A new “Letters to the Editor” section is being added to The Orthopod that allows AOAO members to comment on publications, discuss aspects of the practice of Osteopathic Orthopedic Surgery, or offer opinions on any subject pertaining to our profession.
For the inaugural editorial, I have asked Dr. Richard Howard to give us his perspectives on Osteopathic vs. Allopathic Orthopedic Surgery Residency. Dr. Howard is uniquely qualified to comment on this topic, being a career-long resident trainer in both sides of the profession.
It is an honor to write to a life long friend in this venue. We have enjoyed each other’s counsel for many years. As you and I come to the sunset of our careers, the field of osteopathic orthopedic surgery is in a crisis of identity. The change to ACGME accreditation of our programs has resulted in the closing of a number of programs (mine included), and the questionable future of many other programs. This is a good time for us to appreciate the value of what we (osteopathic orthopedic surgeons) contribute to our communities.
My perspective on this is unique, in that I have taught orthopedic surgery in both allopathic and osteopathic programs over the last 30 years. In addition, I have served on the AOBOS and the ACGME for orthopedics. From this perspective I have witnessed many training models, and I know that our approach works best.
Our allopathic colleagues don’t agree. The “apprentice model” is the term they use to describe our training approach. They prefer a team approach in which learners learn from each other and their professors. The crux of our current identity crisis is that we are being forced into their mold. I challenge program directors and the AOAO to prevail in this struggle.
Although osteopathic orthopedic programs are changing to meet the ACGME standards, we must preserve our identity and concepts of training. I truly believe the osteopathic method produces a more competent community surgeon. I believe this comes from our greater emphasis on psychomotor performance in training, and consequent decreased emphasis on scholarly activity. The ideal program will be the merger of both! While we are in the storms of change we may not appreciate the value of the merger.
I believe we have much to contribute under the ACGME, but we must maintain our unique identity and methods of training. Our graduates are a testimony to the quality of our residents, and the dedication of our all-volunteer trainers.