Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The merging of MDs and DOs: A unification of training standards

John Schumann, MD
Education
March 13, 2014
Share
Tweet
Share

More than a century of American medical history was turned on its ear recently by the announcement that the groups that accredit medical residencies will unify their standards. Don’t be too hard on yourself if you failed to understand the significance (or notice at all). But this should be viewed as good news across the land. As someone who trains doctors from both traditions, I certainly welcome a more level playing field.

First, a little background.

Osteopathic physicians (those with a D.O., or doctor of osteopathy degree) have a history dating back to the 1800s. They comprise slightly more than 10% of practicing doctors in the United States. Currently, there are 35 osteopathic medical schools, compared with 135 allopathic institutions, the kind that confer the M.D. (doctor of medicine) degree.

Though historically the two educational paths varied in principles and practice, there aren’t many remaining differences. Both disciplines now use biomedical science as their core. Originally, osteopathy relied on manipulation of bones and joints to diagnose and treat illness. This tradition, known as osteopathic manipulative treatment (OMT), lives on in the osteopathic curriculum, though it’s now mostly used as an adjunct for treatment of chronic musculoskeletal conditions. Today, most D.O.s leave OMT behind after they finish their training.

Throughout the 20th century, as allopathic medicine became the dominant model, its practitioners and leaders sought to discredit osteopathy. Attempts to unite the fields have come in sporadic fits and starts. The warring sides reached a detente of sorts in 1969, when the American Medical Association granted full and unrestricted membership to D.O.s.

Osteopathic doctors play a vital role in U.S. health care, as about 60% of D.O.s practice primary care, a far higher percentage than M.D.s, who mostly subspecialize. Osteopathic education also emphasizes rural health and community care. In states with strong osteopathic schools, like Oklahoma (where I practice), Iowa, and Michigan, D.O.s constitute about 20% of the physician population.

The announcement about unification of accreditation standards only applies to graduate medical training, or what is commonly known as residency, the three-to-seven year period of training after medical school that leads to licensure and certification. The agreement will be phased in between 2015 and 2020, as the governing bodies for the osteopathic movement align their training standards with those of the Accreditation Council of Graduate Medical Education (ACGME), the large Chicago-based non-profit that accredits more than 9200 residency programs across the U.S.

The agreement brings competency standards into alignment for all physicians, which in the long run will allow those of us involved in training the nation’s physicians to speak with a more unified voice. This will help foremost with question of funding for residency programs, which for decades have been funded almost exclusively by the federal Medicare program. At an annual cost of nearly $10 billion, members of Congress have been threatening to put this funding on the chopping block.

One thing I wonder is whether the unification of training standards will do anything to address the perceived shortage of primary care doctors.

Speaking in a conference call about the historic agreement, American Osteopathic Association President Norman Vinn noted that the osteopathic focus on primary care would not change. Further, he stated, “Future growth would include primary care, community-based hospitals, and rural and underserved communities.”

John Schumann is an internal medicine physician who blogs at GlassHospital.

Prev

When patients ignore the evidence: Try to understand their values

March 13, 2014 Kevin 18
…
Next

Why isn't tranexamic acid used more often in routine practice?

March 13, 2014 Kevin 1
…

Tagged as: Primary Care, Residency

Post navigation

< Previous Post
When patients ignore the evidence: Try to understand their values
Next Post >
Why isn't tranexamic acid used more often in routine practice?

ADVERTISEMENT

More by John Schumann, MD

  • Doctors as the gatekeepers of marijuana is a race to the bottom

    John Schumann, MD
  • Rallying at the end of life

    John Schumann, MD
  • The evolution of a hospital admission

    John Schumann, MD

More in Education

  • Why medical student debt is killing primary care in America

    Alexander Camp
  • Why the pre-med path is pushing future doctors to the brink

    Jordan Williamson, MEd
  • Graduating from medical school without family: a story of strength and survival

    Anonymous
  • 2 hours to decide my future: Why the NRMP’s SOAP process is broken

    Nicolette V. S. Sewall, MD, MPH
  • What led me from nurse practitioner to medical school

    Sarah White, APRN
  • Bridging the rural surgical care gap with rotating health care teams

    Ankit Jain
  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • Why Canada is losing its skilled immigrant doctors

      Olumuyiwa Bamgbade, MD | Physician
    • How to speak the language of leadership to improve doctor wellness [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • Why Canada is losing its skilled immigrant doctors

      Olumuyiwa Bamgbade, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Would The Pitts’ Dr. Robby Robinavitch welcome a new colleague? Yes. Especially if their initials were AI.

      Gabe Jones, MBA | Tech
    • Why medicine must stop worshipping burnout and start valuing humanity

      Sarah White, APRN | Conditions
    • Why screening for diseases you might have can backfire

      Andy Lazris, MD and Alan Roth, DO | Physician
    • How organizational culture drives top talent away [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 5 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • Why Canada is losing its skilled immigrant doctors

      Olumuyiwa Bamgbade, MD | Physician
    • How to speak the language of leadership to improve doctor wellness [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • Why Canada is losing its skilled immigrant doctors

      Olumuyiwa Bamgbade, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Would The Pitts’ Dr. Robby Robinavitch welcome a new colleague? Yes. Especially if their initials were AI.

      Gabe Jones, MBA | Tech
    • Why medicine must stop worshipping burnout and start valuing humanity

      Sarah White, APRN | Conditions
    • Why screening for diseases you might have can backfire

      Andy Lazris, MD and Alan Roth, DO | Physician
    • How organizational culture drives top talent away [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The merging of MDs and DOs: A unification of training standards
5 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...