So why osteopathic recognition? Who needs another drink from the ACGME application fire hose? Do any of you deserve another round of rejection? Let’s explore the why and then the how!
Some program directors plan to exercise their sense of loyalty to the osteopathic profession and outright select their residents from the osteopathic applicant pool. This may be perceived as equally discriminatory, as the MD residencies have been to the DO applicants in the past. This attempt at fair play may someday backfire if the osteopathic program director is replaced. Other directors plan to be more “objective” and rank whom they consider the best applicant regardless of their degree, and, eliminate the osteopathic component of their education or reserve it for the osteopathic resident with dual curricula. Ceding positions will effectively decrease orthopedic opportunities for osteopathic medical students. A hybrid, with some positions osteopathically recognized and others not, will yield the same decrease in opportunity for the DO applicant and still require completing another ACGME application. To me, this seems to be the worst of both worlds!
The education of our osteopathic medical students includes approximately 200 plus hours of OMM, OPP and OMT in the first two years and frequently a third-year clinical rotation as well. To understand the basic fabric of our ingrained osteopathic philosophy and assimilate with the osteopathic residents in a common curriculum, an applicant unfamiliar with this philosophy would have to become knowledgeable and as proficient as the osteopathic resident. Shouldn’t there be an equal opportunity for the MD or international applicant, if we are to someday expect parity of participation in each other’s programs? To achieve equivalence to the osteopathic programming, a prerequisite comparable education in OMM, OPP and OMT, prior to entering one of our programs, is available. Michigan State University has one such program, interestingly, developed by an MD. This can provide the prerequisite hours for the MD or international applicant. The exactitude of the details is hidden within those unwritten pages of the “unification” novel mentioned earlier. How many hours, what proficiency, what clinical utilization, and academic integration into the program is up to us to write.
The good news is that the osteopathic recognition application and acceptance process was not nearly as ominous as the original ACGME Accreditation. Dealing with the osteopathic recognition RRC has been more facile and pleasantly helpful. I have offered to share our application with anyone interested. Although we were not without citation, we were accredited first time and will fix any deficiencies promptly and share those amendments as well.
The concept of a reasonable quid pro quo, two-way acceptance, shoulder to shoulder training between the professions has always been an academic and professional goal of mine since graduation. Having trained and taught in both osteopathic and allopathic institutions, it remains my hope for the future. However, wishful thinking does not answer the call to maintain the osteopathic orthopedic identity that has evolved since the early 1900s. Osteopathic recognition is one way to preserve some of what we have already lost, and hopefully add a happy and equitable ending in the final “Unity” chapter. I would refer everyone to the History of the AOAO and its Contributions to the Osteopathic Profession by John H. Drabing, DO, FAOAO and David W. Smith DO, FAOAO as well as The American Osteopathic Academy of Orthopedics (AOAO), 75 years of Quality Healing, 1941-2016 by Daniel Beck.
I want to offer my special thanks to Laurel Lewis, C-TAGME.
Thomas G. DiPasquale, DO, FACOS, FAOAO
Medical Director
Orthopaedic Trauma Services
WellSpan Health York Hospital
Level One Trauma Center
Program Director
The Orthopaedic Residency of York
WellSpan Health York Hospital
An AGCME Accredited Program
Program Director
The Orthopaedic Traumatology Fellowship
WellSpan Health York Hospital
Level One Trauma Center