Letters to the Editor  |   October 2005
Jumping Through Hoops for Osteopathic Internships
Author Affiliations
  • Joseph J. Snyder, DO
    Dyersville, Iowa
Article Information
Medical Education / Graduate Medical Education
Letters to the Editor   |   October 2005
Jumping Through Hoops for Osteopathic Internships
The Journal of the American Osteopathic Association, October 2005, Vol. 105, 443. doi:
The Journal of the American Osteopathic Association, October 2005, Vol. 105, 443. doi:
To the Editor:
I have read with interest the ongoing debate18 over osteopathic internships in JAOA—The Journal of the American Osteopathic Association. I chose to attend a family medicine residency program accredited by the Accreditation Council for Graduate Medical Education (ACGME) for several reasons—first and foremost among these being the high quality of training that was available in the program I selected. I chose not to attend an osteopathic residency program at Des Moines (Iowa) General Hospital because I felt the program was not very strong. Furthermore, there were widespread rumors that the hospital would soon be closing or sold, which, in turn, would close the hospital's internship and residency programs. Des Moines General Hospital was acquired by Des Moines Community Hospital Corp in 2000, and the residency program was subsequently moved to Mercy Medical Center in Des Moines.9 
I applied to have my first year of ACGME residency training approved by the American Osteopathic Association (AOA) as an “AOA-approved internship,” but my application was refused several times. Since then, I have declined membership in the AOA and have not attended any AOA-sponsored conferences. Instead, I have been very successful as a member of the American Academy of Family Physicians and the American Medical Association, which have both welcomed me wholeheartedly. 
I serve as a preceptor for allopathic medical students and residents in ACGME-accredited programs without difficulty. However, if an osteopathic medical student wants to do a rotation in our office, he or she has to “jump through hoops.” Why would I want to pay money to or support an organization that has chosen to ostracize me? 
I am proud to be a DO, and I support my daughter's interest in attending an osteopathic medical school, but I will never force her to do an osteopathic internship if she has no need for it or interest in it. I agree with Edward Zawadzki, DO,2 who wrote in a March 2005 letter in JAOA, “It appears as though the current generation of osteopathic medical students and residents are choosing not to obsess over the differences between MDs and DOs, but rather focus on our similar yet distinct roles as leaders of the healthcare profession—choosing to be included rather than alienated from our allopathic colleagues. If this means training in an allopathic residency for whatever reason, that decision should be respected.” 
 As the premier scholarly publication of the osteopathic medical profession, JAOA—The Journal of the American Osteopathic Association encourages osteopathic physicians, faculty members and students at osteopathic medical colleges, and others within the healthcare professions to submit comments related to articles published in JAOA and the mission of the osteopathic medical profession. The JAOA's editors are particularly interested in letters that discuss recently published original research.
 Letters to the editor are considered for publication in JAOA with the understanding that they have not been published elsewhere and that they are not simultaneously under consideration by any other publication.
 All accepted letters to the editor are subject to copyediting. Letter writers may be asked to provide JAOA staff with photocopies of referenced material so that the references themselves and statements cited may be verified.
 Readers are encouraged to prepare letters electronically in Microsoft Word (.doc) or in plain (.txt) or rich text (.rtf) format. The JAOA prefers that letters be e-mailed to Mailed letters should also be sent electronically, in one of the aforementioned electronic formats on an IBM-compatible CD or a 3½-inch disk, and addressed to Gilbert E. D'Alonzo, Jr, DO, Editor in Chief, American Osteopathic Association, 142 E Ontario St, Chicago, IL 60611-2864.
 Letter writers must include their full professional titles and affiliations, complete preferred mailing addresses, day and evening telephone numbers, fax numbers, and preferred e-mail addresses. Authors are responsible for disclosing financial associations and other conflicts of interest.
 Although JAOA cannot acknowledge the receipt of letters, a JAOA staff member will notify writers whose letters have been accepted for publication. Mailed submissions and supporting materials will not be returned unless authors provide self-addressed, stamped envelopes with their submissions.
 All osteopathic physicians who have letters published in JAOA receive continuing medical education (CME) credit for their contributions. Writers of original letters receive 5 hours of AOA Category 1-B CME credit. Authors of published articles who respond to letters about their research receive 3 hours of Category 1-B CME credit for their responses.
 Although JAOA welcomes letters to the editor, readers should be aware that these contributions have a lower publication priority than other submissions. As a consequence, letters are published only when space allows.
Cain RA. Promoting active engagement with osteopathic principles and practice in interns and residents [letter]. J Am Osteopath Assoc. 2005;105:236-237. Available at: Accessed September 1, 2005.
Zawadzki E. “Hardship exception” is necessary [letter]. J Am Osteopath Assoc. 2005;105:124-126. Available at: Accessed September 1, 2005.
Opipari MI. Chairman of COPT concludes debate on “hardship exception” [letter]. J Am Osteopath Assoc. 2005;105: 53-54. Available at: Accessed September 1, 2005.
Steier KJ. Rebuttal regarding the “hardship exception” [letter]. J Am Osteopath Assoc. 2005;105: 4-5. Available at Accessed September 1, 2005.
Clark RC, Smith AB. Osteopathic medical training: developing the seasoned osteopathic physician [letter]. J Am Osteopath Assoc. 2004;104:452-455. Available at: Accessed September 1, 2005.
Hornbeck KL, Opipari MI. DO notes difference between residency programs [letter]. J Am Osteopath Assoc. 2004;104:367-368. Available at: Accessed September 1, 2005.
Steier KJ, Opipari MI. In opposition to resolution 42 [letter]. J Am Osteopath Assoc. 2004;104:314-315. Available at: Accessed September 1, 2005.
Smith AB, Opipari MI. Evaluating the rationale of the osteopathic internship [letter]. J Am Osteopath Assoc. 2004;104:230-231. Available at: Accessed September 1, 2005.
Mercy Capital. Mercy Medical Center Web site. 2005 . Available at: Accessed September 1, 2005.