BILL ANALYSIS                                                                                                                                                                                                    Ó




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                                    THIRD READING


          Bill No:  ACR 97
          Author:   Bonilla (D), et al.
          Amended:  9/2/15 in Assembly
          Vote:     21

          ASSEMBLY FLOOR:  Read and adopted, 9/2/15

           SUBJECT:   Medical training:  osteopathic students


          SOURCE:    Author

          DIGEST:   This resolution urges both private and public medical  
          training institutions to provide equal access to, and to work  
          toward greater acceptance and integration of, training and  
          education programs for both Osteopathic Physicians (DOs) and  
          Allopathic Physicians (MDs).  

          ANALYSIS:   This resolution makes the following legislative  
          findings:

          1)California has a significant shortage and inequitable  
            distribution of physicians throughout the state due to the  
            aging population, current population growth and the increasing  
            number of insured.

          2)According to a study by the Robert Graham Center in 2013, it  
            was estimated that the state would need 8,243 more primary  
            care physicians by 2030 - a 32% increase of its current  
            workforce.

          3)The state's ability to meet the need for primary care DOs and  
            MDs is directly affected by the number of medical residency  
            slots available in physician training programs across the  
            state, and the current number of graduate medical education  








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            slots must be increased substantially. 

          4)DOs are one of the fastest growing segments of health care  
            professionals in the United States:  by 2016, more than  
            100,000 DOs are expected to be in active medical practice.

          5)Approximately 60% of practicing DOs specialize in primary care  
            fields such as family medicine, internal medicine, and  
            pediatrics and many DOs fill a critical need by practicing in  
            rural and other medically underserved areas.

          6)Beginning in 2020, DO and MD residency programs will be  
            overseen by a single unified accrediting body.

          7)Quality medical training for DO and MD students is critical to  
            their success as fully trained and licensed physicians and all  
            medical schools should provide the support necessary for their  
            students to receive the best possible medical training.

          8)Many public and private institutions have provided equal  
            access to the application process for their medical training  
            programs by all students and physicians, and have trained  
            exemplary DO and MD students by choosing those candidates who  
            best suit their programs.

          9)In many areas of the state there are outstanding examples of  
            medical training programs that have been integrated  
            effectively and are providing DO and MD students with  
            exceptional training opportunities.

          This resolution urges both private and public medical training  
          institutions to provide equal access to, and to work toward  
          greater acceptance and integration of, training and education  
          programs for both DOs and MDs.  

          Background

          Osteopathic Physicians.  DOs are similar to MDs in that both are  
          considered to be "complete physicians."  A key difference  
          between the two professions is that DOs have an additional  
          dimension in their training and practice, one not taught in  
          medical schools which grant MD degrees.  Both DOs and MDs take  








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          the prescribed amount of pre-medical training, graduate from an  
          undergraduate institution with an emphasis on science courses,  
          and receive four years of training in medical school.   
          Specifically, DOs must possess a Doctorate of Osteopathic  
          Medicine Degree from an accredited osteopathic medical school,  
          complete one year of post-graduate training, which includes at  
          least four months of general medicine, and complete all levels  
          of the National Board of Osteopathic Medical Examiners'  
          Comprehensive Osteopathic Medical Licensing Examination.  

          The same laws govern the required training for DOs and MDs who  
          are licensed in California.  In recognition of this fact,  
          Business and Professions Code (BPC) Section 2453 states: "?it is  
          the policy of this State that holders of MD degrees and DO  
          degrees shall be accorded equal professional status and  
          privileges as licensed physicians and surgeons."  Licensing  
          examinations for DOs are also comparable in rigor and  
          comprehensiveness to those given to MDs.  

          Training Programs.  Prior to DO or MD students completing their  
          medical school education and entering into residency programs,  
          they must first complete the degree requirements for medical  
          school which may include elective clerkships.  As part of  
          osteopathic medical school education, after successful  
          completion of the first two years of classroom-based education,  
          DO students are eligible to apply for elective clerkships as  
          part of their medical school curriculum.  These clerkships are  
          often "hands-on" rotations which help inform many students about  
          the area or areas of medicine in which they would like to  
          practice.  Many DO students will apply for these elective  
          courses at training institutions outside of the two osteopathic  
          medical schools in California.  According to the author, in the  
          last year, there have been a number of training institutions  
          that have specifically excluded DO students from applying to  
          their programs for elective clerkships or rotations.  Further,  
          the author notes that there was a fee differential for DO  
          students who applied for these programs compared to their MD  
          counterparts.  Also, it was noted that DO student applicants  
          were required to have a higher United States Medical Licensing  
          Examination score compared to their MD counterparts.  

          BPC Section 2064.2 states that no medical school or clinical  








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          training program shall deny access to elective clerkships or  
          training programs solely on the basis that a student is enrolled  
          in an osteopathic medical school.  While this does not require  
          institutions to accept DO students, it makes it clear that DO  
          students should not be denied access to these elective programs  
          solely based on their choice of medical education.  

          In an effort to encourage equity for both allopathic and  
          osteopathic medical students who are entering into training  
          programs, this resolution simply urges both public and private  
          medical training institutions to provide equal access to both  
          osteopathic and allopathic students in applying for training  
          programs and urges training institutions, along with allopathic  
          and osteopathic medical schools, to work together toward greater  
          acceptance and integration of its osteopath and allopath  
          students.  

          FISCAL EFFECT:   Appropriation:    No          Fiscal  
          Com.:NoLocal:    No


          SUPPORT:   (Verified9/4/15)


          American Osteopathic Association
          California Medical Association
          Osteopathic Physicians and Surgeons of California


          OPPOSITION:   (Verified9/4/15)


          None received





          Prepared by:Melissa Ward / SFA / (916) 651-1520
          9/4/15 16:42:37










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