The development of our schools is segmented. There are the 5 legacy schools, which were established between 1892 and 1916. The first burst of expansion started in 1969 and ended in 1990; it was followed by the second burst, which occurred from 1992 through 2001. We have now moved from “burst” to “geyser.” With 26 schools in 32 locations and several more in development, our profession is national in scope. While most of our earlier schools were free-standing, the trend has moved toward more affiliations with larger institutions. Tax status has also entered the mix of the different variables seen in our COMs. The accreditation of the modern era's first-ever forprofit medical school, which is osteopathic, brought attention to that school. However, I found that regardless of a COM's tax status, osteopathic medical students exhibit the same pride in the profession and dedication to the tenets of Andrew Taylor Still, MD, DO.
Facilities at COMs vary greatly. From a converted department store in downtown Harlem, New York, with a policeordered 3-foot-wide main entrance or a revitalized military base with buildings dating back to the Civil War, to brand-new buildings standing alone in the grass or integrated into large university campuses, our schools do not look very much alike on the outside. On the inside, though, there is a great deal of similarity, with classrooms, libraries (some with actual books!), osteopathic manipulative treatment laboratories, and clinics. Inside our COM walls, we actually do look very much alike.
Faith-based connections for our COMs represent another evolution of our schools. We have COMs located in institutions of higher education that represent Baptist, Jewish, and Roman Catholic religious beliefs. There is a wonderful concordance between the faith-based emphasis on the sacred nature of the human being and the same emphasis osteopathic medicine places on the body's ability to heal itself. The religious backgrounds are clear (eg, the blowing of the shofar at Touro University California, College of Osteopathic Medicine's white coat ceremony), but all COMs are open and welcoming to students of all backgrounds. While this concordance reinforces our tradition of being a patient-focused profession, it has also introduced challenges in ensuring nondiscrimination for all students, a requirement for accreditation of a COM.
1 The American Osteopathic Association Commission on Osteopathic College Accreditation is doing an admirable of job balancing this equation.
Another important difference is that of public vs private status. While the majority of our COMs are still privately constituted, the development of publicly affiliated COMs has opened a new door to state support of osteopathic research and other resources. This is a major boon to the profession. While the funding for public COMs is much more robust than for private COMs, the vagaries of state budgets and legislative priorities provide a variable pressure not previously associated with osteopathic medical education.