2020 DO & MD Merge: Impact on Caribbean Med Students

This article has been updated to provide the greatest relevance & timeliness for our readers. It was originally published in June 2018.

‍Previously, DO and MD residencies have been matched in separate processes. In 2020, there was a DO & MO  merge, becoming a single program. Today we're going to dive into what that actually means for MD students. Specifically, Trinity and its graduates.

But first, let's cover the basics. There is a myth out there that international medical graduates, or IMGs, will have a more difficult time in the match now. This is because more US-trained DO students will be applying for the same residencies. This is verifiably false. In fact, the opposite is true. MD students of any kind, including Caribbean medical school graduates, will have a better opportunity to match after the merge.

‍With that baseline understanding set, let's get into the specifics of the merger and what it means for med students.

Understanding the 2020 Merge: Accreditation

The MD & DO merge has led to the claim of tightening of competition for residencies for allopathic (MD) students. Such as those studying at Trinity and many other Caribbean medical schools.

Here's how it actually works: Because doctors of osteopathic medicine have to effectively know how to "be" an MD and a DO for regulatory reasons, they could traditionally apply for both residency matches (AOA and NRMP). They did this by taking both sets of licensing exams. This includes the USMLE Step for the NRMP, and COMLEX for the American Osteopathic Match, that is, the DO match.

Following the 2020 merger, all residencies will be MD residencies. Although some will offer optional DO training for the DOs on top of the standard residency training. DO students will still take the COMLEX to graduate, but it will be sufficient to take part in the new, larger match. As a result, there will be significantly more residencies now available to MDs. Though there’s a net zero change in total residents, as far as "competition" goes.

How the DO & MD Merge Affects the Residency Match: The Numbers

Let's get into the math with a real-world scenario.

Prior to the merge, in 2017, there were 3,109 DO-only residencies available. Assuming all of them remain extant after the merge and opt to meet ACGME accreditation standards, that's an additional 3,109 matches that MD students previously did not even have access to. The DO students were only competing amongst themselves for those spots. Painting an even more sunny picture for MD students, even if DO-trained students match into the same residencies, MD students still come out ahead with greater opportunity.

‍Here's why.

The AOA match that year was only 71% overall. That year, there were 895 DO residencies that went unfilled.

If those 895 maintain their accreditation as residencies through the new match. That's an additional 895 residencies that are now open to MD students that were previously unavailable and went unfilled.

For context, the current General Medical Education bill (GME) funds the addition of 3,000 new residency slots each year. This is across the US between 2015 and 2019. This was used as a means of alleviating the physician shortage. The 895 unfilled spots alone are effectively a 29% bonus for MDs on top of that 2019 funding boost at no additional cost to taxpayers or hospitals.

Are Some Students at a Disadvantage After the Merger?

Neither MD or DO students should see any negative impact from the merge in terms of match potential or residency access.

According to the AOA's own website, all residency matches will give equal weight to DO and MD students for every residency slot.

‍This means that those DO students have the same "shot" they had before in the NRMP, while MD students have a significant boost in available slots through greater access.

Final Benefits of the DO & MD Merge for Med Students & Beyond

In addition to expanding match opportunities for MD students, the merge has several far-reaching benefits for the medical community at large:

1. The merge will save a significant amount of money in an already taxed healthcare system. This is through the streamlining of multiple bureaucratic processes into one.
2. The merge consolidates quality standards into the umbrella of ACGME. Further unifying and elevating the standards of advanced medical education in the United States.
3. The process provides a stress relief for DO students who will only need to take a single licensing exam to access their prior network of residencies
4. Greater access to residencies and medical licensing leads to a major boon for patients who need doctors

Though the 2020 DO-MD merger may have brought with it some stress and confusion for both current and prospective medical students, the journey of a medical student remains fundamentally the same.

If you're looking to learn more about how Trinity can bolster your medical aspirations through high-quality education, immediate hands-on clinical experience, and a dedication to personalized learning, contact us today.

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