Graduate Medical Education (GME)

The education students receive in an osteopathic medical school is undergraduate medical education, and the subsequent training provided in a residency and fellowship program is graduate medical education (GME).

After graduating from an osteopathic medical school, students seeking licensure continue training in graduate training programs called “residency,” the first year of which may be called an “internship” or a “transitional year.” Successful completion of a residency program is required for specialty board certification.

GME typically focuses on one field of practice. Examples include family medicine, pediatrics, emergency medicine, surgery, preventive medicine, dermatology, radiology, and others.

Two organizations currently accredit GME programs: the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA), which accredits osteopathic residency programs only. As of July 1, 2015, implementation of a single GME accreditation system (SAS) is underway under the umbrella of the ACGME. The new system is slated to be in place by June 30, 2020. By the end of the transition period for the single accreditation system (June 30, 2020) the AOA will no longer accredit residency programs. As a result of this new system, there will be significant changes to GME that will ease the application and participation process, as well as broaden opportunities to participate in GME programs.

Osteopathic Recognition

In the new GME accreditation system, osteopathic medical school graduates have the option to pursue ACGME programs with an osteopathic emphasis or programs with “Osteopathic Recognition” designation. Any ACGME-accredited program can apply to receive Osteopathic Recognition, which indicates that osteopathic principles and practices are integrated within the training program. Osteopathic medical students can pursue programs with osteopathic recognition in all the options below. Students can view an up-to-date list of programs with the ACGME Osteopathic Recognition designation on the ACGME’s website at Learn more and keep up with changes on the transition to the single accreditation system at

In pursuing GME, osteopathic medical school graduates can choose the following options:

1. Residency (Categorical): A graduate of a college of osteopathic medicine can match directly into a residency program and start specialty training. A “categorical” position is one which offers full residency training required for board certification in that specialty.

2. Preliminary: The doctor of osteopathic medicine chooses to go into a specialty and will be in a first-year program that may be separate or linked to the specialty training they will pursue. Some specialties will require a preliminary year.

3. Transitional Year: A one-year training program in multiple clinical disciplines designed to facilitate choice of and preparation for a specific specialty.

4. Military GME

5. Fellowship: A graduate of a residency training program may choose to pursue further training in a particular sub-specialty.

Residency Match

Graduating osteopathic medical students apply to hospitals and programs that offer their preferred GME programs. Applications to GME programs are administered through the Electronic Residency Application Service (ERAS). Following interviews that provide students and programs with information about each other, students submit their choices, ranked from their first to last choice. Programs also rank the applicants they would like to have working in their programs.

DO students typically enjoy a high rate of placement into GME programs. Current match data reflect the existing match processes—National Resident Matching Program (NRMP) and AOA National Matching Service (NMS) systems—in a given year. The 2020 match is expected to be the first in which there will be a single match system administered by the NRMP, although this could occur earlier as AOA-accredited programs receive ACGME accreditation with the transition to the single accreditation system for graduate medical education (July 2015 through June 30, 2020). This single system will simplify the matching process for osteopathic medical school students. A result of the new process will be a shift in the way the match rate percentage is reported, and AACOM will continue to provide details on these changes.

Osteopathic Physician (DO) Medical Education Timeline

Academic Degrees

4 years undergraduate study (Bachelor's degree)

4 years osteopathic medical (DO) degree

Board Certification / Licensure

3 - 7 years internship / residency

1 - 3 years specialty fellowship

Medical Education Roadmap
Complete training to become a physician includes supervised
post-doctoral graduate medical education (GME) training in a
specific field of medicine.