5 W’s of the ACGME Merger (MD/DO Merger)

Who and What

The American Association of Colleges of Osteopathic Medicine (AACOM) and the American Osteopathic Association (AOA) will be merging with the MD programs’ Accreditation Council for Graduate Medical Education (ACGME). The merger will result in a unified ACGME Match for both students from MD and DO schools. DO programs will still have the opportunity to apply for “osteopathic recognition” in order to keep providing training in osteopathic manipulative treatment.


USMLE vs. COMLEX Requirements

This is a very interesting area of the ACGME Merger, which will likely evolve in the coming years as the merger progresses. Here are some key points to keep in mind:

  • According to the American Association of Colleges of Osteopathic Medicine, “COMLEX-USA will continue to be the required examination series and the pathway to licensure for osteopathic physicians. It is widely recognized and universally accepted as the valid examination for osteopathic physician competency assessment for licensure. It is also required by accreditation standards established by the Commission on Osteopathic College Accreditation (COCA), and is a requirement for graduation from all COMs. COMLEX-USA is regarded by the majority of residency program directors of AOA and ACGME accredited residency programs as an important and useful assessment tool as part of the evaluation of DO residency applicants for their programs.
  • However, now, MD students will also be able to take their USMLE scores to previously DO-only programs.
  • In essence, the ACGME Merger will allow MDs to apply to all programs.  But, for DOs, if specific programs require USMLE scores as part of a complete application, DOs will still have to take both examinations to qualify for such programs.
  • Yet, it is expected that over the years, a more universal acceptance of the COMLEX as a valid and sufficient qualification for residency will continue to grow. Again, according to the AACOM: “The single GME accreditation system is not expected to reduce acceptance of the COMLEX-USA for residency admissions, but rather to continue to grow acceptance with the goal of one day achieving universal acceptance. However, it is likely – at least for a while – that some ACGME programs will continue to prefer to receive a USMLE score. If a student has aspirations for such programs, then that student will have to make the decision about whether to take the USMLE in addition to the COMLEX-USA.


When and Where?

Although there has been a 5-year transitory period beginning in 2015, the MD/DO merger is taking place in the United States in 2020, where there will no longer be exclusive DO programs. All MD and DO programs will be available to both applicant types.



The MD/DO merger is designed to address several issues:

  • Save a significant amount of money by streamlining bureaucratic processes to operate under one authority (For example – dually accredited programs will no longer have to pay twice to both governing bodies)
  • Provide more consistent evaluation and accountability for GME training nationwide
  • Create a more transparent system for both the federal government (which gives money for graduate medical education) and the public, the ultimate consumer and recipient of results of GME
  • Ideally, the merger will help a greater percentage of physicians land residency positions, which would address the physician shortage in the United States, which is especially pronounced in rural areas


Additional Benefits

Not only will the ACGME Merger save money and provide more consistent training, it is also expected to:

  • Provide the same opportunities for MDs and DOs, eliminating a possible “glass ceiling” for DOs (For example – programs oftentimes limited Fellowship opportunities to only Allopathic trainees, excluding DOs from many chances for more specialized advanced training)
  • Hopefully, reduce the stigma around Osteopathic DO training since it will all be done under ‘one roof’ – so to speak
  • A unified Match will give residents the opportunity to ‘mix’ their Rank Order Lists, expanding their opportunities without fear of sacrificing program choice
  • Give MDs the opportunity to apply to less competitive DO subspecialties
  • Give MDs opportunities to apply for Osteopathic training programs


Potential Drawbacks

There are many benefits to the ACGME Merger, however, there are some negative aspects, which primarily affect DO applicants:  

  • DO subspecialties will become more competitive
  • DOs are no longer going to have as large of a buffer of unfilled programs (usually almost 1,000 unfilled positions a year!)  


All in all, the ACGME Merger of MD and DO programs seems to have many expected benefits including streamlined management and oversight (leading to large cost savings) and more opportunities for both MDs and DOs.


If you have questions about how this will affect your application process, please leave your thoughts, questions, and feedback in the comments below!

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