AOA that the listing for a University of Virginia (UVA) internal medicine residency program on the AMA’s FREIDA website stated that the program was only open to applications from MDs.

“Before we reached out, we did some research,” Prober says. “UVA had several DOs in their other residency programs, and UVA’s medical faculty includes a number of DOs. Thus, it did not appear that this was a school-wide policy.”

The AOA’s legal team brought the issue to the attention of UVA’s internal medicine program director, who responded within 72 hours to say he had updated the language to include DOs.

Ongoing advocacy

The AOA engages in ongoing advocacy to address inequitable tuition policies at institutions that impact osteopathic medical students.

For instance, a policy at the University of Utah charges significantly higher tuition and fees to DO students than MD students in the university’s visiting students program. The AOA’s legal team is currently working directly with an official at the University of Utah as well as John Dougherty, DO, dean of the Noorda College of Osteopathic Medicine in Provo, Utah, to resolve the tuition discrepancy.

Students encouraged to report discriminatory behavior

Students who encounter audition rotation sites and residency programs that don’t treat DO and MD applicants equally should first alert their school’s administration to raise awareness of the issue at the COM level, Prober says. They should also report the behavior to the AOA at do-discrimination@osteopathic.org so that our legal team can investigate the issue. DO trainees who encounter discrimination in residency programs should report it to the AOA as well.

“The AOA is interested in addressing discrimination against DOs where it exists,” Prober says. “Sometimes it is a matter of education. Institutions may not realize that their language will be perceived as discriminatory or disqualifying or that it will likely result in DO trainees not seeking that opportunity.”

In October, the AOA House of Delegates passed policy directing the AOA to work with other stakeholders to address the practice of charging higher fees to DO students for audition rotations or denying rotations to DO students on the basis of their osteopathic training. The policy also directs the AOA to work with institutions to get any policies that discriminate against DO students changed. Find the resolution here (page 29).

Other medical leadership organizations have spoken out against discrimination toward DOs as well. The American Medical Association has an official policy stating that it discourages discrimination against medical students by institutions and programs based on osteopathic or allopathic training. Last month, the Utah Medical Association adopted policy stating that it opposes any kind of discrimination against osteopathic physicians and students.