AACOM Endorses Bipartisan Bill to Ensure Residency Fairness for DOs

Legislation eliminates unfair barriers for osteopathic applicants

IMMEDIATE RELEASE

(Bethesda, MD) – Today, the American Association of Colleges of Osteopathic Medicine (AACOM) applauds U.S. Representatives Diana Harshbarger (R-TN), Chellie Pingree (D-ME), Sam Graves (R-MO), Carol Miller (R-WV) and Don Davis (D-NC) for reintroducing the Fair Access in Residency (FAIR) Act, H.R. 2314—a crucial step toward ensuring equal opportunities in residency training for osteopathic medical students.

“As our nation grapples with a worsening physician shortage, we must eliminate unnecessary barriers that prevent highly qualified osteopathic medical students from accessing residency opportunities,” said AACOM President and CEO Robert A. Cain, DO. “The FAIR Act provides a commonsense solution to longstanding inequities in the residency selection process—without federalizing medical education, imposing quotas or regulating the makeup of residency programs. We are deeply grateful to Representatives Harshbarger, Pingree, Graves, Miller and Davis for their leadership in advancing a fairer, more transparent system.”

Discrimination against DO applicants remains a persistent problem in residency placement. According to the National Resident Matching Program, 29 percent of residency program directors never or seldom interview DO candidates, and among those who do, 73 percent require DO students to take the MD licensing exam (USMLE)—despite the fact that DOs are already required to pass their own comprehensive licensing exam, the COMLEX-USA. These practices place an undue emotional and financial burden on DO students and create unnecessary obstacles to residency placement.

The FAIR Act enhances transparency by establishing two straightforward reporting requirements for Medicare-funded (71 percent of all) graduate medical education (GME) programs:

1. An annual report detailing the number of DO and MD applicants and accepted residents
2. An affirmation that DO applications and COMLEX-USA exam scores are accepted for consideration

Programs that fail to comply would face a two percent annual reduction in Indirect Medical Education payments.

Importantly, the FAIR Act does not change how residency positions are allocated, mandate specific admissions decisions or impose quotas of any kind. Instead, it levels the playing field for osteopathic applicants in the selection process, expanding access and reducing physician shortages—particularly in rural and underserved areas.

“I represent a very rural part of Tennessee that’s already facing physician shortages. There’s no reason to continue practices that keep qualified doctors from serving the communities that need them most. That’s why I’m proud to lead the reintroduction of this legislation,” said Rep. Harshbarger. “Congress must ensure our taxpayer-funded residency programs are tapping into the full pipeline of talent — both DOs and MDs — without discrimination. The FAIR Act promotes transparency and fairness in GME, with the ultimate goal of increasing the number of trained physicians ready to care for our communities.”

“Doctors of osteopathic medicine play a critical role in our health care system, particularly in Maine's rural and underserved communities," said Rep. Pingree. "Sadly, osteopathic medical students are being held back by outdated biases and systemic barriers that have no place in modern medicine. Our bipartisan FAIR Act takes an important step toward ensuring transparency and accountability in residency programs, so that all qualified students—regardless of their degree—have a fair shot at continuing their training. I’m proud that Maine is home to so many dedicated DO students, and I’ll keep doing all I can to remove unnecessary hurdles that stand between them and the communities that need their care.”

“It is imperative that there is full transparency for all federally funded graduate medical education to provide an accurate record of who is getting selected for residency programs. The Fair Access in Residency (FAIR) Act will improve reporting requirements and ensure that osteopathic medical students are treated fairly when applying for residency slots. The West Virginia School of Osteopathic Medicine enrolls more than 800 students, and this legislation will make certain they are treated fairly when applying to residency programs,” said Rep. Miller.

DOs play a vital role in addressing primary care and rural health needs. In 2024, 52.1 percent of matched U.S. DO seniors entered primary care, compared to just 35.6 percent of U.S. MD seniors. Moreover, more than 73 percent of DOs remain in the state where they complete residency training, making fair access to residency a critical issue for states struggling with physician shortages.

“Doctors of osteopathic medicine (DOs) are essential to the physician workforce, particularly in rural and underserved communities, yet unnecessary barriers exist that limit their access to residency opportunities,” said Alan Morgan, CEO National Rural Health Association. “That’s why the National Rural Health Association supports the FAIR Act, which would increase transparency, address physician shortages and ensure a more equitable residency selection process. We commend Representatives Harshbarger, Pingree, Graves, Miller and Davis for their leadership in advancing policies that support rural providers and urge Congress to act on this critical legislation.”

By increasing transparency in Medicare GME, the FAIR Act will enable DOs to compete fairly for residency positions, better serve their communities and help strengthen America’s healthcare workforce.

About AACOM:

Founded in 1898, the American Association of Colleges of Osteopathic Medicine (AACOM) is the leading voice for the education and training of physicians who practice osteopathic medicine in settings across the medical spectrum—from primary care to the full range of medical specialties. We support our member colleges of osteopathic medicine in their efforts to attract and train individuals who are fueled by a desire to make a difference in our healthcare system by treating the whole person and building a future emphasizing health and wellness for all people. Today, more than 36,000 future physicians—25 percent of all U.S. medical students—are being educated at one of our 42 accredited colleges of osteopathic medicine, encompassing 67 teaching locations in 36 states.  To learn more about AACOM, please visit our website.

Contacts:

Joseph Shapiro
Director of Media Relations
(240) 938-0746
jshapiro@aacom.org

Christine DeCarlo
Senior Manager of Media and Public Affairs
(202) 603-1026
cdecarlo@aacom.org