Letters to the Editor  |   December 2009
Author Affiliations
  • Diane N. Burkhart, PhD
    AOA Department of Education, Chicago, Illinois; Secretary to the Task Force to Study the Impact of Admitting MDs into OGME Programs
Article Information
Medical Education / Graduate Medical Education
Letters to the Editor   |   December 2009
The Journal of the American Osteopathic Association, December 2009, Vol. 109, 652-653. doi:
The Journal of the American Osteopathic Association, December 2009, Vol. 109, 652-653. doi:
As director of the Department of Education at the American Osteopathic Association (AOA), I want to assure Student Doctor Brown and all AOA members that the current leaders in osteopathic medical education are committed to the development of high-quality AOA-approved residency programs in multiple specialties. In 2008, AOA President Carlo J. DiMarco, DO, focused his presidential theme on the development of osteopathic graduate medical education (OGME). 
Medical Education Summits (MES) I and II, in 2006 and 2007, brought together leaders from the entire osteopathic medical profession, including student and resident representatives. The AOA and the American Association of Colleges of Osteopathic Medicine have been busy implementing and tracking progress on recommendations that were approved at these summits, with the intent of providing high-quality education and training. Many innovative changes that support the needs of our graduates and trainees have already been approved and implemented. After MES I and II, the AOA developed a number of initiatives to remove barriers and streamline the accreditation process for OGME. It took almost 2 years of planning to restructure the osteopathic internship so that graduates from colleges of osteopathic medicine had the option in most specialties to start residency training immediately after graduation (effective July 2008). 
The AOA intends to be prepared for the physician workforce shortage predicted by about 2015,1,2 but we cannot achieve all the MES goals alone. The responsibility to create new training programs in competitive specialties and in desired geographical locations must be assumed by the entire osteopathic medical profession. The AOA is providing trend data to all stakeholders who have the opportunity to develop residency programs and training slots. For example, from 1998 to 2008, one popular surgical specialty demonstrated a 43% increase in number of AOA-approved residency positions. However, during the same period, the number of graduates from colleges of osteopathic medicine increased by 55%. Thus, this specialty should be reviewing its plans for growth in the future. 
Osteopathic physicians have been widely accepted into primary care specialty programs accredited by the Accreditation Council for Graduate Medical Education (ACGME)—though these are not considered competitive specialties. With the expected growth in number of allopathic medical school graduates over the next 4 to 5 years, all ACGME-accredited residency positions are likely to become more competitive.3 Strategic planning by the osteopathic medical profession is further complicated by difficulties in finding a balance between providing the number of residency positions in desired specialties and locations and meeting public healthcare needs. Finding funding for these positions is equally challenging. 
Leaders of the AOA agree that our profession must increase its efforts to reach out to osteopathic physicians in ACGME-accredited residency programs. As a result of Resolution 42 (A/2000, Approval of ACGME Training as an AOA-Approved Internship), ACMGE-trained osteopathic physicians are no longer required to prove significant hardship due to unusual or exceptional circumstances. Core rotations in an AOA-approved OGME program during the first year of residency are still required, but the AOA allows the rotations to match either the internship or first-year rotations approved in the osteopathic specialty. 
Very few applicants through Resolution 42 have been denied approval, and those applicants who were denied approval in previous years for not meeting the exceptional circumstances requirement have since been notified that they are now approved. In addition, the AOA Division of Trainee Services will work directly with ACGME training programs to approve the entire training program, and the division has also streamlined its operations, resulting in a quicker and less cumbersome process for applicants to complete. 
Applications for approval of ACGME training via Resolution 42—along with directions for completing the application and contact information for assistance—can be accessed on the DO-Online Web site ( by selecting the “For Residents” tab on the left side of the page, and then clicking on “AOA Approval of ACGME Training Applications.” 
The AOA staff in the Department of Education is dedicated to assist you in all matters related to training. The AOA Division of Trainee Services can be contacted at (800) 621-1773, extension 8276. 
Council on Graduate Medical Education. Physician Workforce Policy Guidelines for the United States, 2000-2020. 16th report. Rockville, MD: US Department of Health and Human Services; 2005. Accessed September 10, 2009.
Association of American Medical Colleges. Recent Studies and Reports on Physician Shortages in the US. Washington, DC: Association of American Medical Colleges; 2006.
Association of American Medical Colleges Center for Workforce Studies. Medical School Expansion Plans. Washington, DC: Association of American Medical Colleges; February2007 .