Letters to the Editor  |   October 2005
Missed Opportunity for Osteopathic Medical Education
Author Affiliations
  • J. Jerry Rodos, DO, DSC
    Midwestern University's Chicago College of Osteopathic Medicine Downers Grove, Ill Ohio University College of Osteopathic Medicine Athens, Ohio
    Adjunct Professor of Behavioral Medicine, Adjunct Professor of Social Medicine
Article Information
Medical Education / Graduate Medical Education
Letters to the Editor   |   October 2005
Missed Opportunity for Osteopathic Medical Education
The Journal of the American Osteopathic Association, October 2005, Vol. 105, 441-442. doi:
The Journal of the American Osteopathic Association, October 2005, Vol. 105, 441-442. doi:
To the Editor:
The longtime controversy over nonosteopathic internships and residencies was highlighted yet again by the letter to the editor from Kenneth J. Steier, DO, 1 and the response from Michael I. Opipari, DO, 2 in the January and February 2005 issues, respectively, of JAOA—The Journal of the American Osteopathic Association. I propose here that to better understand this controversy, we should step back in time about 25 years and examine an important document in the history of osteopathic medicine—the so-called Kellogg Report. 
This report, formally titled “Report of the Task Force on Graduate Osteopathic Medical Education,” was published—with recommendations from the October 1980 Kellogg Dissemination Conference—as a supplement to The DO in April 1981. 3,4 The task force, which was charged with analyzing the effect of the osteopathic medical profession's burgeoning expansion in osteopathic graduate medical education (GME), was supported by a grant from the W.K. Kellogg Foundation of Battle Creek, Mich, and directed by the late George A. Faverman, PhD. 3  
One of the key take-home messages generated by the report was that the osteopathic medical profession was soon going to need significantly more internship and residency slots than were available at that time. 4 The report dramatized the challenge facing the profession by presenting a graph projecting an increase in the number of osteopathic physicians from about 17,000 in the late 1970s to more than 29,000 by the late 1980s. (As of May 2005, the number of DOs had grown to more than 56,500. 5 ) 
Robert Sparks, MD, the program director of health for the Kellogg Foundation, was so taken by this challenge that he made a proposal to the Board of Trustees of the American Osteopathic Association (AOA) to assist in creating a unique and innovative osteopathic GME system. The proposal included the creation of a mixed advisory group of osteopathic and allopathic medical educators. The Kellogg Foundation offered a second, more extensive grant to the AOA to undertake this project (personal notes, 1979). However, the AOA Board of Trustees rejected the proposal. 
In the ensuing years, it has become increasingly clear that the osteopathic GME system is not producing enough internship and residency positions to meet the ever-growing demands of the profession. It has also become increasingly clear that the osteopathic medical profession missed an excellent opportunity in the 1980s by not pursuing the Kellogg Foundation's proposal for reforming the profession's education system. 
Perhaps this perspective helps us understand the osteopathic medical profession's continued wrestling with the issue of GME. Some people in the profession apparently feel that if more and more of our graduates seek nonosteopathic pathways for GME, fewer and fewer of them will return to the AOA during their professional careers. This concern may be fueled by statistics that show the percentage of DOs belonging to the AOA decreasing from approximately 80% from the late 1960s to the early 1980s 6 to slightly more than 60% today. 5  
Part of the concern in any profession is retaining control of its education and accreditation processes. While the AOA has retained control of the accreditation process for osteopathic medical colleges, it has lost control of its GME. The fork in the road occurred a quarter of a century ago. We cannot go back now, but it is beneficial to understand the various events surrounding the current debate and dilemma over osteopathic GME. 

Editor's note: Dr Rodos was the AOA's associate executive director from 1978 to 1979, when the AOA Task Force of Graduate Osteopathic Medical Education was developing its “Kellogg Report.”

  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.
Steier KJ. Rebuttal regarding the “hardship exception” [letter]. J Am Osteopath Assoc. 2005;105: 4-5. 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.
McDevitt FJ, for the Task Force on Graduate Osteopathic Medical Education. Introduction. The DO. 1981;21(suppl):3 .
McDevitt FJ, for the Task Force on Graduate Osteopathic Medical Education. Recommendations. The DO. 1981;21(suppl):72-74.
American Osteopathic Association Fact Sheet 2005. Chicago, Ill: American Osteopathic Association; August 2005. Available at: Accessed September 8, 2005.
American Osteopathic Association Yearbook and Directory of Osteopathic Physicians 1982–1983. Chicago, Ill: American Osteopathic Association; 1982:368 .