Transcript The AOA Match and the Future of Osteopathic Residency Positions

The AOA Match and the Future
of Osteopathic Residency
Positions: The Good News
and the Bad News
MAME- March 7, 2012
Jon Rohrer, Ph.D., D.Min.
[email protected]
Associate Director
Perceptions
 What is your perception about the future of
osteopathic residency education?
 What is the evidential foundation of your
perception about the future of osteopathic
residency education?
 What impact does this have on your sphere of
influence and practice?
Presentation
 Overview of trends for colleges of osteopathic medicine.
 Summary of recent match results and positions
 Review of LCME accredited schools and ACGME
residency positions and the impact on the future of GME
for osteopathic students
 Observations and summary conclusions- good news bad
news with not recommendations for response and
application.
Total Enrollment in COMs
1968-2010
Total Enrollment
Thousands
22
20
18
16
14
12
10
8
6
4
2
0
1968 1973 1978 1983 1988 1993 1998 2003 2004 2005 2006 2007 2008 2009 2010
Total Enrollment
1.879
2.780 4.221
6.212
6.614
7.822
9.882
11.857 12.525 13.406 14.409 15.634 16.893 18.143 19.427
Data drawn from the AACOM Annual Osteopathic Medical School Questionnaire
Trends in COMs
 Significant Increase in Colleges of Osteopathic
Medicine
 Exponential Growth in Enrollment of Osteopathic
Students
 Disconnect with Osteopathic GME
DOs in Residency Training, 1995-2009
Totals in AOA and ACGME Programs*
Year
AOA
ACGME
Total
Percent in
AOA
1995
2606
3333
5939
43.9
1996
2141
3288
5429
39.4
1997
2632
3367
5999
43.8
1998
2998
3639
6637
45.1
1999
2928
3869
6797
43.1
2000
2781
4175
6956
39.9
2001
2499
4658
7157
34.9
2002
2532
5327
7859
32.2
2003
2523
5838
8361
30.2
2004
2422
5675
8097
29.9
2005
2535
6474
9009
28.1
2006
2989
6629
9618
31.1
2007
3289
6784
10073
32.7
2008
4794
7237
12031
39.8
2009
5247
7628
12875
40.8
*DOs in AOA/ACGME Accredited Programs are Counted Twice
Trends in Osteopathic Matching
1988-2011
3000
2500
2000
1500
1000
500
0
1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2011
Funded Slots
1515 1701 1799 1676 1877 1878 1814 1989 2147 2206 2312 2443 2553
Number Matched
1369 1257 1145 1385 1255 1353 1314 1291 1205 1196 1353 1473 1640
No. of Non-Participants
Unfilled Slots
146
502
654
291
661
663
994 1212 1363 1356 1748 1992 2114
622
525
500
698
942 1010
959
970
Funded Slots
Number Matched
No. of Non-Participants
Unfilled Slots
*Data drawn from AOA Office of Education and the AACOM Annual Report
913
AOA Deficit in Residency Positions
2005 to 2012
Thousand
s
4
2.8
1.6
0.4
2005 2006 2007 2008 2009 2010 2011 2012
Eligible DO Participants
.
2.908
2.886
3.173
3.600
3.899
4.106
4.581
5.014
Option 1 & 2 Slots
928
1.030
1.154
1.558
1.754
1.801
1.918
1.995
Residency Deficit
1.980
1.856
2.019
2.042
2.145
2.305
2.663
3.019
Positions Left Over in the AOA Match Program
2006-2012
Year
Traditional
Internships
Family Practice
Internal
Medicine
Other
Specialties
# of
Unmatched
Students
Unfilled
Positions
2006
615
170
93
132
123
1010
2007
534
180
88
120
182
922
2008
397
310
152
100
273
959
2009
422
306
173
101
361
1002
2010
379
339
174
78
423
970
2011
390
333
144
46
572
913
2012
351
302
142
93
606
888
Number of DOs in ACGME Residencies, 1992-2009
The Annual Number of DO Graduates, 1992-2009
7600
6800
6000
5200
4400
3600
2800
2000
1200
DOs in ACGME Progs.
No. of DO Grads.
92
94
96
98
OO
O2
O4
O6
O8
O9
3137
3264
3288
3639
4176
5327
5675
6629
7237
7628
1532
1732
1932
2096
2279
2536
2769
2814
3462
3724
DOs in ACGME Progs.
No. of DO Grads.
NRMP PGY-1 Slots 1975-2011
Number of USMD and DO Graduates
Year
PGY-1 Slots
USMD
Grads
DO Grads
1975
1980
1985
1990
1995
2000
2005
2010
2011
15691
18055
18535
20101
20751
20598
21454
22809
23421
12714
15135
16400
16179
15892
15714
15761
16427
16893
809
1151
1560
1534
1932
2510
2707
3845
4228
IMGs in ACGME Programs
1995-2010
32
Thousands
31
30
29
28
27
26
25
24
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Number
24,982 24,703 25,531 25,41525.880 24,707 25,40325,783 26,577 26.720 27,636 28,17628,824 29,48830,068 30,441
Number
DOs In The NRMP
1996-2011
Year
No. of Applic.
Active Applic.
Matched PGY-1 Unmatched PGY-1
1996
1176
799
552
247
1997
1185
790
509
281
1998
1343
890
614
276
1999
1451
984
671
313
2000
1665
1150
823
327
2001
1793
1241
876
365
2002
1859
1316
933
383
2003
1937
1408
995
413
2004
2034
1559
1099
461
2005
2043
1524
1045
479
2006
2222
1509
1024
485
2007
2398
1652
1136
516
2008
2711
1870
1339
531
2009
2875
2015
1408
607
2010
2045
1444
601
2011
2178
1561
617
Number of DOs Scrambling*
2006-2012
Year
Match
Participants
AOA Match
Results
NRMP Match
Results
No. in
Scramble
2006
2007
2008
2009
2010
2011
2012
2886
3173
3600
3899
4106
4581
5014
1196
1267
1353
1433
1473
1640
1767
1024
1136
1339
1408
1444
1561
666
770
908
1058
1189
1380
1311
*Includes Current and Past Graduates
Results of the 2010 Medical School Enrollment Survey June 2011- AAMC
Future Growth Trends: AAMC and AACOM
 Using a baseline of first year students enrolled in 2002, US MD
schools will increase by 22% from 16,488 to 20,181 by 2015.
 Using a baseline of first year students enrolled in medical schools in
2002 US DO schools will increase enrollment by 102% from 3,079 to
6,222
 By 2015, MD and DO schools will have a combined increase of 35%,
producing almost 7,000 more new doctors every year compared to
2002.
2012 Match Projections for
Osteopathic Students
 The final picture will only be known after the NRMP.
 2,352 Students did not participate in the AOA Match.
 70% of osteopathic students applying to the NRMP match
with a residency program
 30% will not match (705)
 705 unmatched NRMP +606 unmatched AOA match
candidates= 1311 students that will seek to fill 888 slots
that were unfilled in the AOA Match
 Some may find positions in the NRMP SOAP Program
Educational Directions MSUCOM Graduates
2010
2011
2012
MSUCOM Grads
192
187
197
SCS Hospitals
Other AOA
Programs
137
138
138
17
16
14
Military
Total AOA
Programs
10
7
7
164
161
159
27
26
24*
ACGME Programs
Not Matched in
AOA Match
*Not participating in AOA Match
13
MSUCOM: Top 10 Specialty Choices
AOA and ACGME Programs for 2010 and 2011
2010 List of Top 10
Number
2011 List of Top 10
Number
Internal Medicine
42
Family Medicine
43
Family Medicine
41
Internal Medicine
43
Trad. Internship*
29
Emer. Medicine
17
Emer. Medicine
22
OB/GYN
17
Anesthesiology
12
Trad. Internship*
12
Pediatrics
12
Pediatrics
12
PM&R
9
Neurology
9
General Surg.
8
Psychiatry
7
Orthopedic Surg.
8
Orthopedic. Surg.
7
OB/GYN
5
General Surg.
4
*Many Interns Matched to ACGME Advanced Residencies at the PGY-2
Level
SCS Composition by COM
Years 2000-2011
COM
2000
MWU/AZCOM
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
19
27
33
40
41
44
38
34
37
46
54
66
MWU/CCOM
52
51
58
46
46
54
44
56
74
71
61
NSUCOM
52
57
58
46
49
53
52
56
67
63
57
59
DMU/COM
159
141
134
110
88
90
117
120
130
120
124
113
KCUMB/COM
81
95
98
93
92
113
108
119
128
132
134
132
ATSU/KCOM
136
136
127
116
102
113
101
94
94
93
91
108
LECOM
4
19
24
23
35
61
73
79
113
112
105
96
UNECOM
18
19
13
9
9
9
13
20
17
18
17
14
MSUCOM
323
367
364
333
365
377
366
401
384
425
457
493
UMDNJSOM
4
6
6
5
1
1
7
6
4
6
5
6
NYCOM
8
13
17
13
19
18
25
20
15
13
14
14
OUCOM
14
22
22
21
17
17
18
18
17
24
20
22
OSUCOM
17
11
8
5
6
8
14
13
20
22
19
13
PCOM
20
28
23
23
21
26
22
22
20
17
20
22
6
8
10
12
8
17
25
37
39
46
43
20
15
16
15
14
22
25
23
27
28
22
19
8
13
19
30
34
42
41
48
41
48
37
PCSOM
UNTHSCTCO
M
TUCOM/CA
WVCOM
12
17
19
17
18
18
17
24
29
22
20
24
WU/COMP
56
55
46
42
36
36
42
44
36
42
46
46
4
11
16
24
29
VCOM
LECOM-FL
17
30
31
41
TUNCOM/NV
12
25
40
45
PCOM/GA
0
8
13
21
TUCOM/NY
0
0
0
4
RVUCOM
0
0
0
0
LMUCOM
0
0
0
18
ATSU/SOMA
0
0
0
8
PNWUCOM
TOTALS
976
1085
1081
979
1000
1099
1147
1223
0
0
0
0
1336
1404
1460
1547
SCS Intern and Resident/Fellows Numbers
2000 to 2011
1800
1600
1400
1200
Rotating Interns
1000
Residents/Fellows
800
Totals in OGME
600
400
200
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Rotating Interns
143 139 154 129 157 155 137 163
95
Residents/Fellows
867 812 812 883 891 979 10511115 1291 1366 1463 1549
Totals in OGME
1010 951 966 1012 1048 1134 11881278 1386 14601530 1616
94
67
67
SCS Primary Care vs. Non-Primary Care
2000 to 2011 Minus the Intern Count
1200
1000
800
600
400
200
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Primary Care
367.5318.5 281.5 289.5 261.5 276
298
316
353
368 416.5 463.5
Non-Primary Care
499.5493.5 530.5 593.5 629.5 703
753
804
951
998 1046.51085.5
SCS Hospital Match Summary
 SCS hospitals offered 436 slots for the AOA match (16% of the 2,655
positions offered nationally.)
 347 slots have filled, leaving 89 vacant positions
 Majority of the unfilled slots are traditional internships (33), family
medicine (26), and internal medicine (14).
 Given the number of students that did not match nationally in the AOA
match (606) and the projected number that will not match in the
NRMP, it is assumed that all open SCS slots will be filled.
Good News Bad News
Good News
Bad News
 Osteopathic Colleges will continue  GME will not grow to meet the
demands of the growth in
to grow.
osteopathic graduates.
 Hospitals with osteopathic slots will  The number of osteopathic
students will increase
fill their positions
\
 Michigan will be a destination for
osteopathic students seeking
osteopathic residencies,
particularly in the surgical
specialties
 The increase in MSUCOM
graduates will narrow the
availability of residency slots in
Michigan
Good News Bad News
Good News
Bad News
 The COCA Study Group on
 Measures recommended are too
Osteopathic Graduate Medical
little too late
Education has published a report
on recommended requirements for
osteopathic GME
 The AOA has formulated a Blue
Ribbon Panel to propose solutions
to the AOA BOE and BOT
 At this point, no one knows what
the recommendations will entail.
Conclusion: Multiple Factors in Play With
No Immediate Solutions
 Combined first year MD and DO enrollment in 2015 is projected to be
26,403, 35% above 2002.
 Increase in GME slots shows no significant projected increase to
correspond to the increase of students as the disparity between
student and GME slots worsens.
 Osteopathic dependence on ACGME programs will increase at a time
when MD students and IMGs grow in number.
 Osteopathic medicine will remain rooted in primary care.
 ACGME guidelines will restrict access of residents trained
osteopathically.
 All this against the projected shortage of physicians by 2020.
Good News Bad News
 Osteopathic dependence on ACGME programs
will increase
 Osteopathic medicine will remain rooted in
primary care
 The disparity between students and GME slots
will worsen
Jon Rohrer, Ph.D., D.Min.
[email protected]
scs.msu.edu