Stephen C. Shannon, DO, MPH
Continued Growth at the Nation’s COMs and the Future of U.S. GME
The nation’s osteopathic medical colleges are recording a dramatic increase in enrollment this academic year. As reported in AACOM’s “Preliminary Enrollment Report – Fall 2013,” new osteopathic medical school enrollment has increased by 11.1 percent in 2013 over enrollment in 2012, with a total of 6,449 first-year students beginning instruction at one of 29 colleges of osteopathic medicine delivering instruction in fall 2013. Total enrollment at the colleges tops 22,000, nearly a 5 percent over fall 2012, with roughly 1 in 5 medical students in the United States studying to become osteopathic physicians.
This spike in enrollment numbers, amidst the steady growth in osteopathic medical school enrollment over the past decade, can be attributed in large part to the opening of three new colleges of osteopathic medicine this year: the Alabama College of Osteopathic Medicine (ACOM) in Dothan, AL; the Campbell University School of Osteopathic Medicine (CUSOM) in Buies Creek, NC; and the Marian University College of Osteopathic Medicine (MU-COM) in Indianapolis, IN. All three of these schools welcomed inaugural classes of student this fall and are each located in states previously without DO-granting institutions. The expansion of class sizes at the University of New England College of Osteopathic Medicine (UNECOM) in Biddeford, ME, and at the Pacific Northwest University of Health Sciences College of Osteopathic Medicine (PNWU-COM) in Yakima, WA, also contributed to the total growth in enrollment for fall 2013.
This year’s marked growth is accompanied by an increase in applications submitted through the AACOM Application Service (AACOMAS), the centralized application service for the nation’s osteopathic medical colleges (with the exception of the University of North Texas Health Science Center Texas College of Osteopathic Medicine (UNTHSC/TCOM), which processes applications through the Texas Medical and Dental School Application Service). During the 2013 application cycle, AACOMAS received 137,542 individual school applications from 16,454. There were 2.95 applicants for each of the 5,577 COCA-approved first-year class seats in fall 2013—a 10.1 percent growth in applicants and an 18.3 percent growth in applications over the 2012 application cycle. MD-granting medical schools are also experiencing growth in student enrollment.
It should be noted that these figures do not reflect the end of the anticipated growth in osteopathic medical school enrollment. The Liberty University College of Osteopathic Medicine (LUCOM) in Lynchburg, VA, is scheduled to open its doors to its first class of students in fall 2014, along with an additional Ohio University Heritage College of Osteopathic Medicine (OU-HCOM) campus in Dublin, OH and an additional Touro College of Osteopathic Medicine-New York (TouroCOM-NY) campus in Middletown, NY, and class size expansion is also being planned at a number of existing locations.
Despite repeated reports and projections of current and future physician shortages, current federal policy reflecting these issues is virtually non-existent. The availability of care in the nation is quickly becoming incapable of meeting the needs of a growing and aging United States population, and the lack of federal policy aimed at establishing a viable long-term solution to this issue generates real concern across a broad audience of key stakeholders, including medical educators, medical students, health policy experts, and many others. Perhaps nowhere is the abrogation of responsibility more evident than in the lack of federal funding and policy to support the necessary growth in graduate medical education (GME). As both MD- and DO-granting medical schools in the nation ramp up to graduate the number of physicians needed in our health care system, the level of support for specialty residency and fellowship training falls far short of what is needed. Although several worthy reform attempts have been made (e.g., see AACOM Supports Bipartisan Legislation to Expand Medical Residency Positions), overall GME is governed by a cap established in the Balanced Budget Act of 1997 and other lingering restrictions making innovations to improve the system very difficult to achieve. While at least 98.5 percent of DO graduates in 2013 obtained residency training program positions, the lack of GME growth coupled with the growth of United States medical school graduates (and ongoing numbers of international medical graduates seeking U.S. GME placement), raise doubts about the future of our nation’s health care system.
AACOM, of course, continues to work with its many partner organizations to highlight the growing crisis in GME as well as other obstacles and opportunities facing the U.S. health care and medical education systems; ensuring high-quality clinical training for medical students, enabling innovation in medical education curriculum, implementing new technologies, expanding diversity, and mitigating rising student loan debt are among these priorities.
AACOM believes that our osteopathic medical education system is producing the kind of physicians our nation needs, and we are currently engaged in strategic planning for the association’s future agenda in light of all the aforementioned circumstances in order to continue to address our mission: To “promote excellence in osteopathic medical education, in research and in service, and foster innovation and quality among osteopathic colleges to improve the health of the American public.”