AOA transitional year

my understanding was that the AOA transitional year was only “required” if you wanted to practice in states that required it for licensure (e.g. WV, FL, etc)
I’ve been reading some of the DO schools sites, and it seems assumed that one will complete the AOA transitional year before going on to a “normal” AOA or ACGME residency.
is this the case? is it required or not by AOA?
Lisa

LisaS,
The AOA Transitional Year is required for any new grad DO prior undertaking an AOA residency. Five states also stipulate that for a DO to be licensed there as a new graduate, you must have completed the AOA transitional year: PA, MI, FL, OK & WV; irregardless of whether or not you have undertaken AOa or ACGME post-grad training. All other states are ambivalent as to whether or not you have the AOA transitional year. This only applies to DO grads who are doing AOA accredited post-grad training or to DOs who wish to practice in any of those 5 states immediately upon completion of of their training.
For the other 45 states, there is no such requirement. And, of those 5 states, only MI require you to have completed the AOA transitional year before you undertake either an AOA or an ACGME residency…meaning, w/o that year, you can’t even get a training certificate.
Why? Damned good question…the AOA has been repeatedly been asked by medical students, residents & young physicians to re-evaluate and drop the required internship year…but the AOA simply refuses to do so. Last year, the AOA again “considered” it, but came to the conclusion that the transitional year was one of the things that made osteopathic medicine substantiably different, better all-around physicians and more wholistic in our approach.
What is the internship year? It is essentially the same as the Transitional year offered by the ACGME + some OMM time. It emulates the third year of medical school in that you have rotations in multiple disciplines. But it differs in that you are the the first in-line physician carrying a lot of responsibility. This is, in theory, excellent for your development as a physician; but potentially adds a year to your post grad training. To address the concerns over the additional year, the AOA has begun combining internships & residencies for certain specialties: FP, IM, OB/Gyn and some ER programs. The more the AOA system evolves, the less distguishable it becomes from how the ACGME post-grad programs are structured.
At one point in time, both the ACGME & the AOA treated the intern year, PGY-1, and the residency as separate entities. However, for the most part, the ACGME has incoporated their “internship” into their residencies and the term exists mostly out of tradition. Certain specialties: anesthesia, pathology, radiology & surgery to name a few; continue to have their trainees undertake some form of “internship”. But, for the remiander of their programs, the internship has largely disappeared in the ACGME.
Regarding those 5 states…there are ways to circumvent these regulations. First, as I understand it, they only apply to physicians newly or short-term out of their residencies. If you are compelled to work in one of these states, you can accomplish this two ways:
1) obtain a license in a state that grants reciprocity to physicians licensed in the state in which you’re interested in practicing…OR
2) apply for a license there after you have a few years under your belt
Feel free to post any other questions you may have on this topic…