MEDICAL EDUCATION

Undergraduate Osteopathic Medical Education

Susan Sweet

his article presents basic data about the 20 colleges College of Osteopathic Medicine (PCOM); New York Tof osteopathic medicine for the 2003–2004 academic College of Osteopathic Medicine of New York Institute year. Information in this article has been adapted from of Technology (NYCOM); Midwestern University/ the American Association of Colleges of Osteopathic Chicago College of Osteopathic Medicine (MWU/ Medicine (AACOM)/American Osteopathic Association CCOM); A. T. Still University of Health Sciences/ (AOA) Annual Osteopathic Medical School Questionnaire Kirksville College of Osteopathic Medicine (ATSU/ for the 2003–2004 academic year, fiscal year (FY) 2002, KCOM); and Des Moines University–College of Osteo- and the 2004–2005 AACOM Tuition Survey. In addi- pathic Medicine (DMU-COM). These five schools—as tion, the draft of the AACOM’s 2003 Annual Statistical well as most of the other 15 colleges of osteopathic Report and its historical database compiled from pre- medicine—had an increase in the number of applica- vious surveys have been used to prepare this article. tions for the 2003–2004 academic year. Only three colleges of osteopathic medicine had a decrease in the number of Osteopathic Medical Student Applicants applications for the 2003 entering classes (Table 2). For the second consecutive year, the number of applica- tions has increased, represented by a 5.8% growth Enrollment between 2003 and 2004 (Figure 1). Even with this slight First-year enrollment continues to increase. The first- increase in the number of applicants for 2004, however, year enrollment in the 2003–2004 academic year was the overall numbers continue to be considerably lower 3308, an increase of 229 students (Figure 2). than the high point in 1997 (10,764). Since 1999 (8396), the The percentage of ethnic minority students rose total number of applicants has decreased by 14% (Table 1). again in 2002–2003. Ethnic minorities (Black, Hispanic, After its peak in 1997, the number of underrepre- and Native American students) represent 7.8% and sented minority applicants has steadily decreased. In Asian/Pacific Islander students represent 15.4% of the 1998, 936 individuals of underrepresented minorities total enrollment in the 2003–2004 academic year (Table 3). applied to the 19 colleges of osteopathic medicine, and The number of female osteopathic medical students that number dropped further in 1999 to 790 before enrolled at the colleges of osteopathic medicine con- rebounding to 829 in 2000. The decline in underrepre- tinues to increase. For the 2003–2004 academic year, sented minority applicants continued through 2001 and 46.9% of all students were female. The total number of 2002 to 693 and 684, respectively; however, this number women enrolled in 2003–2004 was 5557 (Table 4). rebounded again to 732 in 2003 and 817 in 2004. Between 1999 and 2004, the number of underrepresented minority Geographic Source of First-Year Students applicants declined by just 3%, but the number of under- For the first time, more than half of all first-year osteo- represented minority applicants increased by 11.6% pathic medical students seek medical education outside between 2003 and 2004. their home state. Of the 3308 first-year students enrolled In the 2003–2004 academic year, the five colleges at the 20 colleges of osteopathic medicine during the with the most applications received were the Philadelphia 2003–2004 academic year, 47.8% were residents of the state in which the college of osteopathic medicine is located and 51.5% were nonresidents. During the Correspondence to Ms Susan Sweet, Director, Division of Predoc- 2002–2003 academic year, 1590 (51.6%) of the first-year toral Education, AOA Department of Accreditation, 142 E Ontario St, Chicago, IL 60611-2864. students were from the state in which the college of E-mail: [email protected]. osteopathic medicine is located.

460 • JAOA • Vol 104 • No 11 • November 2004 Sweet • Medical Education MEDICAL EDUCATION

Applications by Group

Figure 1. 6000

5000 Total Underrepresented 4000 minority Asian/Pacific Islander 3000 White, non-Hispanic 2000

1000

0 1999 2000 2001 2002 2003 2004

Table 1 Applicants to Osteopathic Medical Schools Participating in the American Association of Colleges of Osteopathic Medicine Application Service (AACOMAS)–Ethnic Groups and Women by Entering Year*

Group 1999 2000* 2001 2002 2003† 2004

Black 378 414 335 342 358 404

Hispanic 342 343 290 287 314 350

Native American 70 72 68 55 60 63

Total Underrepresented Minority 790 829 693 684 732 817

Percent Underrepresented Minority 9.9 10.8 10.0 10.8 10.7 11.3

White; non-Hispanic 5583 5099 4731 4285 4567 4725

Asian/Pacific Islander 1592 1346 1226 1086 1201 1357

Other and Unknown 431 434 248 269 314 341

Total All Groups 8396 7708 7259 6324 6813 7240

No. of Women Among Total Applicants 3518 3402 3151 3058 3348 3638

Percent Women 41.9 44.1 45.7 48.4 49.1 50.2

No. of Colleges of Osteopathic Medicine Participating in AACOMAS‡ 19 19 18 18 19 19

* Data from the University of North Texas Health Sciences Center/Texas College of Osteopathic Medicine (UNTHSC/TCOM) is not included after 2000 as those applications are processed through the Texas Statewide Application Service. † The Edward Via Virginia College of Osteopathic Medicine at Blacksburg, Va, began participating in AACOMAS in 2003 and admitted its first class that year. ‡ This table includes applicants processed by AACOMAS, but does not include those applicants who may have applied directly to the schools. For the 2003 entering class, the schools received 1491 direct applications, with 1350 of these at the University of North Texas Health Science Center at Fort Worth. Other schools receiving direct applications in 2003 are Des Moines University, College of Osteopathic Medicine (19), Kansas City University of Medicine and Biosciences–College of Osteopathic Medicine (6), Lake Erie College of Osteopathic Medicine (4), New York College of Osteopathic Medicine of New York Institute of Technology (109), and Edward Via College of Osteopathic Medicine (3). Non-AACOMAS applicant data for 2004 are not yet available. Source: AACOMAS, American Association of Colleges of Osteopathic Medicine Application Service.

Sweet • Medical Education JAOA • Vol 104 • No 11 • November 2004 • 461 MEDICAL EDUCATION

Table 2 Number of Applications Received, First-Year Enrollment, and Total Enrollment by College

No. of Applications† First-Year Enrollment Total Enrollment

College* 2002–2003 2003–2004 2002–2003 2003–2004 2002–2003 2003–2004

ATSU/KCOM 2,249 2,441 165 170 631 626

DMU-COM 2,070 2,180 216 204 802 795

KCUMB-COM 2,042 2,103 228 232 887 901

LECOM 2,093 2,076 223 227 721 806

MSUCOM 1,621 1,609 124 143 527 533

MWU/AzCOM 1,900 2,090 154 147 546 547

MWU/CCOM 2,452 2,747 172 188 643 664

NSUCOM 1,977 2,059 188 214 757 769

NYCOM‡ 2,569 2,808 333 312 1,147 1,161

OSU-COM 1,059 1,162 90 90 348 350

OU-COM 1,918 2,041 114 114 432 428

PCOM 3,154 3,396 266 264 1,013 1,011

PCSOM 1,264 1,334 65 75 251 253

TUCOM 1,805 1,942 130 141 443 490

UMDNJ-SOM 1,564 1,737 90 96 327 352

UNECOM 1,903 1,867 131 124 468 488

UNTHSC/TCOM 1,159 1,350 127 129 479 492

VCOM§ NA // 660 NA 154 NA 154

WesternU/COMP 1,936 1,994 182 181 702 700

WVSOM 1,372 1,432 81 103 308 337

Total 36,107 39,028 3,079 3,308 11,432 11,857

* Full names of colleges with abbreviations appear in the Appendix. † Because most applicants apply to several schools, the number of applications shown in this table is significantly higher than the number of individual applicants shown in Table 1. ‡ New York College of Osteopathic Medicine’s data include the Accelerated Program for Émigré Physicians (APEP) students. § The Edward Via Virginia College of Osteopathic Medicine admitted its first class in Fall 2003. // NA indicates not available. Source: American Association of Colleges of Osteopathic Medicine/American Osteopathic Association, Annual Osteopathic Medical School Questionnaire, 2003-2004 academic year.

The University of Medicine and Dentistry of New and 96.1%, respectively) of in-state students for the Jersey–School of Osteopathic Medicine (UMDNJ-SOM) 2003–2004 academic year. Kansas City University of and the University of North Texas Health Science Center Medicine and Biosciences–College of Osteopathic of Fort Worth—Texas College of Osteopathic Medicine Medicine (KCUMB-COM) and the University of New (UNTHSC/TCOM) had the highest percentages (97.9% England College of Osteopathic Medicine (UNECOM)

462 • JAOA • Vol 104 • No 11 • November 2004 Sweet • Medical Education MEDICAL EDUCATION

Freshman Enrollment

3500 3308 3043 3079 2848 2927 3000 2692 2745 2535 2500 2217 2274

2000

1500

1000

500

0 1994 1995 1996 1997 1998 1999 2000 20012002 2003

Figure 2.

had the highest percentage of out-of-state students for the Tuition 2003–2004 academic year, 86.6% and 83.1%, respectively For the academic year beginning in 2004–2005, tuition is (Table 5). Because of special funding relationships with the expected to average $16,481 for in-state residents in public states, public colleges generally admit a much higher schools and $30,192 in private schools. For out-of-state res- proportion of state residents than do private schools. idents, tuition averages $32,610 in public schools and $31,101 in private schools (Table 7). College Record of Freshmen Freshmen entering the 2003–2004 academic year had a Income and Expenditures mean grade point average (GPA) of 3.45, which is slightly of Osteopathic Medical Colleges higher than the mean GPA of the 2002–2003 academic The 20 colleges of osteopathic medicine reported total rev- year (3.43). Mean MCAT scores for these freshman were enue of $809,862,891 in FY 2003, which constitutes a 3.9% as follows: biological sciences, 8.51; physical sciences, increase from 2002 ($778,900,000). As in the past, tuition 7.77; and verbal reasoning, 8.07. contributes substantially more to total revenues in the pri- vate schools than it does in the public schools, which Faculty draw more heavily from state subsidies. The 20 colleges of osteopathic medicine had 12,726 fac- Students benefit from state government funding, ulty members in 2003–2004, including full-time, part- which continues to play an important role in the fiscal time, and volunteer faculty. Most full-time and part-time health of osteopathic medical education. The Armed faculty serving the colleges of osteopathic medicine (86%) Forces also continues to be a significant source of funds teach clinical sciences, and the remainder teaches pre- to students and their schools through the Armed Forces clinical sciences (5.1%). Health Professions Scholarship Program. In the 2003–2004 academic year, approximately 80.6% Total expenditures in FY 2003 were approximately of the faculty at the 20 colleges of osteopathic medicine $743,903,417, an increase of 3.2% from FY 2002 were volunteer faculty. The largest percentage of full- ($720,400,000). Instruction continues to account for the time and part-time academicians teach general prac- largest portion of expenditures. tice/family practice (Table 6).

Sweet • Medical Education JAOA • Vol 104 • No 11 • November 2004 • 463 MEDICAL EDUCATION

Table 3 Total Enrollment and Percentage of Minority Ethnic Groups By College

Underrepresented Ethnic Minority Asian/Pacific Islander Total Ethmic Minority

Percent Percent Percent Total of Total of Total of Total College* Enrollment No. Enrollment † No. Enrollment † No. Enrollment †

ATSU/KCOM 626 12 1.9 74 11.8 86 13.7

DMU-COM 795 38 4.8 35 4.4 73 9.2

KCUMB-COM 901 51 5.7 88 9.8 139 15.4

LECOM 806 29 3.6 98 12.2 127 15.8

MSUCOM 533 28 5.3 63 11.8 91 17.1

MWU/AzCOM 547 15 2.7 59 10.8 74 13.5

MWU/CCOM 664 26 3.9 119 17.9 145 21.8

NSUCOM 769 119 15.5 129 16.8 248 32.2

NYCOM‡ 1,161 171 14.7 326 28.1 497 42.8

OSU-COM 350 53 15.1 17 4.9 70 20.0

OU-COM 428 63 14.7 30 7.0 93 21.7

PCOM 1,011 91 9.0 105 10.4 196 19.4

PCSOM 253 10 4.0 10 4.0 20 7.9

TUCOM 490 9 1.8 110 22.4 119 24.3

UMDNJ-SOM 352 89 25.3 82 23.3 171 48.6

UNECOM 488 6 1.2 37 7.6 43 8.8

UNTHSC/TCOM 492 43 8.7 126 25.6 169 34.3

VCOM§ 154 16 10.4 17 11.0 33 21.4

WesternU/COMP 700 53 7.6 274 39.1 327 46.7

WVSOM 337 4 1.2 23 6.8 27 8.0

All Colleges 11,857 926 7.8 1,822 15.4 2,748 32.2

* Full names of colleges with abbreviations appear in the Appendix. † These percentages are based on total enrollment. Percentages may not add across because of rounding. ‡ New York College of Osteopathic Medicine’s data include the Accelerated Program for Émigé, Physicians (APEP) students § The Edward Via Virginia College of Osteopathic Medicine admitted its first class in Fall 2003 Source: American Association of Colleges of Osteopathic Medicine/American Osteopathic Association, Annual Osteopathic Medical School Questionnaire, 2003–2004 academic year.

464 • JAOA • Vol 104 • No 11 • November 2004 Sweet • Medical Education MEDICAL EDUCATION

Table 4 Total Enrollment and Enrollment of Women at Colleges of Osteopathic Medicine

Total Enrollment

Entering Women Year Total No. (%)

1994 8,146 2,870 (35.2)

1995 8,475 3,075 (36.3)

1996* 8,961 3,308 (36.9)

1997† 9,434 3,591 (38.1)

1998 9,882 3,862 (39.1)

1999 10,388 4,181 (40.2)

2000 10,817 4,443 (41.1)

2001 11,103 4,781 (43.1)

2002 11,432 5,099 (44.6)

2003‡ 11,857 5,557 (49.9)

* Data include the Accelerated Program for Émigré Physicians (APEP) at New York College of Osteopathic Medicine of New York Institute of Medicine and Midwestern University/Arizona College of Osteopathic Medicine’s first class of 103, including 33 women. † Data include Pikeville College School of Osteopathic Medicine and Touro University College of Osteopathic Medicine’s first classes of 60 students (14 women) and 66 students (26 women), respectively. ‡ Data include Edward Via College of Osteopathic Medicine’s first class of 154 students, including 74 women. Source: American Association of Colleges of Osteopathic Medicine/American Osteopathic Association, Annual Osteopathic Medical School Questionnaire, 2003–2004 academic year.

Sweet • Medical Education JAOA • Vol 104 • No 11 • November 2004 • 465 MEDICAL EDUCATION

Table 5 Number of State Residents and Nonresidents Enrolled in First Year by College

2002–2003 2003–2004

No. of No. of No. of No. of No. of Foreign College* Residents Nonresidents Total No. Residents Nonresidents Students Total No.

ATSU/KCOM 26 139 165 28 139 3 170

DMU-COM 52 164 216 40 164 0 204

KCUMB-COM 28 200 228 29 201 2 232

LECOM 78 145 223 63 164 0 227

MSUCOM 119 5 124 132 11 0 143

MWU/AzCOM 45 109 154 40 107 0 147

MWU/CCOM 76 96 172 69 119 0 188

NSUCOM 97 91 188 117 91 6 214

NYCOM† 207 126 333 196 115 1 312

OSU-COM 77 13 90 84 6 0 90

OU-COM 93 21 114 95 19 0 114

PCOM 177 89 266 149 113 2 264

PCSOM 27 38 65 33 42 0 75

TUCOM 66 64 130 56 85 0 141

UMDNJ-SOM 83 7 90 94 2 0 96

UNECOM 25 106 131 18 103 3 124

UNTHSC/TCOM 123 4 127 124 5 0 129

VCOM NA‡ NA NA 44 109 1 154

WesternU/COMP 140 42 182 121 55 5 181

WVSOM 51 30 81 50 53 0 103

Total 1590 1489 3079 1582 1703 23 3308

* Full names of colleges with abbreviations appear in the Appendix. † Data for New York College of Osteopathic Medicine of New York Institute ot Technology includes the Accelerated Program for Émigré Physicians (APEP) students. ‡ NA indicates not available. Source: American Association of Colleges of Osteopathic Medicine/American Osteopathic Association, Annual Osteopathic Medical School Questionnaire, 2003–2004 academic year.

466 • JAOA • Vol 104 • No 11 • November 2004 Sweet • Medical Education MEDICAL EDUCATION

Table 6 Table 7 Full-time Faculty Assignments by Discipline Colleges of Osteopathic Medicine Tuition (Subject to Change) Percent of Faculty Assigned* Tuition Discipline 2002–2003 2003–2004 College* State Residents Nonresidents Anatomy 7.8 7.8 Private Biochemistry 4.6 4.8 ATSU/KCOM $31,700 $31,700 Emergency Medicine 0.6 † DMU-COM $29,050 $29,050 General Practice/Family Practice 17.2 17.5 KCUMB-COM $33,247 $33,247 Geriatrics 2.2 2.2 LECOM $24,100 $25,100 Internal Medicine 10.3 10.8 MWU/AzCOM $34,099 $34,099 Microbiology 5.9 5.2 MWU/CCOM $29,755 $35,391 Neurology 1.1 1.3 NSUCOM $23,267 $29,358 Obstetrics/Gynecology 3.3 2.9 NYCOM $31,749 $31,749 Osteopathic Principles & PCOM $32,334 $32,334 Practice 5.0 4.3 PCSOM $27,000 $27,000 Pathology 3.2 2.9 TUCOM $30,650 $30,650 Pediatrics 3.6 3.7 UNECOM $33,000 $33,000 Pharmacology 4.7 4.1 VCOM $29,500 $29,500 Physical Medicine/ Rehabilitation Medicine 0.9 1.2 WesternU/COMP $33,230 $33,230 Physiology 4.9 4.6 Mean $30,192 $31,101 Preventive Medicine/ Public Public Health 2.6 2.4 MSUCOM $20,900 $44,700 Psychiatry 5.2 5.3 OSU-COM $14,995 $30,144 Radiology 1.1 1.5 OU-COM $19,455 $28,353 Surgery (General) 3.4 3.6 UMDNJ-SOM $20,567 $32,185 Other‡ 12.4 13.8 UNTHSC/TCOM $ 6,550 $19,650 * Percentages may not add to 100% because of rounding. † Now reported under “Other”. WVSOM $16,418 $40,630 ‡ Includes anesthesiology, dermatology, emergency medicine, ophthalmology, orthopedic surgery, otolaryngology, and urology. Mean $16,481 $32,610 Source: American Association of Colleges of Osteopathic Medicine/American Osteopathic Association, Annual Osteopathic Medical * Full names of colleges with abbreviations appear in the Appendix. School Questionnaire, 2003–2004 academic year. Source: American Association of Colleges of Osteopathic Medicine, Tuition Survey for 2004-05.

Sweet • Medical Education JAOA • Vol 104 • No 11 • November 2004 • 467