DO Student Number Has Grown by 85% in the Past 10 Years

Marcia Frellick

January 11, 2018

The number of osteopathic medical students in the United States has grown 85% in the past 10 years, according to a report from the American Osteopathic Association (AOA).

That brings the total number of osteopathic medicine (DO) students and physicians to 137,099 in 2017. There are now 34 DO schools in the United States operating at 49 sites, and enrollment has increased an average of 25% every 5 years.

For comparison, the number of students seeking MDs has risen 18.6% from 2008 to 2017, according to the Association of American Medical Colleges (AAMC).

Adrienne White-Faines, AOA's chief executive officer, writes in a press release, "This 'whole-person philosophy,' appreciating the influences of mind, body and spirit, resonates with patients and physicians alike. It is why more and more medical student applicants are choosing colleges of osteopathic medicine for their medical training."

The number of DO physicians in the United States has more than tripled to 108,118, up from 30,990 in 1990, according to the report.

More Than Half of DOs Are Aged Less Than 45 Years

The DO profession is increasingly popular in the younger ranks, the report shows. As of 2017, more than half of all DOs (54%) were aged 45 years or younger. The report notes that 41% of DOs are women, and women aged less than 45 years make up 47% of DOs, a number that has been growing steadily for the past 25 years.

Both those trends are good news for the profession, Thomas A Scandalis, DO, FAOASM, dean of Pacific Northwest University of Health Sciences College, College of Osteopathic Medicine (PNWU-COM), in Yakima, Washington, told Medscape Medical News.

"There are opportunities for women that didn't exist 20 years ago," he said, noting, however, that the first osteopathic medicine class in 1892 included women, "which was unheard of back then."

The high percentage aged less than 45 years is also a good sign, he said, a counterbalance to the graying of the physician population.

Most Go Into Primary Care

Most DOs (56%) go into primary care, the numbers show, with 32.4% landing in family medicine, 17% in internal medicine, and 6.7% in pediatrics.

The top nonprimary care specialties for DOs were emergency medicine (9.7%), followed by anesthesiology (4.3%) and obstetrics and gynecology (4.2%).

Dr Scandalis said that the growth in DO medicine is particularly important in addressing the shortage of primary care physicians.

"The focus of osteopathic medicine has been on primary care and a higher percentage of DOs go into rural and medically underserved areas than our allopathic colleagues," he said. "It's a natural fit for our schools with the missions that we have."

He said that at PNWU-COM 60% of graduates go into primary care "and if you add other generalist physicians that are also in acute shortage — general surgery, psychiatry, ob-gyn, emergency medicine — we're graduating about 82% in primary and generalist medicine."

DO training will complement MD training when both fall under a single accreditation system in 2020, Dr Scandalis said. Then some programs will have "osteopathic recognition," meaning they have DO faculty who will train DO and MD residents. MD students would then get training in osteopathic manipulative treatment, the hands-on techniques that assist with diagnosis and treatment, particularly with musculoskeletal issues.

"When that starts to happen, the graduates of those residencies that have osteopathic recognition will go back to their alma maters and say 'listen, you've got to teach this stuff,' " he said.

Both kinds of education have crucial roles in addressing the need for providers in the future, Dr Scandalis said.

"It's going to take both the MD schools and the DO schools to be able to address that shortage," he said.

"Work Together"

John Prescott, MD, AAMC's chief academic officer, agrees, adding that both kinds of schools can learn from each other.

"We work together on a number of issues. The issues that we face with regard to healthcare aren't defined by being MD or DO," he told Medscape Medical News.

Interest in becoming an MD has risen as well, he said, pointing out a 50% rise in applications to medical schools since 2002 and a 30% increase in graduates in the past 15 years.

And though the promise of more doctors in the pipeline from all schools is encouraging, a critical problem remains both in finding clinical settings for them to train in and in inadequate federal funding to add residency slots, he said.

"The schools have certainly stepped up to address the coming shortage of physicians. Really we need the federal government to step up," he said.

The report authors and Dr Prescott have disclosed no relevant financial relationships.

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