Currently, DO and MD residencies are matched in separate processes. In 2020, they merge into a single program. Today we're going to dive into what that actually means for MD students, specifically Trinity and its graduates. Not to get out ahead of ourselves but: the news is good.
There is a myth already out there that IMGs will have a more difficult time in the match because more US trained DO students will be applying for the same residencies. This is verifiably false. In fact, the opposite is true. MD students of any kind, including Trinity's graduates, will have a better opportunity to match after the merge. Let's get into why.
The upcoming merge is a lot more intensive than just the match processes coming together. Today, doctors of osteopathic medicine and medical doctors have separate residency curriculum, each with separate accreditation oversight.
In 2020, the DO's American Osteopathic Association (AOA) and the American Association of Colleges of Osteopathic Medicine (AACOM) will merge with the MD programs' Accreditation Council for Graduate Medical Education (ACGME). This will create a single accreditation system for graduate medical education in the US. In addition to bringing both pools of residencies under a single academic governance, it will collect all of the AOA (DO) and NRMP (MD) residents, into a single pool for a match. Everyone, including DO students, will use the ACGME's National Residency Match Program, the NRMP.
This has lead to the claim of tightening of competition for residencies for allopathic (MD) students like those studying at Trinity. Here's why it's false, and here's how it actually works: Because doctors of osteopathic medicine have to effectively know how to "be" an MD and a DO for regulatory reasons, they could traditionally apply for both residency matches (AOA and NRMP). They did this by taking both sets of licensing exams, the USMLE Step for the NRMP, and COMLEX for the American Osteopathic Match, that is, the DO match.
This was a statistical boon for them. DO students could try to match twice in a single year via two different large-scale matches. MD students, without access to DO training to take the COMLEX, did not apply for DO residencies via the AOA.
With the upcoming merger, all residencies will be MD residencies (although some will offer optional DO training for the DOs on top of the standard residency training). DO students will still take the COMLEX to graduate, but it will be sufficient to take part in the new, larger match. As a result, there will be significantly more residencies now available to MDs, even though there’s a net zero change in total residents, as far as "competition" goes.
Let's get into the math.
There were 3109 DO-only residencies available last year. Assuming all of them remain extant after the merge and opt to meet ACGME accreditation standards, that's an additional 3,109 matches that MD students previously did not even have access to. The DO students were only competing amongst themselves for those spots. Painting an even more sunny picture for MD students, even if DO-trained students match into the same residencies as last year, MD students still come out ahead with greater opportunity.
The AOA match in 2017 was only 71% overall. To that end, half DO students that matched into residencies at all went to NRMP residencies (50%), not DO programs. They're already "here." Furthermore, of the 3109 residencies exclusively available to DO students, only 2,214 were even filled. Last year, there were 895 DO residencies that went unfilled. If those 895 maintain their accreditation as residencies through the new match, and they likely will, that's an additional 895 residencies that are now open to MD students that were previously unavailable and went unfilled.
For context, the current General Medical Education bill (GME) funds the addition of 3,000 new residency slots each year across the US between 2015 and 2019 as a means of alleviating the physician shortage. The 895 unfilled spots alone are effectively a 29% bonus for MDs on top of that 2019 funding boost at no additional cost to taxpayers or hospitals.
Finally, the AOA's own website confirms that all matches will give equal weight to DO and MD students for every residency slot. This means that those DO students have the same "shot" they had before in the NRMP, while MD students have a significant boost in available slots through greater access.
It comes down to this: the merge itself will save a significant amount of money in an already taxed healthcare system through the streamlining of multiple bureaucratic processes into one. It will also consolidate quality standards into the umbrella of ACGME, further unifying and elevating the standards of advanced medical education in the United States. Ultimately though, it's a stress relief for DO students who will only need to take a single licensing exam to access their prior network of residencies, and a major boon for patients who need doctors, as well as Trinity students who will have access to significantly more residencies to serve their communities than ever before.
This is the first in what will be several pieces covering the differences between DO and MD programs for US and Canadian students, unforeseen challenges, and finding the right program for you.
There's no need to wait on the next post, though. You can contact us today and we'll answer your burning questions and help you make the next big step towards your career as a doctor.