For those of you that don’t know, the ACGME and AOA are merging to form the single graduate medical education (GME) accreditation system (SAS). Basically that means that the osteopathic and allopathic residency accreditation systems are merging to be one system. As of right now, the DO and MD residencies are separated. As DO students, we can apply for both types of residencies, as long as we take the USMLE in addition to the COMLEX (the MD and DO licensing exams). The point of the merger is to create one accreditation system to ensure a consistent method of evaluating residences and expand the types of training available for both DOs and MDs. To maintain the training for osteopathic manipulative treatment, residencies can apply for “osteopathic recognition.” We are in the second year of this five-year phase-in period, and a lot of changes are going to be happening.
To start, all current osteopathic residency programs are going to need to apply for ACGME accreditation. This inevitably means that some residency programs will not meet requirements in time and will be shut down. This is especially unfortunate in this day and age because we already have more people graduating from medical school than there are residency positions available, making the application process more competitive than ever. On top of that, the US is experiencing a physician shortage, particularly in rural areas, which cannot be fulfilled if doctors cannot obtain residency positions.
What does all of this mean for current medical students? The merger should be completed by the time the class of 2020 (current first year medical students) apply for residency. But what about the students that are applying for residency during this transition time? There is a lot to consider, especially for DO students. Right now, DO residencies generally look at COMLEX scores while MD residencies look at USMLE scores. There are many programs that accept and look at both, but with the merger, all programs are going to accept both. Ideally, that means that DO students should be able to just take the COMLEX. However, because all programs are going to become more competitive due to the shortage of residency spots versus medical students graduating, it might be in our best interest to take the USMLE as well. Another thing that DO students need to take into consideration is the fact that some current AOA residencies will not make the cut for the merger. So if you begin a residency that does not meet the requirements for the SAS, the program you are in will be shut down and you will be out of luck mid-residency training.
At the end of the day, this merger is designed to improve the quality and requirements of medical education, leading to more competent physicians and better healthcare. However, during the transition time there is a lot that needs to happen and a lot to consider as current medical students preparing for our future careers.