OHPI Mianna Armstrong, OMS-IV, MS

It is hard to believe that my time in Washington is coming to a close, and I am heading back to the Midwest soon! During my time here, I have often felt like a sponge, listening to and learning from everything that is going on around me, including the scope of actions that AACOM’s Office of Government Relations (GR) carries out on behalf of colleges of osteopathic medicine (COMs) across the country. These include providing testimony to Congress regarding issues that directly affect COMs and osteopathic medical students; nominating osteopathic medical education (OME) professionals to federal advisory committees, councils, agencies, boards, workgroups, and task forces; posting public statements on issues that directly affect osteopathic medical schools and students; and publicizing federal grant opportunities COMs can apply for, among many other things!

THCGME Program

One of the main programs that AACOM GR advocates for is the Teaching Health Center Graduate Medical Education (THCGME) Program, which is a federal program established in 2010 focused on the development and expansion of primary care residency programs in community-based ambulatory patient care settings. More than half of the THCGME centers are located in medically underserved communities, with 65% of trainees being family medicine residents. Funding for this program is set to expire after September 30, 2019, without congressional action. AACOM leads a THCGME Coalition focused on reauthorization of this crucial program, and has worked closely with U.S. Senator Collins’ (R-ME) office to introduce and support a reauthorization bill, the Training the Next Generation of Primary Care Doctors Act of 2019 (S. 1191). AACOM played an active role in ensuring that that the bill included provisions critical to the OME community and encourages you to reach out to  your Senators in support of this vital bill.

Higher Education Act

Of all the osteopathic medical students graduating in 2018, only The Higher Education Act was passed in 1965 with a goal of expanding access to all students wishing to pursue an advanced education. At the federal level, this involves providing access to financial aid and federal loans, which AACOM advocates for through ED to MED. ED to MED is a grassroots campaign focused on addressing the physician workforce shortage by protecting federal financial aid and loan repayment programs such as Grad PLUS and Public Service Loan Forgiveness (PSLF).

Seventy percent of osteopathic medical students who graduated in the 2017-2018 academic year relied on Grad PLUS. Grad PLUS loans cover the full cost of attendance minus any other financial aid received, including tuition, textbooks, room and board, and other important living expenses. Grad PLUS loans are not currently capped. Imposing borrowing limits or caps (as proposed in the PROSPER Act) could force students to take out private loans with higher interest rates, fewer borrower protections, limited repayment options, and stricter credit checks.

The PSLF Program was signed into law in 2007 and encourages providers to work in public service positions in medically underserved areas in exchange for forgiveness of the remaining balance of their loans after 120 qualifying monthly payments. 55 percent of osteopathic medical students graduating in 2017-2018 indicated their intention to enter a loan forgiveness program; of those, 70 percent said they planned to participate in the PSLF Program. Every osteopathic medical student can help advocate to #SavePSLF and #SaveGradPLUS by joining ED to MED today!

Opioid Crisis

While underserved and rural communities tend to be particularly hard hit by the opioid crisis, substance use disorder is a disease that doesn’t discriminate based on age, race, gender, or socioeconomic status. The first event I attended that focused on the opioid crisis, Tracking Federal Funding to Combat the Opioid Crisis, was hosted by the Bipartisan Policy Center where I learned that nearly 50,000 Americans died from an opioid overdose in 2017 alone. This event focused on the 57 programs, under 6 different federal agencies, that distributed $3.3 billion in fiscal year (FY) 2017 and $7.4 billion in FY18 and assessed the success and long-term sustainability of the funding opportunities.

The second event was the Action Collaborative on Countering the U.S. Opioid Epidemic, hosted by the National Academy of Medicine. The collaborative consists of over 100 organizations, including AACOM, that have committed to implementing recommendations produced by four working groups. The focus areas include education and training; prescribing guidelines and evidence standards; prevention, treatment, and recovery; and research, data, and metrics. AACOM is particularly active with this collaborative, as Dr. Shannon, AACOM’s President and CEO, serves as a member of the Health Professional Education and Training Working Group. The goal of the collaborative is to identify the complex challenges and research gaps of the opioid crisis, elevate and accelerate evidence-based and interprofessional solutions, and catalyze action on shared priorities to overcome the crisis.

Thank you all for following along on my eight-week journey as an OHPI. I would strongly encourage anyone who is interested to apply for this opportunity! Medical school has taught me how to be a strong advocate for my patients within the context of the clinical setting, and the internship has shown me that advocacy in the public policy world can have a tremendous impact on patient lives, both directly and indirectly!

April 24, 2019

Hi Everyone! My name is Mianna. I am currently a fourth-year student at Kansas City University of Medicine and Biosciences College of Osteopathic Medicine (KCU-COM) and will be graduating in May, going on to complete my OB/GYN residency in Columbus, OH.

I didn’t always know I was going to be an OB/GYN, or even a doctor. I grew up in a farming community of less than 300 people in rural Alberta (that’s in Canada), and graduated from high school in a class of just ten people. I played every sport imaginable as a kid and was recruited to play volleyball in college. I chose Hampton University in Virginia, a historically black university, where I was a first-generation student and completed my bachelor’s degree before deciding to go to medical school.

Spoiler alert: I chose KCU-COM, and as a third-year medical student found that I had a passion for women’s health. Between my third and fourth years of medical school, I took time to complete a yearlong, on-campus teaching and research fellowship, exposing me to the policy and administrative side of medicine, which encouraged me to apply for the AACOM Osteopathic Health Policy Internship Program!

Appropriations Season

n March 11, 2019, just one week before I arrived in DC, the President’s budget for fiscal year (FY) 2020 (October 1, 2019 – September 30, 2020) was released. As you may have heard, the U.S. government shut down for a record 35 days just a few months ago. This was because the remaining appropriations bills for FY19 could not be agreed upon.

• What is the process for appropriations? The President releases a budget proposal in the early months of the calendar year for the following fiscal year. (It is very important to note, however, that the President’s annual budget proposal is received by Congress as a statement of the Administration’s priorities and does not serve as a directive of federal funding.) Congress holds a series of hearings on the President’s budget request to discuss the funding priorities and numbers requested. Then, lawmakers must determine the high-level spending numbers by passing a budget resolution, and attempt to agree on bipartisan, bicameral appropriations bills. These bills appropriate dollar amounts to specific initiatives, tasks, or purposes in the final budget that is then sent to the President for signature, all before the next fiscal year.

• What does this mean for me, the intern? It means that I have been to several Senate and House hearings, hosted by multiple committees and subcommittees, to hear testimony for the priorities President Trump has outlined in his proposed budget. I’ve heard Secretaries Betsy DeVos and Robert Wilkie testify about the proposed budgets for the U.S. Departments of Education and Veterans Affairs, respectively. I’ve also heard testimony from Francis Collins, MD, PhD, the Director of the National Institutes of Health, and listened to Robert Redfield, MD, Director of the Centers for Disease Control and Prevention, regarding the proposed cuts in their budgets and the long-term impact they would have on the American people.

AACOM Annual Conference

Big data was the theme of Educating Leaders 2019, AACOM’s Annual Conference, from April 10 – 12 in Washington, DC. Kyu Rhee, MD, MPP, was the Wednesday morning plenary speaker. He spoke about the functionality of incorporating IBM Watson, an artificial intelligence system, into the future of healthcare. On Thursday morning, Dr. Eric Warm, MD, FACP, described how novel methods of assessing and evaluating residents could be used to help better instruct and prepare them for their future practice.

Jennifer Golbeck, PhD, MS, was Friday morning’s plenary speaker (and is also behind The Golden Ratio social media accounts) who utterly captivated the crowd. She discussed the research her team does using public data from social media profiles by analyzing patterns of behavior that when detected among millions of people can become predictive. Through this process, one of the amazing things they have been able to accurately predict is postpartum depression from public Twitter feeds (remember, future obstetrician here)! Even if you think your privacy settings are secure, there are ways for data collection to compute and predict your location, spending habits, and the multitude of devices you use, even if they are not linked in any way.

I also had the opportunity to take part in the Residents and Fellows Council (RFC) activities, which included a fantastic workshop on employment contracts for new physicians by Susan Sanford, JD. On Saturday, the RFC hosted a Leadership Track that offered personal and professional learning opportunities as well.

I also attended sessions that covered graduate medical education expansion, an update on the single accreditation system, increasing diversity in medicine, responses to the opioid epidemic, and of course the awards banquet! At the awards banquet I had the honor of seeing Mustafa Basree receive the 2019 ED to MED Outstanding Advocate of the Year Award. The organizing committee also did a great job surprising Dr. Shannon, AACOM’s President and CEO, with the presence of his family and friends to celebrate all that he has done to advance the osteopathic profession in his tenure at AACOM.

Thank you for reading, and I can’t wait to tell you all about the next four weeks!