The two-tiered system of matching medical residents in DO vs. MD schools is about to go away, as all medical students will soon be able to apply using a single residency match system for both DO and MD residencies. By July 2020, the process of merging MD and DO schools into a common portal for residency matches will be finalized.

Smoother, more transparent

The Accreditation Council for Graduate Medical Education (ACGME), the organization overseeing the merger, is seeking a smoother, less duplicative, more transparent process for all students as they apply for residency matches. The change is intended to provide better opportunities for both MD and DO students.

After the change, 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. Medicare funding for residencies will be kept in place when a transfer occurs.

MD and DO students combine residencies | residency match programs combine | premedfaq

Match me, residency!

How will the new accreditation system affect MD students?

All schools—DO and MD—will be required to become ACGME-accredited, but the transition for students should look seamless. MD students can apply to MD residencies, and also to DO residencies if they meet prerequisites related to osteopathic medicine. In the past, MD students were not welcomed into the NMS residency match, even if they wanted to receive osteopathic training. Now, all med students in 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?

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

In the past, DO students could only apply for MD residencies if they took the USMLE. Once the merger is final, all residency programs will accept either a COMLEX or USMLE score. Given that all programs could become more competitive with more students bidding for the same residencies, DO students may want to sit for the USMLE to boost their chances of a residency match in traditional MD residencies.

How to skip the COMLEX

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.

Could some DO programs lose their certification?

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 for schools that are working towards certifying if they haven’t met the deadline of July 2020.

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

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/downsides to single residency match accreditation system?

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.

In the past, residency programs had to pay fees to two separate organizations (AOA and ACGME) and meet the prerequisites of both to apply through both. As of two years ago, 150 programs were accredited by both organizations. This requirement will end with the formation of a single accrediting 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 schools are worried that traditional DO slots could be snatched up by qualified MD students, lessening the pool of residencies available to DOs.

Could more residency spots open up?

There is a move underway to ask Congress to create up to 15,000 more residency positions over the next five years, to meet the shortage in existing residencies. Unfortunately, the legislation has no sponsors yet.

With the combined system, no institution will be required 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 residency match system should make it simpler to do so. All programs will have more options, which should benefit everyone!