I believe so. My Dean told me that happened because 500 MD students didnt match after the scramble and med schools and alumni went ballistic because there were DOs who did match.
That had been happening for years. MD match rate and SOAP rate have not changed much since the inception of the SOAP, Now the first iterations of the SOAP was a mess from I recall, but I can't imagine it was as bad as the scramble. At the time they were discussing the Common requirements and the merger, the MD side of the expansion was just starting to ramp up.
US MD schools had been complaining for years about this, because they were expected to continue expanding seats to get that 30% increase from 2006-2016, and so they were pursuing multiple avenues to increase available GME spots and improve filling them. The SOAP, the NRMP "all-in" policy minimizing the "pre-match", lobbying for GME expansion, etc. were all ways to increase numbers and improve placement. The Common requirements were another way to do that, and the merger ended up being an even better deal.
I can’t say I agree with the bolded. IIRC: DOs are ~10% of physicians and ~25% of US medical students, yet managed to grab 33%(?) of the voting power in the new ACGME. In the long term, I see that as a massive win...
DOs were 10% of the physicians and at the time of the talks ~18% of US medical students (but projected to become closer to 25% in the coming years). They negotiated for 28% voting rights in the ACGME alongside organizations that represent US MD students, schools, and FMGs.
It was honestly the only decision they could make that was reasonable. DOs had 0 voting rights with the ACGME before it yet depended on the ACGME for placement of half of their graduates, and the AOA simply did not have enough spots to accommodate half of the graduates they were producing, let alone the many more created by the expansion. It wasn't sustainable and if the ACGME wanted they could have at any time put more barriers up for DOs, which is essentially what happened with the Common requirements and the path from AOA internship -> ACGME residency or AOA residency -> ACGME fellowship.
There have been a lot of other benefits to the merger that rarely get talked about, and I'm not going to extol them all now (I've done it many times in the past including when the merger first happened), but the biggest ones I see are the elimination of two matches, it improves most DO programs, gives DO training a little more legitimacy (and even OMM for that matter with the new NMM/OMM RRCs), and opens doors from the standpoint of international practice rights (ACGME training is a known entity to many international medical boards, and the fact that DOs could be trained elsewhere made boards more likely to restrict recognition/practice rights).
The decision rocked the AOA since they were completely unaware and was caught by surprise. The AOA started negotiating and initially things looked bleak. The ACGME and AOA couldn't come to an acceptable agreement. Finally, after a lot of back and forth, they came to the agreement (having the AOA programs become ACGME accredited, and giving the AOA a seat at the governing boards/table)
But I think it all started with fellowships and restricting it to ACGME residency graduates only.
If you search through SDN's forum archives, you can find the conversations as this was unfolding.
The Common requirements required all ACGME advanced training programs to only accept applicants who had completed prior training at ACGME programs. In other words it limited the paths for AOA internship -> ACGME residency and AOA residency -> ACGME fellowship. Given that the AOA simply didn't have a ton of fellowships and that at the time many states required AOA internships for licensure, this would have hurt a not small subset of DOs, limited DO specialists, and further de-legitimize AOA training.
From what I recall, the MOU came out after representatives from the AOA and ACGME had been talking for a while. The cluster of the rejection of the MOU at the AOA delegate meeting and the anti-merger/pro-merger battle that ensued was crazy to watch, especially as a student. Personally, I was glad they finally worked it out.
33% of the vote is no voting power. I refer you to the recent impeachment vote in the senate
While its not enough to make unilateral policy (which DOs shouldn't really be making anyway since the ACGME is for all of medicine not just DOs), the alternative was to have 0% voting rights despite relying on an entity that could at any time may half of the DO degrees useless by limiting training. They can also now present proposals and be on committees that shape future training.
Given the perceived level of (lack of) difficulty for Step II, then I submit that this hue and cry about "Step II mania" is overblown. My understanding of Step II is that it is much more an assessment of clinical thinking and knowledge than Step I, and so M3s/OMSIIIs are all on a more even playing field. Yes, those students who have poor rotation sites will be the ones who suffer, but we see that already with the weakest DO schools.
That said, I can't foresee massive amounts of pre-studying for Step Ii when people haven't set foot in the clinic. To my eye, it's like a pre-med trying to study for Step I.
Step 2 CK is not really "easy" from the standpoint of content. Its actually very similar to Step 1, but has more real world clinical applications. The main reason people prepared less for it was partly because it was less important from a residency standpoint and it mainly tested knowledge that was gained by "doing". I agree that it makes having good clinical rotations even more important, and to be honest, the schools whose students I met with the lowest Step/Level 2 pass rates were also the ones that complained the most about shadowing on rotations and poor clinical sites.
A lot of medical schools have significantly changed the curriculum to have preclinical last about 1.5 yrs and for Step 1 to be taken in mid 3rd yr after 1 full year of rotations. One school I'm familiar with does Step 1 in early Feb and Step 2 CK in like Mar/April. I think that's what we'll see happen. Students have actually seemed to do better on the Steps apparently.
