Abstract
The authors report on the status of osteopathic graduate medical education training for the 2010-2011 academic year. Data are presented on approved programs and trainee positions, including distribution by state and by specialty. The authors also examine other trends in postdoctoral training including programs dually accredited by the American Osteopathic Association and the Accreditation Council for Graduate Medical Education.
The annual report on osteopathic graduate medical education (OGME) is based primarily on annual data provided through the American Osteopathic Association (AOA) Intern/Resident Registration Program (ie, the AOA Match) and the AOA Trainee Information, Verification, and Registration Audit reporting system. Data in the present article are current as of May 31, 2011, and are reported primarily for the 2010-2011 academic year. Information on AOA-approved postdoctoral training programs and positions is drawn from the AOA database, and program information data are current as of May 31, 2011, except where otherwise noted.
The AOA Program and Trainee Review Council (PTRC) reviews and approves all OGME programs and positions. For the 2010-2011 academic year, 9110 positions were approved in 827 residency programs (
Table 1). This number of AOA-approved positions is an increase from the 2009-2010 academic year, at which time 8501 positions in 792 residency programs were approved.
1 The number of internship programs and approved internship positions continues to decline because of the internship restructuring program that began in 2008. Beginning July 1, 2008, the first year of training in a residency was accepted in lieu of the internship year and, for most specialties, the internship year was no longer needed for completion of a residency.
1-3 Internship positions for the 2010-2011 academic year totaled 1284 in 134 programs compared with 1318 positions in 142 programs for the 2009-2010 academic year. Internship and residency positions have increased by 575, or 5.9%, since the 2009-2010 academic year.
The number of trainees in OGME programs continues to grow (
Figure 1). In the 2010-2011 academic year, 6322 DOs trained in AOA-approved programs, an increase of 517 trainees, or 8.9%, from the previous academic year.
1
Table 2 identifies the number of residency programs, approved positions, and trainees by specialty for the past 3 academic years. On the basis of feedback we have received from hospital and program directors, primary care specialties directly support the needs of the hospitals and therefore have the greatest number of slots. Specifically, family practice and internal medicine continue to show strong growth in terms of the number of programs, positions, and trainees. Internal medicine showed the most growth this past year with an additional 6 programs, 196 positions, and 139 trainees. Family practice grew by 5 programs, 162 positions, and 134 trainees.
The percentage of filled positions in osteopathic residency programs continues to increase. In the 2010-2011 academic year, there were 827 AOA-approved residency programs with 9110 approved positions, of which 5731 were filled, for a fill rate of 63%—an increase over the 62% fill rate for 2009-2010 and 59% fill rate for 2008-2009.
2,3,8,6
Table 3 notes AOA-approved residency programs and approved and filled positions. From 2009-2010 to 2010-2011 there was a net growth of 35 programs, 609 positions, and 484 trainees.
Primary care continues to be a popular choice among trainees. Family practice and internal medicine trainees account for 23.5% and 16.3% of all osteopathic residents, respectively.
Most dually accredited training programs are programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) that carved out slots specifically for osteopathic trainees. Programs accredited by the ACGME that become AOA approved can maximize funding from the Centers for Medicare and Medicaid Services by filling training positions with osteopathic physicians.
9 Osteopathic trainees who complete a residency in a dual program are registered as completing both AOA and ACGME training programs and are eligible to become board certified by the AOA, the American Board of Medical Specialties, or both. As of May 31, 2011, a total of 2108 approved positions in 171 residency programs were dually accredited by the AOA and the ACGME.
7,9
Figure 2 is a map that depicts the geographic concentration of approved OGME positions. Programs approved by the AOA are located in 38 of the 50 states. Approximately 55% of all AOA-approved training positions are located in the following 4 states: Michigan, New York, Ohio, and Pennsylvania. Florida had the most growth in 2010-2011 with an increase of 10 programs and 196 approved positions. Also of note are increases in New York, with an additional 79 positions; Michigan, with an additional 58 positions; and New Jersey, with an additional 48 positions. Internship and residency data by state for the 2010-2011 academic year are also provided in
Table 1.
Data reports continue to show modest but steady increases in available OGME positions and trainees in AOA-approved slots. However, the percentage of growth has not kept up with the increasing number of graduating DOs each year. This insufficient growth has resulted in a decline of market share of DOs training in AOA-approved programs. Strategies to increase the number of training positions for graduating DOs have clearly become a new priority for the osteopathic medical profession. It is likely that DO students are looking for more training options in the AOA match, particularly in specialties and locations of interest, while efforts to increase primary care positions remain a priority of the government.
10
Although postdoctoral training positions have increased, the rate of increase has not kept up with the rate of students graduating from DO schools. Strategies to increase the number of residency slots for DO students continue to be an important priority for the osteopathic community.