Comprehensive Study Notes — “Welcome to the Profession”
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• Formal welcome to the profession of osteopathic medicine.
• Speaker/author credentials: \text{TIMOTHY J. KOWALSKI, DO, D.FACN} – Founding Dean of the VCOM–Carolinas Campus; Vice Dean for Professional & Public Relations; Board of Trustees member, American Osteopathic Association (AOA).
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Objectives (students should be able to):
Recognize that osteopathic physicians predominantly train and practice in primary care specialties versus non–primary-care specialties.
Identify the major osteopathic principles & practice (OPP) training requirements that enabled AOA + AACOM collaboration with ACGME to create the Single Accreditation System (SAS) for Graduate Medical Education (GME).
List major leadership positions developed for AOA & AACOM members within ACGME during SAS formation.
4–7. Compare what changed vs. stayed the same (residency accreditation, medical-school accreditation, board certification, licensing exams).Distinguish an ACGME program with Osteopathic Recognition (OR) from the new Osteopathic Neuromuscular Medicine (ONMM) residency.
Identify which residents (by degree) are eligible for OR tracks and ONMM residencies.
State the required licensing exam (COMLEX-USA Levels 1 & 2) for graduation from a COCA-accredited COM.
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• Class of 2029 at Edward Via College of Osteopathic Medicine (VCOM).
• Emphasis on earning entry into the “House of Medicine” through the DO door.
• VCOM culture: sharing, caring, family; mission-driven to serve those in need.
• Selection factors: academic rigor and character for service.
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• Many incoming students possess a servant’s heart—commitment to rural & underserved care, peer support, empathy.
• Osteopathic philosophy: healing from within – body, mind, spirit.
• Central tools: touch (OMT), preventive health, compassionate engagement.
• Every DO personalizes application of osteopathic principles; VCOM’s role is to equip students to practice osteopathically with passion, gratitude, loyalty.
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VCOM campuses:
• \text{Virginia}
• \text{Carolinas}
• \text{Auburn}
• \text{Louisiana}
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“Almost 200{,}000 strong!”
• Rapid growth – DOs & students quadrupled in three decades.
• Counts (AOA Masterfile, 2024):
– 157{,}456 osteopathic physicians.
– 39{,}942 osteopathic medical students.
– Total 197{,}398 DOs + students.
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• Osteopathic students now 28\% of all U.S. med-students.
• COM matriculants 2009–2023: growth from 5{,}260 to 8{,}636 per year (steady upward trend).
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• 43 accredited Colleges of Osteopathic Medicine (COMs)
• Represent \gt20\% of U.S. med schools.
• Training delivered on 69 campuses across 36 states.
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DO demographics
• Nearly 70\% of practicing DOs are under age 45.
• Female DOs = 45\% of DO workforce; rises to 48\% in the under-45 subset.
• Women now comprise >50\% of all COM students.
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• 57\% of DOs practice primary care; 43\% non-primary care.
• Primary-care head-counts:
– Family Medicine \approx30{,}235
– Internal Medicine 20{,}083
– Pediatrics 8{,}036
• Top non-primary-care fields (with DO counts & \% of total DOs):
– Emergency Med 10{,}363 (10\%)
– Anesthesiology 4{,}345 (4\%)
– OB-GYN 4{,}275 (4\%)
– General Surgery 3{,}894 (4\%)
– Psychiatry 3{,}883 (4\%)
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Medical schools producing most primary-care clinicians (top 22): first 7 are DO institutions; 15/22 are COMs. Notable rankings:
#1 ATSU–SOMA (AZ) … #22 VCOM.
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Schools with alumni in underserved areas (top 50): 14 COMs listed; COMs constitute 58\% of schools located in Health Professional Shortage Areas (HPSAs). Notable ranks: #1 OSU-CHS; #3 MSU-COM; … #43 UP-KYCOM.
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Practice-location tendencies:
• 86\% of students who attend med-school and residency in a state stay to practice there.
• 73\% of DOs practice in the state of residency training.
• 58\% of COMs situated in HPSAs.
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VCOM targeted recruitment (SE U.S., Appalachian & Delta regions):
• 84\% of students from targeted SE region.
• 50\% from designated rural areas.
• 64\% from medically underserved areas/populations.
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VCOM alumni practice patterns:
• 49\% rural.
• 56\% primary care.
• 59\% underserved areas.
• 73\% in combined target region.
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Creation of the Single Accreditation System (SAS)
• 2015–2020 five-year transition.
• Parties: AOA + AACOM joined ACGME.
• Purpose: accredit all U.S. residency programs (former AOA-only programs folded in).
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Leadership & structural changes:
• AOA & AACOM gained equal institutional membership on ACGME Board.
• Senior Vice-President, Osteopathic Accreditation position created (held by \text{Lorenzo Pence, DO}).
• New committees:
– Osteopathic Recognition Committee.
– Review Committee for Osteopathic Neuromuscular Medicine.
• DO representation added to each specialty Review Committee (RRC).
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Integrity safeguards:
• Only GME accreditation changed.
• Unchanged domains: board certification, undergraduate medical education (UME), licensing exams, CME.
• Collaboration limited strictly to residency accreditation.
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Summary table
✓ Changed: GME accreditation (now single via ACGME).
✓ Unchanged: Board certification, CME, Predoctoral education, COMLEX-USA.
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Osteopathic Recognition (OR) within ACGME programs:
• Distinctive OPP/OMT training embedded without extending residency length.
• Eligibility: DO and MD residents.
• Standards crafted with DO input to each specialty.
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Osteopathic Neuromuscular Medicine (ONMM) residency
• Newest ACGME specialty preserving high-level OMT expertise.
• Pathways:
– 3-year route (ONMM 1–3) incl. broad-based internship.
– 1-year program for physicians after another residency.
– 2-year entry after PGY-1 broad-based.
– Integrated 4-year FM/ONMM program.
• Same ACGME standards across tracks.
• Open to both MDs & DOs – graduates become board-eligible in ONMM.
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AOA/AACOM support mantra: “Helping you succeed through every stage of your career.”
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Medical-student parity efforts:
• Joint statements validating equivalence.
• ACGME directives promoting equitable residency selection.
• Outreach to program directors; adjustments in ERAS & VSLO policies.
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Specialty-college endorsements of holistic review & COMLEX-USA acceptance:
Family Med (10/2022), Psychiatry (4/2023), Pediatrics (5/2023), OB-GYN (9/2023), PM&R (5/2023), Emergency Med (10/2023), Anesthesiology (5/2023), Internal Med (3/2024).
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NRMP Match 2025 (DO seniors):
• Match rate: 93\%.
• 53\% matched into primary care; 47\% into other specialties.
• Match-rate growth since 2021: +3.5\%.
• Increased DO presence in Child Neurology (+4.9\%), Pediatrics (+2.9\%), Orthopedic Surgery (+1.3\%).
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Top 12 specialties for DO matches (2025):
Internal Med 2{,}067 (DOs occupy 16.6\% of IM spots).
Family Med 1{,}482 (32.6\% of FM).
Emergency Med 1{,}078 (35.9\%).
Pediatrics 645 (21.0\%).
Psychiatry 542 (22.8\%).
Transitional Yr 346 (21.4\%).
General Surgery 325 (13.3\%).
OB-GYN 315 (19.8\%).
Anesthesiology 308 (17.1\%).
Neurology 154 (16.6\%).
Orthopedic Surgery 131 (14.1\%).
Pathology 104.
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SOAP 2025 unmatched eligible applicants:
• US-MD 1{,}563
• US-DO 378
• US-IMG 2{,}038
• non-US IMG 6{,}056
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VCOM assures students that, by following strategic guidance, there will be a residency spot.
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Predoctoral accreditation unaffected:
• COCA (AOA) continues to accredit COMs.
• LCME accredits MD schools.
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AOA Board Certification promotes commitment to osteopathic distinctiveness.
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Board-certification structures unchanged:
• AOA Certifying Board Services (CBS) – 16 specialty boards, 27 primary specialties, 48 subspecialties.
• Allopathic counterpart: ABMS – 24 member boards, 40 specialties, 89 subspecialties.
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23 Osteopathic Specialty Colleges supporting DO specialists (AAO, ACOFP, ACOPeds, etc.).
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Licensure vs. Board Certification
• Licensure (state boards): requires DO degree, \ge1 yr GME, pass COMLEX-USA; legally permits practice.
• Board certification: voluntary, signifies specialty expertise; requires finished GME + specialty exam (AOA or ABMS).
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Licensing exams maintain professional distinctiveness:
• 2008 FSMB resolution validated COMLEX-USA & USMLE as equivalent for intended purposes while preserving distinct identities.
• COCA-accredited COMs mandate passing COMLEX-USA Levels 1 & 2 for graduation.
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AOA Mission: professional home, education, certification, advocacy.
AOA Vision: North Star guiding DOs, advancing interests & patient-care excellence aligned with osteopathic philosophy.
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Student leadership pathways within AOA: House of Delegates, Board of Trustees, and multiple bureaus/committees – stars (★) denote guaranteed student seats (e.g., Bureau of Emerging Leaders, COCA, Council of OMED).
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Advocacy infrastructure: AOA & AACOM Government Relations teams in Washington DC; initiatives include DO Day on Capitol Hill & AACOM Advocacy Day—students meet legislators.
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AOA membership benefits by career stage
• Students: free membership, advocacy, leadership, finance literacy, networking, research grants, OMED Residency Fair.
• Residents/Fellows: discounted dues, exam-prep, licensure support, etc.
• New physicians & mid/late career: CME tracking, business tools, Find a DO inclusion, continuous networking.
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Activate free AOA student membership; leadership/engagement venues:
• Advocacy, DO Editorial Board, Leadership Academy, OMED student track, AOF scholarships, Bureau of Emerging Leaders, SOMA collaboration.
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Inspirational close: “In four short years you will be here. You can DO it!”