Osteopathic medical education in 2006: charting a course for the future.

48 • JAOA • Vol 106 • No 2 • February 2006 Shannon • Guest Editorial W to the annual osteopathic medical education issue of JAOA—The Journal of the American Osteopathic Association. Articles in this issue provide the most current information about osteopathic medical education, outlining several trends in the past year. Because these are significant times for osteopathic medical education, I would like to take a moment to talk about the current state of affairs as we enter 2006. A number of issues are converging: projected physician workforce shortages1–3; growth in the number of and enrollments in colleges of osteopathic medicine (COMs)4; declining numbers of osteopathic medical students participating in the Association’s Intern/Resident Registration Program (the “Match”)5; implementation of information technology in healthcare provision and medical education6–8; cutbacks in federal and state funding (eg, Title VII program, Medicare and Medicaid funding for clinical practices within our schools); increasing economic pressures on practicing physicians; the effect of the federal government’s “cap” on the growth of graduate medical education4; the need to implement quality-control measures in osteopathic medical practice and education (eg, the Clinical Assessment Programs); changes in the scope of practice of our allied health colleagues; growing noninsured and underinsured populations; the combined pressures of increasing rates of chronic disease9; and an aging baby-boom population. In this changing environment, key organizations have come together to assess the circumstances. For example, the American Association of Colleges of Osteopathic Medicine (AACOM) and the American Osteopathic Association (AOA) jointly sponsored a major study of osteopathic medical education under the direction of Howard S. Teitelbaum, DO, PhD, MPH.10 After surveying fourth-year osteopathic medical students, as well as interns and residents, and the deans of the nation’s COMs, this study10 looked across the continuum of osteopathic medical education at outcome measures, trends, curricula, areas of success, and areas that need improvement. Although a number of issues were raised by the Teitelbaum study,10 policy issues related to osteopathic medical education (eg, topics introduced by individual osteopathic medical educators, resolutions by the AOA House of Delegates, the actions of the Osteopathic Medical Educators Council, Bureau of Osteopathic Education, and Council on Osteopathic Postdoctoral Training) also led to last month’s Osteopathic Heritage Foundation Medical Education Summit in Chicago, Ill. The summit was attended by leaders of AACOM, the AOA, and the COMs, as well as others involved at all levels in the delivery of osteopathic medical education. However, one issue was abundantly clear: there is a strong need within the profession for better and improved data as we chart the course for the future of osteopathic medicine in the United States.4 At publication, several new COMs have been proposed and a number of them are at various stages in the AOA’s accreditation process.11 In addition, many of our COMs are expanding their class sizes in an effort to help meet a projected physician shortage in the United States.1,2,6,12 As we experience a time of tremendous growth and opportunity in osteopathic medical education, we must continue to focus on quality—both in undergraduate and graduate medical education programs—and we must continue to recruit high-quality students to osteopathic medicine. It is also critical that those involved in osteopathic medical education continue to collaborate to find ways to foster innovation in educating the next generation of osteopathic physicians. We need to understand and study the unique qualities that current and future osteopathic physicians bring to patient care, and to see that a high standard of osteopathic medical care can meet the needs of our ever-changing society. In this issue of the JAOA, readers will note that the mean grade point averages and Medical Colleges Admission Test scores of applicants to COMs have continued to increase—and that our profession continues to recruit a large number of women and members of racial minorities.12 This issue of the JAOA also includes articles on other trends in undergraduate medical education,12 as well as trends in osteopathic graduate medical education,4 osteopathic postdoctoral training instituGUEST EDITORIAL