If you are a medical student training at an osteopathic medical school—a population that represents roughly a quarter of U.S. medical students—you should understand that changes to accreditation systems designed to increase your options may affect how residency programs view your board exam scores, which board exams you take and when and how you match with a program. Read on to get the details that will affect your future as a physician.

Whether you're an osteopathic or allopathic medical student navigating the Match, FREIDA™—a comprehensive AMA tool that captures data on more than 11,000 residency and fellowship programs accredited by the Accreditation Council on Graduate Medical Education—will help you find the right fit.

FREIDA, the AMA Residency & Fellowship Database®, offers more than 35 filters to sort programs by location, program type, application information, demographics, benefits, special tracks and more to help applicants find all of the programs available within their desired specialty throughout the country.

Why are these changes taking place and what do they mean for students pursuing a doctor of osteopathic medicine (DO) degree? Here’s a quick primer.

Out of many, one

In an effort to simplify the graduate medical education accreditation system in the United States, the organizations that accredit GME—the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA)—are changing how they do things.

As part of that process, residency programs that were accredited by the AOA for graduates of osteopathic medical schools—students who earn DOs rather than doctor of medicine degrees (MDs)—are moving into the ACGME. For those wondering how this affects your Match, FREIDA has a filter for programs that are osteopathic-focused or have become accredited by the ACGME as part of the single accreditation system.

The impact on licensing exams 

One potential hiccup in that transition is the incorporation of the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) into the residency application process at ACGME-accredited residency programs.

The COMLEX is required for graduation with the DO degree. Students in MD programs take the United States Medical Licensure Exam (USMLE).

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More than two-thirds of ACGME-accredited programs were accepting the COMLEX as part of their evaluation of osteopathic medical student applicants, according to a 2018 survey of residency program directors conducted by the NRMP National Resident Matching Program (NRMP).  Still, certain program directors report requiring the USMLE exam for all applicants, including DOs.

That logic seems to run contrary to the data—a recent study of the exam results of 795 students from three osteopathic medical schools who took both USMLE Step 1 and COMLEX Level 1 found that there was "a strong association between COMLEX Level 1 and USMLE Step 1 performance." Because there may be some unfamiliarity among program directors who are MDs—and may have limited experience interpreting COMLEX scores—the AMA House of Delegates has adopted policy to promote equal acceptance of the USMLE and COMLEX at all U.S. residency programs.

Note: The AMA selected Kaplan as a preferred provider to help you study for the USMLE or COMLEX-USA exams. AMA members can save 30 percent on access to additional study resources, such as Kaplan’s Qbank and High-yield courses.

The effect on residency match

In the past, residency programs for trainees from osteopathic medical schools and allopathic medical schools have generally matched with residency programs through separate processes.

DO students who matched with AOA-accredited programs did so the through the National Matching Service in January, while MD students matched with ACGME-accredited programs through the National Resident Matching Program in March.

That will change by 2020. At that time, most medical trainees matching to residency programs that are ACGME-accredited, which will be the vast majority of programs for DOs and MDs, will do so through the NRMP in the spring.

The changes are already beginning to take hold as more DO residency programs gain ACGME accreditation. Last spring, 4,617 U.S. osteopathic medical school students and graduates submitted program choices in the NRMP’s Main Residency Match. Since 2014, the year of the announced move to a single GME accreditation system, the number of U.S. osteopathic medical school students and graduates seeking positions has risen by nearly 70 percent, according to NRMP data.

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