Abstract
For the 2004-2005 academic year, as in preceding years, the number of graduates from colleges of osteopathic medicine (COMs) and the number of osteopathic medical internship positions approved by the American Osteopathic Association (AOA) continued to increase, by 2% and 1%, respectively. However, student participation in the AOA's Intern/Resident Registration Program dipped by 5% to a total of 44% for the class of 2005. Notwithstanding, a striking majority (1120 [91%]) of participating 2005 COM graduates were matched to their first choice training program—most often in traditional osteopathic rotating internships (63%). Next in popularity for osteopathic medical graduates were internships in family practice (11%), internal medicine (9%), and emergency medicine (5%). As a model for training, the traditional osteopathic rotating internship has undergone extensive revision in the past year as a result of extensive collaboration among the AOA's Council on Postdoctoral Training and each of the 23 osteopathic specialty colleges. The restructured plan will go into effect as of July 1, 2008.
Annual data on osteopathic graduate medical education (OGME) is reported using information gathered from the American Osteopathic Association's Intern/Resident Registration Program (ie, the AOA “Match”) and data reported by AOA-approved residency programs using the AOA's Trainee Information, Verification, and Registration Audit (TIVRA) reporting system. Although data from the Match does not change in a given year, program data does change because the AOA Council on Osteopathic Postdoctoral Training's (COPT's) Program and Trainee Review Committee meets quarterly to approve residency programs and positions. These new programs and positions are added to TIVRA at that time.
When compared with the data reported for the class of 2004,
1 the class of 2005 represented a 2% increase in the number of graduates from colleges of osteopathic medicine (COMs). Concurrently, there was an increase of 1% in the number of AOA-approved osteopathic medical internship positions available to these COM graduates—though this number is to be considered incomplete until finalized
1 in THE JOURNAL's 2008 Medical Education issue.
So-called match rates through the AOA's Intern/Resident Registration Program have dipped by 5% to 44%, with 1120 (91%) of the 1228 participating COM graduates being matched to their first choice training program. For match participants, the majority (778 [63%]) seek and obtain traditional rotating internships, followed by internships in family practice (137 [11%]), internal medicine (106 [9%]), and emergency medicine (64 [5%]).
In July 2006, the AOA's Board of Trustees and House of Delegates supported a COPT resolution for restructuring the traditional osteopathic internship (ie, Resolution 19 [A/2006]—Restructuring of the Osteopathic Internship). After long-standing discussions about the traditional rotating internship's ongoing relevance,
2 ongoing deliberation by the COPT, and widespread conjecture within the osteopathic medical profession,
3 the plan for restructuring is finally complete.
4 The arrangements for this new postgraduate training model are moving forward quickly and will go into effect July 1, 2008.
After reviewing the three options, each specialty college specified its preferred model for OGME in the first year of postgraduate training (OGME-1) (
Figure 1):
Students who subsequently choose to enter a medical specialty that has selected either option 1 or option 2 for its trainee pathway must then contact their specialty college to determine whether advanced standing will be granted. Obtaining advanced standing will depend on the number of residency positions available (if any) because most will already have been filled with matched first-year trainees who are advancing to AOA OGME-2 positions. All option 3 positions will be recorded as internship positions in the AOA's TIVRA reporting data. In addition, the COPT has decided to retain the same six rotation requirements as in the existing/current version of the internship for the option 3 requirement (
Figure 2).
Each specialty college is in the process of defining its first-year rotational requirements. These requirements will be submitted to the COPT for review in April. As this restructuring continues, the Association and the COPT will provide additional information to the osteopathic medical profession well in advance of the July 2008 launch date.
At the nation's COMs, a total of 2826 students graduated in the class of 2005 (
Table 1). The addition of 57 students to COM capacity reflects a 2% increase on the 2769 graduates from the class of 2004.
1 The number of approved osteopathic medical internship positions available to COM graduates increased by 36 (1%), from 2616 positions in 2004 to 2652 positions in 2005.
1
The AOA's Intern/Resident Registration Program provides osteopathic medical students with an opportunity to secure osteopathic internship positions before graduation. Data on students from the class of 2005 who participated in the AOA's Intern/Resident Registration Program is presented in
Table 1. A total of 1228 (44%) class of 2005 COM graduates participated in the program and were matched to osteopathic internships for the 2005-2006 academic year. Although a large number of COMs had 50% or more of their participating graduates matched to internships through this program (
Figure 3), for the class of 2005, Michigan State University College of Osteopathic Medicine (East Lansing) once again had the highest percentage of participating graduates matched.
1,5-8 Of its 124 graduates, 107 (86%) of Michigan State University College of Osteopathic Medicine's students secured internship positions through the Match during the 2005-2006 academic year.
Somewhat predictably, participation in the AOA's Intern/Resident Registration Program is lower for COMs located in states with fewer osteopathic postdoctoral training opportunities. Of the 1228 participating students, 1120 (91%) were matched to the internship positions they listed as their first choice (
Table 1).
In the class of 2005, 778 (63%) of COM students chose a traditional osteopathic rotating internship (
Table 2). Collectively, about 25% of the matched students in this graduating class chose internships in emergency medicine (64 [5%]), family practice (137 [11%]), or internal medicine (106 [9%]). These figures are comparable to data previously reported for the 2769 students who graduated in the class of 2004. For these students, 774 (65%) of the 1196 participating students were matched with a traditional rotating internship and approximately 26% chose internships in emergency medicine (69 [6%]), family practice (120 [10%]), or internal medicine (116 [10%]).
1
As noted elsewhere, annual data on OGME is reported using information gathered from the AOA's Intern/Resident Registration Program and data reported by AOA-approved residency programs using the AOA's TIVRA reporting system. Although data from the Match does not change in a given year, program data does change because the AOA COPT's Program and Trainee Review Committee meets quarterly to approve residency programs and positions. These new programs and positions are added to TIVRA at that time. Program data presented in this article is current as of May 31, 2006, and will be finalized
1 in THE JOURNAL's 2008 Medical Education issue.
Because of a reduction in the number of AOA-approved internship training positions available in several of the traditional “Big Six” states,
1 Illinois gained in relative prominence for this measure during the 2005-2006 academic year. Approximately 75% of all AOA-approved internship training positions currently available are located in seven states (
Table 3): Florida, Illinois, Michigan, New Jersey, New York, Ohio, and Pennsylvania. When compared with data for the 2004-2005 academic year,
1 the number of approved internship positions for the 2005-2006 academic year increased in 9 states and decreased in 10 states (
Figure 4).
In the 2005-2006 academic year, there were 649 AOA-approved residency training programs (
Table 4), representing a 14% increase over the 569 programs reported for the previous academic year.
In addition, there were 2535 residents in AOA-approved training programs in the 2005-2006 academic year, representing a 5% increase from the 2422 residents in training during 2004-2005.
The AOA has established mechanisms by which osteopathic physicians may obtain approval for training provided through residency training programs approved by the ACGME (ie, Resolution 42 [A/2000]—Approval of ACGME Training as an AOA-Approved Internship). This approval is key for osteopathic physicians seeking medical licensure in states that require an osteopathic internship (ie, Florida, Michigan, Oklahoma, Pennsylvania, and West Virginia) and for physicians who seek osteopathic specialty board certification. Between July 2001 and October 2006, a total of 1241 osteopathic physicians petitioned the AOA for approval of their first year of ACGME postgraduate training. As of October 10, 2006, 774 (62%) of these applications have been approved; 455 (37%), approved pending completion of residency training or requirements under Resolution 42; and 12 (<1%), denied.
The AOA's Division of Postdoctoral Training continues to look forward to working with osteopathic training programs and their osteopathic postdoctoral training institutions during the coming year as the new internship process is implemented. Postdoctoral residency training continues to demonstrate positive growth in geographic regions where osteopathic opportunities were previously limited for COM graduates. The AOA is committed to working collaboratively with other stakeholders in OGME to provide high-quality training opportunities to COM graduates.