The two-tiered MD DO residency match system is about to end, as medical students will soon be able to apply using a single accreditation system for all residencies. By July 2020, the process of merging MD and DO schools into a common portal for residency matches/fellowships should be finalized.

Smoother, more transparent process

The Accreditation Council for Graduate Medical Education (ACGME), the organization single accreditation system | residency match system | DO, MD same residency match program | premedfaqoverseeing the merger, envisions a smoother, less duplicative, more transparent process for all students as they apply for residency matches. The change is intended to have the effect of providing additional opportunities for both MD and DO students.

After the change to the MD DO residency match system, all residency and fellowship applicants—from DO or MD schools—will be eligible to enter accredited U.S. programs. They will also be able to transfer between accredited programs without needing additional training. This will have the added benefit of keeping Medicare funding in place when transfers occur.

How will the MD DO residency match system affect MD students?

Since all schools—DO and MD—will be required to become ACGME-accredited, the transition for students should look somewhat seamless. MD students will still be able to apply to MD residencies, and can also apply for DO residencies if they meet prerequisites related to osteopathic medicine. In the past, MD students were not welcomed into the NMS match, even if they wanted to receive osteopathic training. Now, all MD programs with ACGME accreditation can apply for osteopathic recognition.

Every year there are some AOA (osteopathic) residencies that don’t fill. Those slots will now be available to the entire pool of graduating students whether they attended MD or DO school. All MD programs with ACGME accreditation will have to ensure their students are prepared to take on residencies that were previously DO-only slots.

What do DO students need to know about the ACGME MD, DO residency match system?

DO programs that apply for recognition and certification under the new residency and fellowship match program will qualify to match in the new ACGME process. (As of December of 2017, 62% of all DO programs were either accredited or had submitted an application through ACGME, with 140 applying to receive osteopathic recognition.)

In the past, DO students could only apply for MD residencies if they took the USMLE. Once the merger is complete, all programs will accept either the COMLEX or USMLE score. This might suggest that students need only take one or the other. However, given that all programs could become more competitive with more students bidding for the same residencies, DO students may still choose to sit for the USMLE to boost their chances in traditional MD residencies.

How to skip the COMLEX

Keep in mind that DO students looking to apply using COMLEX scores must meet the “exceptionally qualified candidate” provisions in the ACGME’s program requirements, and take the COMLEX Level 1, 2 and 3 exam in order to skip the USMLE completely.

Will DO programs shut down?

It’s possible that a DO program could apply to the system and come up short. If that happens, it’s likely the program would be shut down. However, an option will be open to extend the deadline in the case of schools that are actively working towards certifying if they simply have not met the deadline of July 2020.

It’s also possible that some AOA-only programs will voluntarily shut down when they determine that their sponsoring organizations don’t have the resources or patient loads required for the new ACGME MD DO residency match accreditation. This could impact the availability of available DO residencies.

Also, if your DO school is in the application phase and has not yet received its ACGME accreditation, you’ll need to go through the pre-merger National Matching Service match.

What are the benefits and/or downsides to the MD DO residency match program?

According to the administrator, the switch to a single accreditation system will ensure that all physicians in training “are held to a common set of milestones and competencies.” However, students will still have the option of joining other matches, depending on their desired specialty and whether or not they are in the military.

Residency programs always had to pay fees to two separate organizations (AOA and ACGME) and meet the prerequisites of both. As of two years ago, 150 programs were accredited by both organizations. This requirement will go away with the formation of one single accrediting system and organization.

A possible downside for both DO and MD students is that they are all competing for the same residencies, which could mean less available slots overall. Some DO prognosticators are worried that traditional DO slots could be snatched up by qualifying MD students, lessening the pool of residencies available to DOs.

Could more residency spots open up?

There is a move underway to solicit legislation in Congress to create up to 15,000 more residency positions over the next five years, in order to meet the perceived shortage in existing residencies. The legislation has no sponsors as of this date.

The fact is, no institution will have a quota to accept one applicant or another. DO schools are not required to accept MD applicants, nor are MD schools forced to accept DO residents. But the new MD DO residency match system will make it simpler to do so, as already happens. Every program will have more options, which should benefit everyone!

Here’s a quick read from the AMA.

Here are other links you may like:

—What does a resident do, and what do they get paid?

—Choosing a medical specialty

—How to reduce debt from medical school

—US MD and DO schools by state