Senate FAIR Act Introduction Builds Momentum for DO Residency Parity

Legislation increases rural health access and residency fairness for DOs

IMMEDIATE RELEASE

(Bethesda, MD) – Today, the American Association of Colleges of Osteopathic Medicine (AACOM) celebrates the Senate introduction of the Fair Access In Residency (FAIR) Act led by Senators Steve Daines (R-MT), Martin Heinrich (D-NM) and Angus King (I-ME). This bill would ensure residency fairness for osteopathic graduates, marking the first time the Senate has joined the House in introducing this legislation. Its bicameral, bipartisan introduction demonstrates growing momentum for achieving fairness in residency for osteopathic medical students, who represent nearly 30 percent of the current medical school population.

“It is difficult to overstate the importance of the Senate’s FAIR Act introduction,” said AACOM President and CEO Robert A. Cain, DO. “Having both congressional chambers advance this bill brings us one step closer to parity for DOs and improved access to healthcare for communities across the country, especially those in rural and underserved areas. AACOM deeply appreciates the leadership and support of Senators Daines, Heinrich and King in championing this vital effort.”

Despite recent gains, osteopathic applicants still face unfair barriers when applying for residency. According to the National Resident Matching Program, 29 percent of residency program directors never or seldom interview DO candidates, resulting in 35 percent of DO students not ranking in their preferred specialty or program. Among directors who do interview DOs, 73 percent require them to take the MD licensing exam, the USMLE, even though DOs must pass their own comprehensive licensing exam, the COMLEX-USA. The extra exam costs individual DO students an additional $2,335 and 32 hours of exam time, as well as the cost and time to study for the USMLE.

The FAIR Act would require Medicare-funded graduate medical education programs to report on residency applicants and accepted residents, as well as affirm that DO applications and the COMLEX-USA are accepted for consideration. The FAIR Act does not federalize the practice of medicine or establish quotas of DO or MD residents.

“DOs are essential to the physician workforce and provide millions of people in Montana and across the nation with quality care. DOs put in countless hours of hard work and personal sacrifice to help others, but often face unnecessary barriers when applying for residency programs. I’m glad to work with my colleagues on the FAIR Act, which will increase transparency into Medicare-funded residency programs and help expand access for DOs, so we have more doctors serving our country,” said Daines.

“New Mexicans already face too many barriers to accessing care, especially in rural and Tribal communities. We cannot afford to leave qualified medical students on the sidelines because of outdated barriers in the residency process. The bipartisan FAIR Act will bring greater transparency and fairness to residency programs, helping ensure that both DO and MD students have equal opportunity to complete their training and serve patients. By opening the door to more highly trained physicians, this bill will help strengthen our health care workforce and expand access to care for New Mexicans,” said Heinrich.

“Osteopathic medicine is one of the fastest growing health professions in the United States, including in Maine, and is integral to our state’s health workforce. The FAIR Act is a commonsense measure, aimed at ensuring fairness in the medical residency process and affirming that residency candidates graduated from osteopathic schools have an equal shot at these positions. Expanding access to residency slots for DOs means expanding access to healthcare, and primary care in particular, for those in the most rural communities to those in our major urban centers,” said King.

Osteopathic physicians play a vital role in addressing primary care and rural health needs. Fifty-six percent of osteopathic medical schools are located in Health Professional Shortage Areas, 64 percent require clinical rotations in rural and underserved communities and 88 percent have a stated commitment to improving rural health. More than 73 percent of DOs will practice in the state where they do residency training, making fair access to residency a critical issue for states struggling with physician shortages.

First introduced in the House of Representatives in 2022, the FAIR Act companion bill, H.R. 2314, was reintroduced on March 25, 2025, by U.S. Representatives Diana Harshbarger (R-TN), Chellie Pingree (D-ME), Sam Graves (R-MO), Carol Miller (R-WV) and Don Davis (D-NC). It is supported by more than 70 national and state health organizations.

About AACOM:

Founded in 1898, the American Association of Colleges of Osteopathic Medicine (AACOM) is the leading voice for the education and training of physicians who practice osteopathic medicine in settings across the medical spectrum—from primary care to the full range of medical specialties. We support our member colleges of osteopathic medicine in their efforts to attract and train individuals who are fueled by a desire to make a difference in our healthcare system by treating the whole person and building a future emphasizing health and wellness for all people. Today, more than 38,000 future physicians—close to 30 percent of all U.S. medical students—are being educated at one of our 43 accredited colleges of osteopathic medicine, encompassing 70 teaching locations in 36 states. To learn more about AACOM, please visit our website.

Contacts:

Joseph Shapiro
Director of Media Relations
(240) 938-0746
jshapiro@aacom.org

Christine DeCarlo
Senior Manager of Media and Public Affairs
(202) 603-1026
cdecarlo@aacom.org