Osteopathic

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• Osteopathic
• Medical
• Education
• An overview for the NW Confluence
• Tom Levitan,
• VP for Research and Application Services
• AACOM
• March 21, 2009

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"I can't have information I know would be of
interest to someone and not share it." Sanford
Berman (former head cataloger, Hennepin County
Library System)
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• Goal
• To present a brief overview of some of the issues
  and developments around osteopathic medical
  education.

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Applicant Data Trends

• Nearly 1 in 5 US Medical Students attend an
  Osteopathic Medical College

Projected that by 2019 1 in 4 US Medical will be
attending an Osteopathic Medical College
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Total Applicants Average Designations

• Average Designations
• 2009 7.4
• 2008 7.0
• 2007 6.6
• 2006 6.2
• 2005 6.0
• 2004 5.5
• 2003 5.5
• 2002 5.7

Applications received by AACOMAS as of 3/13/09
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(No Transcript)
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AACOMAS Applications - 2009

• Profile of 2009 Application Cycle
• AACOMAS applications 93,670
• 12.9 Increase over 2008
• Number of applicants 12,729
• 8.2 Increase over 2008
• Average number of designations 7.4
• Increase from 7.1 over 2008

Source AACOMAS data as of 3-13-2009
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Academic Profile

• 2008 Entering Class
• Non-Science 3.57 Science 3.35
• Mean GPA 3.47
• Mean MCAT Scores Overall MCAT
• BS 9.13 8.70
• PS 8.40
• VR 8.59

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States with 100 Matriculants -- 2008
Source Applicant data on AACOMAS application
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Baccalaureate Majors 2008 Matriculants
Source Applicant data on AACOMAS application
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Age Distribution Applicants vs. Matriculants
Source Applicant data on AACOMAS application
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Family Members who are Physicians?

• Medical Background
• AACOMAS Question
• Do you have any family members who are D.O.s or
  M.D.s?

Source Applicant data on AACOMAS application
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Race and Ethnicity 2008
Race ethnicity responses are mark all that apply
or none. Applicants/matriculants may select
multiple responses so totals will not equal
100.
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Mean GPA Scores Applicants vs. Matriculants
Source Applicant data on AACOMAS application
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Matriculant Grade Point Averages
Source Until 2006 - AACOM, Annual Osteopathic
Medical School Questionnaires From
2007 Applicant data on AACOMAS application
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Mean MCAT Scores Applicants vs. Matriculants
Source Applicant data on AACOMAS application
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Mean MCAT Scores of Matriculants
Source Until 2006 - AACOM, Annual Osteopathic
Medical School Questionnaires From
2007 Applicant data on AACOMAS application
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Osteopathic Medical School Growth
Annual Growth Survey 2008-09
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Osteopathic Medical School Growth
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Osteopathic College Growth

• Activities in support of medical school growth
• Conducted assessments of financial needs and/or
  implications of expansion (reported by 16
  respondents)
• Conducted an assessment of the depth and quality
  of the applicant pool (reported by 14
  respondents)
• Added new clinical training sites (reported by 15
  respondents)
• Hired new faculty (reported by 11 respondents)
  and
• Constructed new teaching space and/or
  reconfigured existing teaching space (reported by
  11 respondents).

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Osteopathic College Growth

• Challenges to medical school growth
• Competition for rotations (despite a LARGE
  number of major teaching sites) looms for those
  places where MD and DO students co-exist. In
  places where allopathic schools are refusing DO
  students for rotations, our options are limited.
  Intrusion of offshore medical schools into our
  training areas is also occurring with HIGH
  payments for rotations to preceptors or
  hospitals. Our current model relies heavily on
  volunteer faculty who are loyal to our quality
  manner of education. We are concerned that future
  costs to pay these individuals will usurp
  strategic plans for other purposes.
• As the numbers of institutions, both MD and DO,
  continue to grow their class sizes, and as
  pressures continue to increase regarding provider
  productivity, there will be either increased
  pressure to limit the numbers of students at
  training facilities or an increased pressure to
  pay for undergrad clinical education.
  Furthermore, as GME funding stagnates or
  decreases, that too will have a negative effect
  on undergraduate medical education opportunities.
  This may be especially felt at the primary care
  physician level.

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Osteopathic College Growth

• Challenges to medical school growth
• Funding for expansion of facilities, growth of
  faculty, and increased operating expenses of
  larger classes. Several respondents note that
  growth cannot be financed solely by increased
  tuition revenue.
• Sufficient graduate medical education
  opportunities in specialties and geographic
  locations of interest to students.
• The availability of qualified faculty in both
  basic and clinical sciences.

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New Medical School Sites 2009

• LECOM to Expand Medical School to Seton Hill
  University
• Lake Erie College of Osteopathic Medicine
  (LECOM) received approval to open an additional
  site at Seton Hill University in Greensburg, PA. 
  
• LECOM will accept 104 students at this site,
  growing LECOM Erie to 354 students.
• MSUCOM Opens Two New Sites in Southeast Michigan
• Michigan State University College of Osteopathic
  Medicine (MSUCOM) received approval to increase
  its class size by 100 students.
• Students will pursue studies at two new
  locations
• Detroit Medical Center and Macomb University
  Center in Clinton Township.

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New Medical School Sites 2011

• Western University College of Osteopathic
  Medicine of the Pacific to Open Additional Site
  in Lebanon, Oregon
• Western University College of Osteopathic
  Medicine of the Pacific in Pomona, CA has
  received approval to open an additional location
  in Lebanon, Oregon.
• The first class will matriculate in August 2011
  and applicants will be able to apply in the
  AACOMAS 2010 cycle.  

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New Medical Schools

• New Medical Schools in the COCA accreditation
  process
• William Carey University, Hattiesburg, MS - 2010?
• A new medical school, Kansas City,
  MO 2011?

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Health Care Crisis of the 21st Century Primary
Care

• The United States faces a physician workforce
  crisis in Primary Care all parts of the country
  mostly rural underserved.
• Osteopathic Medical Schools are training and
  producing Primary Care Physicians to fill this
  void
• Number of DOs has increased 67 since 1990 to
  60,000
• DOs represent nearly 6 of the total U.S.
  physicians
• 15 of all military physicians
• 100 million patient visits annually are made to
  DOs

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Change in Intent to Pursue Primary Care
Data Source AACOM Survey of First Year Students
and Graduating Seniors
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Primary Care Career Plans and Educational Debt
Data Source AACOM Survey of Graduating Seniors
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Graduate Self Reported Debt
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Data source AACOM annual surveys of osteopathic
colleges. Osteopathic colleges reporting 19 in
2000 and 23 in 2005.
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Data sources AACOM annual surveys of
osteopathic colleges. AAMC Data Book,
2008. Osteopathic colleges reporting 19 in
2000 and 23 in 2005. Allopathic colleges
reporting 125 in both 2000 and 2005.
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Number and Source of Physicians Entering GME
Training in 2004
24,012 Entered MD and DO Training in 2004
IMGs 6,013 (25)
Osteopathic Graduates in DO Programs 1,285 (5)
Osteopathic Graduates 2,756 (11)
Osteopathic Graduates in MD Programs 1,471 (6)
Total IMGs 6,013 Distribution among US and
Non-US IMGs is estimated. Includes Canadian
Graduates (72) Source AAMC GMETrack and AOA
Master File
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US graduates/GME Projection Scenario (GME growth
rate continues at current rate)

• 25,400 (estimate) PGY1 GME positions 2006
• 13 DOs (2700)
• 27 IMGs (6800)
• 60 LCME (15,800)
• LCME DO grads 18,500
• In 2016 expect
• 5500 DO grads
• 19,000 MD grads
• LCME DO grads 24,500 for 28,000 PGY1
  positions
• Current scenarios, by 2020 expect 27,000 MD DO
  grads, 8500 more than 2006 for 29,500 PGY 1
  positions

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The Number of IMGs Entering GME Has Increased
More Than 25 Over The Past Decade
Sources 1995/96 to 2002/03 data based on Form
246 filings as of Aug. 2004. 2003/04 to 2006/07
data are from AAMC GME Track.
Note IMG numbers include Fifth Pathway
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Physician Workforce

• Projections continue to show shortage
• Most plausible scenario based on current trends
  160,000 shortage by 2025 (AAMC-2008)
• Assumptions on physician workforce
• Increased utilization
• Older physicians likely to retire earlier
• Younger physicians (especially females) likely to
  perform less clinical care
• MD schools likely to grow near 30 over next
  10-15 years
• DO schools likely to grow another 30 over next
  10 years
• GME expansion not sufficient to handle DO/MD
  growth
• Number of IMGs continuing to grow
• Assumptions about non-physician health care
  providers -- Number of PAs/NPs growing rapidly

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• Questions?
• Contact
• Tom Levitan, AACOM
• tlevitan_at_aacom.org