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Residency Program Characteristics Associated With Osteopathic Resident Representation
Dhimitri A Nikolla1,2, Vatsala Sachdeva3, Aviya Distefano3
1Department of Internal Medicine/Emergency Medicine, Lake Erie College of Osteopathic Medicine, Erie, USA.
Cureus
|May 19, 2025
Summary
Residency programs with higher osteopathic (DO) resident representation were more common in community settings and programs without U.S. Medical Licensing Examination (USMLE) requirements for DOs. Former American Osteopathic Association (AOA) accreditation and osteopathic recognition were also associated with greater DO matriculation.
Area of Science:
- Medical Education
- Graduate Medical Education
- Osteopathic Medicine
Background:
- Osteopathic (DO) medical students face unique challenges in postgraduate training applications and matriculation.
- Understanding program characteristics influencing DO resident representation is crucial for improving access to residency positions.
Purpose of the Study:
- To examine postgraduate residency program characteristics associated with higher DO resident representation in the United States.
- To identify factors that facilitate or hinder DO student matriculation into residency programs.
Main Methods:
- Retrospective, cross-sectional study of Accreditation Council for Graduate Medical Education (ACGME)-accredited residency programs in the 10 largest specialties.
- Utilized the Fellowship and Residency Electronic Interactive Database Access (FREIDA) dataset from 2022.
- Analyzed program-level characteristics, including former American Osteopathic Association (AOA) accreditation, osteopathic recognition, and U.S. Medical Licensing Examination (USMLE) requirements.
Main Results:
- Of 3,364 programs, 32.1% had ≥33% DO residents.
- Programs with ≥33% DO residents were more likely to have former AOA accreditation (RR 3.65), osteopathic recognition, and be in community settings.
- A USMLE requirement for DO applicants was less common in programs with higher DO representation (RR 0.12).
Conclusions:
- Postgraduate programs with higher DO resident representation are often community-based, lack USMLE requirements for DOs, and may have former AOA accreditation or osteopathic recognition.
- Factors such as fewer first-year positions, fewer programs per sponsor, and fewer full-time faculty were associated with lower DO representation.
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