Resolution: S-20-33: PROTECTING FUTURE OSTEOPATHIC GRADUATES BY ENHANCING COCA STANDARDS THROUGH ADVOCATING FOR A RESIDENCY PLACEMENT FLOOR REQUIREMENT

[Valerie Lile]

WHEREAS, to meet the 30% increase in class size as recommended per the Association of American Medical Colleges¹ there has been a 31% increase in medical school enrollment since 2002, combined with first year matriculation at osteopathic medical schools, medical school enrollment is now 52% higher than in 2002-2003.²; and

WHEREAS, there has been a 27.9% increase in osteopathic medical school first year enrollment between 2013-2018, an increase from 6,135 to 8,124.^2,3; and

WHEREAS, 12 new colleges of osteopathic medicine have been established since 2013 with an additional 2 colleges that currently have applicant status per Commission on Osteopathic College Accreditation^4,5 and 13 M.D. schools with preliminary or provisional accreditation status with the Liaison Committee on Medical Education.⁶; and

WHEREAS, the single accreditation system of the Accreditation Council for Graduate Medical Education and American Osteopathic Association (AOA) residency programs will place osteopathic medical graduates in direct competition with international medical graduates, and the number of international medical graduate residency applicants has increased by more than 25 percent since 2012, and the number of international medical graduates accepted to ACGME residency programs has increased annually since 2012.^7,8; and

WHEREAS, before the single accreditation system, AOA residency spots were protected exclusively for D.O medical students, but now around twenty thousand M.D school graduates are eligible to apply to transitioning AOA residencies⁹, representing a drastic increase in competition for previously D.O protected AOA spots; and

WHEREAS, the increase in enrollment of undergraduate medical education is outpacing the increase of physician graduate medical education, and over the last 20 years, the number of residency spots has risen only 1% a year.²; and

WHEREAS, “Osteopathic Recognition” served as a mechanism to enhance D.O student’s prospects in residency matching, however less than 33% AOA residencies that have switched over to ACGME have applied for “Osteopathic Recognition.”¹⁰; and

WHEREAS, in 2012, COCA enacted guideline 8.3 recommending all Colleges of Osteopathic Medicine (COM) “strive to place 100% of their graduates into Graduate Medical Education programs”, and stated that “at a minimum this retrospective data should demonstrate a rolling average final placement rate of 98%.”¹¹ The part of the guideline beginning “at minimum…” was removed in 2016 from standard 8.3.¹² As of 2016, standard 8.3 was altered to only reflect a loose recommendation of 100% without any minimum expectation.¹² As of 2018, only Element 10.4 addresses GME placement but only requires that COMs publish their placement rate, with no minimum requirement suggested or required.¹³; and

WHEREAS, there is evidence that ACGME programs have discriminated against osteopathic medical school graduates in the past within the context of both residency selection and 4th year undergraduate rotation eligibility¹⁴; and

WHEREAS, Currently the D.O graduate placement rate is roughly 99.61%, ²⁰ but no protection is in place to ensure this number remains high; and, therefore, be it

RESOLVED, that the Student Osteopathic Medical Association (SOMA) adopt an official position to the Commission of Osteopathic College Accreditation (COCA) that all College’s of Osteopathic Medicine be required to maintain a 95% graduate placement rate over a 3 year average; and be it further

RESOLVED, that failure of meeting this requirement result in disciplinary action at the discretion of COCA.

Explanatory Statement

Former guideline 8.3 by COCA was not a hard floor requirement, but was a recommendation. The recommendation was made more lenient in 2016 before it was removed entirely. This resolution aims to establish a requirement in the same spirit of the original “minimal…” aspect of guideline 8.3 that used to exist in COCA standards before 2016.  Currently, the LCME does not have a comparable requirement. The situation of LCME accredited schools and graduates however is markedly different from that of COCA accredited schools in that LCME graduates do not experience significant issues matching into ACGME programs nor is there any research revealing any past or current discrimination on part of program directors towards LCME accredited medical school graduates. This resolution is a preventive measure keeping in mind exponential osteopathic medical school expansion in the last decade.  

References

1. Table B-1.2: Total Enrollment by U.S. Medical School and Sex, 2012-2013 through 2016-2017. (2016, December 19). Retrieved February 15, 2020, from https://www.aamc.org/download/321532/data/factstableb2-2.pdf
2. U.S. Medical School Enrollment Surpasses Expansion Goal (2019). Retrieved March 4, 2020, from https://www.aamc.org/news-insights/press-releases/us-medical-school-enrollmentsurpasses-expansion-goal
3. AACOMAS Profile: Applicant & Matriculant Summary Report. (2019). Retrieved February 15, 2020, from https://www.aacom.org/docs/default-source/data-and-trends/2019-aacomasapplicant-pool-profile-summary-report.pdf?sfvrsn=23a83a97_6
4. COM Accreditation. (2020). Retrieved March 4, 2020, from https://www.osteopathic.org/insideaoa/accreditation/COM-accreditation/Pages/default.aspx
5. American Osteopathic Association. Current List of Colleges of Osteopathic Medicine. Retrieved March 3, 2020, from https://osteopathic.org/wp-content/uploads/2018/03/colleges-ofosteopathic-medicine.pdf
6. Accredited U.S. Programs | LCME. (2020). Retrieved March 4, 2020, from http://lcme.org/directory/accredited-u-s-programs/
7. Education Commision for Foreign Medical Graduates. (2019). IMGs Continue to Show Gains in 2019 Match. Retrieved from https://www.ecfmg.org/news/2019/03/15/imgs-continue-to-showgains-in-2019-match/
8. The National Resident Matching Program (2019). Results and Data: 2019 Main Residency Match [Data File]. Available from http://www.nrmp.org/match-data/main-residency-match-data/
9. AAMC. Retrieved March 3, 2020, from https://www.aamc.org/download/321532/data/factstableb2-2.pdf
10. ACGME. Osteopathic Recognition Status Report. (2020). Retrieved March 3, 2020, from https://apps.acgme.org/ads/Public/Reports/ReportRun?ReportId=17&CurrentYear=2016&SpecialtyId=&OsteopathicRecognitionStatus=.
11. American Osteopathic Association. (2012). Commission on Osteopathic College Accreditation (Standard No. 8.3).
12. American Osteopathic Association. (2016). Commission on Osteopathic College Accreditation (Standard No. 8.3).
13. American Osteopathic Association. (2018). Commission on Osteopathic College Accreditation (Element 10.4). https://osteopathic.org/wp-content/uploads/2018/02/com-continuingaccreditation-standards.pdf
14. Connett, D. A. (2014). Effect of the Single Accreditation System. The Journal of the American Osteopathic Association, 114, 524-526. doi:10.7556/jaoa.2014.101
15. AACOM. (2018). 2018 Match Report. Retrieved March 3, 2020, from https://www.aacom.org/docs/default-source/data-and-trends/osteopathicmed-grad-placements-in2018.pdf?sfvrsn=d82d2597_10

 

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Submitted by:

Harris Ahmed, OMS IV – Burrell College of Osteopathic Medicine at New Mexico State University
Alana Castro-Gilliard, OMS II, Edward Via College of Osteopathic Medicine-VA
Yunus Bekir Tekin, OMS I – Burrell College of Osteopathic Medicine at New Mexico State University
Heather Jao, OMS I – Burrell College of Osteopathic Medicine at New Mexico State University
Furzan Azam OMS II, A.T. Still University School of Osteopathic Medicine Arizona (ATSU – SOMA)
Luis Zuniga, OMS I, Burrell College of Osteopathic Medicine at New Mexico State University
Sidra Ali, OMS 1, Burrell College of Osteopathic Medicine at New Mexico State University
Matthew Mansour, OMS I, Burrell College of Osteopathic Medicine at New Mexico State University

Action Taken:
Date:
Effective Time Period: Ongoing

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