As a pre-med student at Bradley University in Peoria, Nicole Ottens investigated her medical school options: traditional, or allopathic, institutions that confer MD degrees; and osteopathic medical colleges, which grant the less common doctor of osteopathy, or DO, degree. To help her make her decision, Ottens shadowed both an MD and a DO.
The osteopath “really delved into what was going on in their life,” Ottens said. “He looked into possible causes of a patient’s problem rather than the problem itself. He had a more global sense of what was going on in a patient’s life and took that into consideration when dealing with their current health problem.”
Then, when Ottens applied to and interviewed at both allopathic and osteopathic medical schools, more differences emerged. With a bachelor’s degree in psychology, Ottens appreciated the osteopathic medical schools’ more holistic approach not just to patient care but also to student selection.
“As a candidate, I was evaluated by more than numeric scores. They tried to assess the type of physician I could be,” said Ottens, who graduated in May from the Chicago College of Osteopathic Medicine in Downers Grove.
Meeting students at osteopathic medical schools clinched the decision for her. “The students I interacted with genuinely seemed to love what they were doing. They seemed happy to be there. It seemed to be a more positive environment and more focused on the bigger picture,” said Ottens, now in a one-year traditional rotating internship. After that, she’ll complete a four-year residency program in emergency medicine and family medicine at St. James Hospital in Olympia Fields.
Like Ottens, an increasing number of medical students are considering osteopathic medicine. After reaching an all-time high of 10,764 in 1996, applications to osteopathic medical schools declined to a low of 6,324 in 2002 and have been rising since 2003. In 2005, applications hit 8,255. First-year enrollment at osteopathic medical schools exceeded 3,300 students for the 2003-2004 academic year. During that time, applications to U.S. medical schools followed a similar trend.
The patient-centered philosophy of osteopathic medicine accounts for much of this interest, according to Karen Nichols, dean and professor of medicine at the Chicago College of Osteopathic Medicine, part of Midwestern University.
“I ask every first-year student why they chose osteopathic medical school. The answer I get almost 100 percent of the time is that they like the philosophy. We take a whole-person approach as opposed to an organ-system approach,” she said.
Hands-on medicine
The osteopathic philosophy originated with Andrew Taylor Still, a 19th Century American frontier physician who believed that many of the medications of his day were useless or even harmful. Instead, he studied the attributes of wellness to better understand the process of disease. He believed in the unity of the body parts and the importance of the musculoskeletal system in good health. Today, DOs practice alongside MDs, but they often employ osteopathic manipulative treatment, a hands-on technique for diagnosing, treating and even preventing health problems, especially pain-related maladies.
For a profession once deemed a cult by the American Medical Association, osteopathic medicine has struggled to become fully accepted. As recently as 1962, the AMA persuaded California to prohibit osteopathic physicians from practicing in the state; it didn’t lift the ban until 1978. In a turnabout, the AMA in the 1990s invited the American Osteopathic Association to send voting members to its House of Representatives. The AOA declined, preferring to retain its own identity.
The osteopathic profession has actively cultivated its reputation among the allopathic medical community, pre-med advisers at undergraduate schools and the public at large.
“A lot of pre-med advisers simply didn’t understand that it was a complete system of medical care,” said Catherine Schneider of the American Osteopathic Association communications department.
A helpful boost
Recently, this effort has been boosted by the growing interest in and acceptance of complementary and alternative medicine.
“Osteopathy straddles the fence a bit when it comes to complementary medicine,” said Mike Patterson, professor in the College of Osteopathic Medicine at Nova Southeastern University in Bradenton, Fla. “The profession is certainly mainstream in that it has full practice rights. But the practice of manipulative medicine is considered a form of alternative medicine by the National Institutes of Health.”
In the past, some students applied to osteopathic schools as “safety schools” because they were regarded as less selective. That’s no longer the case.
Many students come to osteopathic medicine as their first or even only choice, said Patterson, who has served on admissions committees at several osteopathic medical schools, which, like allopathic schools, require good grades and MCAT scores. Additionally, applicants should have letters of reference and a familiarity with osteopathic medicine.
For the 2005 academic school year, the Chicago College of Osteopathic Medicine received more than 3,200 applications for just 160 positions. Founded in 1900, it is the only osteopathic medical school in Illinois.
Interest from women
The unprecedented flood of women into the field accounts for a large portion of the increase. For the past two years, women have accounted for more than half of all applicants to osteopathic and allopathic medical schools.
The number of osteopathic colleges has grown too over the last 10 years, with 20 osteopathic medical schools now in the United States. That’s created more openings for students, more than 3,300 in the 2003-2004 academic year. New schools have opened and existing schools have established branch campuses, often in other states. Midwestern University, for example, opened a Glendale, Ariz., campus in 1996, introducing osteopathic medicine to the Southwest.
With more schools and more graduates, the number of DOs has increased sharply, and as of June 2005, there were about 50,000 practicing DOs in the country. Still, their numbers are dwarfed by those of MDs, which the American Medical Association estimates at almost 800,000.
On to residencies
Upon graduating from medical school, DOs can apply for residencies at osteopathic hospitals and some allopathic hospitals.
Osteopathic residents generally “perform very well,” and often outshine MDs with their physical examination and diagnostic skills, said Robert Buckley, MD, chairman and executive director of medical education at Resurrection Medical Center on the Far Northwest Side.
Because its primary-care orientation makes it a natural fit, Resurrection’s family practice residency program actively recruits osteopathic physicians. On average, DOs comprise up to one-third of Resurrection’s nearly 70 residents and up to half of the physicians in its family practice residency program.
“The osteopathic residents have a skill which gives them an additional edge that my allopathic brethren and I don’t have,” said Buckley, referring to osteopathic manipulative treatment.
Buckley first became impressed with Chicago College of Osteopathic Medicine graduates in particular long before joining Resurrection 13 years ago. His personal physician, whom he highly respected, was a graduate of the college.
Likewise, “it’s not uncommon that our applicants’ personal physician is a DO,” said Donald Sefcik, past president of the Illinois Osteopathic Medical Society and associate dean at the Chicago College of Osteopathic Medicine. “Based upon their own experience, with the difference a DO makes, they chose to pursue a career in osteopathic medicine.”
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Trends in osteopathic education
OSTEOPATHIC MEDICAL SCHOOL APPLICANTS (1995-2005)
Applications to osteopathic medical schools have been on the rise again after declining for several years.
In thousands of applicants
%% 1995: 10.2
2005: 8.3
%%
OSTEOPATHIC MEDICAL SCHOOL GRADUATES (1195-2009)
The increase in the number of osteopathic medical school graduates is expected to continue until 2009.
In thousands per graduation year
%% 1995: 1.8
2004: 2.7
2009: 3.3 Projected
Note: Applicants processed by the AACOM Application Service
%%
FIRST-YEAR ENROLLMENT IN OSTEOPATHIC MEDICAL SCHOOLS BY GENDER
Numbers per entering year
Women now make up more than 50 percent of first-year students.
%% Men Women
1995 1,424 850
’96 1,578 957
’97 1,621 1,071
’96 1,610 1,135
’99 1,646 1,202
’00 1,687 1,240
’01 1,628 1,415
’02 1,616 1,463
’03 1,646 1,662
%% Source: American Association of Colleges of Osteopathic Medicine
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