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Trends and Outcomes in Residency Matches: Assessing the Post-Merger Landscape for DO and MD Graduates

Journal: Journal of Osteopathic Medicine Date: 2024/12, 124(12):Pages: A13-A14. doi: Subito , type of study: retrospective study

Full text    (https://www.degruyter.com/document/doi/10.1515/jom-2024-2000/html)

Keywords:

matching [9]
osteopathic medicine [1955]
residency [309]
retrospective study [289]
specialty choice [8]
USA [1531]

Abstract:

Context: The merger between the American Osteopathic Association (AOA) and the Accreditation Council for Graduate Medical Education (ACGME) aimed to create a single accreditation system for graduate medical education programs in the United States. This transition, finalized in 2020, was intended to streamline the residency match process, enhance the quality of training, and provide equitable opportunities for both osteopathic (DO) and allopathic (MD) medical graduates.1 However, the impact of this merger on the residency match rates of osteopathic graduates, particularly in competitive specialties, remains a subject of ongoing investigation. Objective: To examine trends in residency placements, we analyzed pre- and post-merger match rates for Dermatology, Neurological Surgery, Orthopedic Surgery, Plastic Surgery, Radiology, and Anesthesiology. Methods: Data was compiled from the National Resident Matching Program (NRMP) from 2014-2024 and the National Matching Service (NMS) for 2014-2019. Additionally, yearly totals of osteopathic and allopathic graduates from the American Association of Colleges of Osteopathic Medicine (AACOM) and the Association of American Medical Colleges (AAMC) were collected. All data was analyzed using Prism v10. Results: Correlation analyses of the number of DO and MD filled competitive residency positions for Dermatology, Neurosurgery, Orthopedic surgery, and plastic surgery was performed. With the exception of Orthopedic surgery (Regression: y = 0.005x + 3.432; r2 = 0.001194; CI95slope = -0.1078 to 0.1182; Spearman’s: r = -0.0091, CI95: -0.6185 to 0.6071, n = 11 pairs, p = 0.9895), the percentage of DOs filling traditionally competitive residency positions was negatively correlated over the last seven years (Dermatology: Regression: y = -0.225x + 464.0; r2 = 0.254; CI95slope = -0.515 to 0.066; Spearman’s: r = -0.618, CI95: -0.890 to -0.029, n = 11 pairs, p = 0.0426; Neurosurgery: Regression: y = -0.6345x + 1286; r2 = 0.813; CI95slope = -0.864 to -0.405; Spearman’s: r = -0.882, CI95: -0.970 to -0.585, n = 11 pairs, p = 0.0007; Plastic Surgery: Regression: y = -1.511x + 3056; r2 = 0.8228; CI95slope = -2.039 to -0.9820; Spearman’s: r = -0.8636, CI95: -0.9655 to -0.5328, n = 11 pairs, p = 0.0012). Moreover, when the positions filled were binned pre- and post-ACMGE merger, there were significantly fewer DO positions filled post-merger for each specialty, except orthopedic surgery which did not demonstrate a change in positions filled across years. Conversely, traditionally less competitive residencies Anesthesiology and Diagnostic Radiology both reported a positive correlation with time (Anesthesiology: Regression: y = 0.4470x – 888.6; r2 = 0.5890; CI95slope = 0.1654 to 0.7286; Spearman’s: r = 0.7455, CI95slope = 0.2442 – 0.9234, n = 11 pairs, p = 0.0112; Radiology: Regression: y = 0.4881x – 968.4; r2 = 0.3852; CI95slope = 0.02311 to 0.9531; Spearman’s: 0.600, CI95: -0.2029 to 0.8868, n = 11 pairs, p = 0.0562) and either a statistically significant increase in DO-filled positions (Anesthesiology: U = 2, p = 0.0173) or a positive trend (Radiology: U = 7, p = 0.1775). Although a positive correlation was also observed with MD-filled positions, no significant increase pre- versus post-merger was observed (Anesthesiology: U = 13, p = 0.7922; Radiology: U = 7, p = 0.1775). Conclusion: The ACGME merger generated variable impact on osteopathic representation in competitive specialties. These analyses demonstrate that while the number of osteopathic graduates has increased, their representation in competitive residencies, such as dermatology, neurosurgery, and plastic surgery, has declined post-merger. Conversely, there was a significant increase in DO match rates to less competitive residency programs. Our study highlights the ongoing imparity between match rates for DO and MD graduates.


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