BILL ANALYSIS Ó ----------------------------------------------------------------- |SENATE RULES COMMITTEE | ACR 97| |Office of Senate Floor Analyses | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ----------------------------------------------------------------- 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 ACR 97 Page 2 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 ACR 97 Page 3 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 ACR 97 Page 4 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 ACR 97 Page 5 **** END ****