Harshbarger, Pingree Introduce Fair Access in Residency (FAIR) Act

Press Release

U.S. Representatives Diana Harshbarger (R-TN), Chellie Pingree (D-ME), and Sam Graves (R-MO) introduced the bipartisan Fair Access in Residency (FAIR) Act (H.R. 8850), to ensure taxpayer-funded physician residency training programs create an equal path to residency for both Doctors of Osteopathic Medicine (DOs) and Medical Doctors (MDs). This legislation aims to address disparities and barriers in Medicare-funded Graduate Medical Education (GME) programs that often exclude or impose burdensome requirements for DOs.

"I am proud to help lead legislation that has the ability to transform accessibility to DOs across the country and strengthen our physician pipeline, especially in rural and underserved areas. It's more critical now than ever that we ensure our taxpayer-funded residency training programs are fairly and equally deploying all the best talent of tomorrow's doctors and specialists, from both DO and MD educational backgrounds," said Harshbarger. "This bill is an important step toward ensuring transparency and equality in our taxpayer-funded GME programs, with the ultimate goal of increasing the number of physicians trained and serving our communities."

"As one of the fastest growing health professions in the country, Doctors of Osteopathic Medicine provide essential care in our communities, particularly in rural and underserved areas. It's ridiculous that osteopathic medical students are facing discrimination and extra hurdles to accessing federally funded residency programs. The FAIR Act will help to ensure more accountability from these programs," said Pingree. "I'm proud that so many dedicated DOs are being trained in Maine and across the country. We should be helping them serve patients without unnecessary barriers, which is exactly what this legislation aims to do."

"North Missouri is the home to A.T. Still University in Kirksville, MO, the birthplace of osteopathic medicine, which continues to train the next generation of DOs. In a day and age when doctors are in short supply, specifically in rural areas, it's critical they are able to complete their training and begin practicing," said Graves. "Yet, many times osteopathic medical students aren't even considered for taxpayer-funded residency programs. Rural healthcare needs the services and expertise of DOs like never before and this bill will remove some of the hurdles which can keep them from taking the next step in their training."

"We appreciate Reps. Harshbarger, Pingree and Graves' effort to address the unfair barriers and discrimination that osteopathic medical students face when applying to federally funded residency training," said AACOM President and CEO Robert A. Cain, DO. "Ensuring that osteopathic medical students have an equitable path to residency not only reflects the spirit of single accreditation, which was designed to increase access to residency programs for both DOs and MDs, but it also addresses persistent and prevalent biases against osteopathic medical students, many of whom will go on to care for patients in rural and medically underserved communities. We also thank our peer organizations for supporting this vital bill."

The FAIR Act requires federally funded GME programs to: 

Report annually the number of applicants for residency from osteopathic (DO) and allopathic (MD) medical schools and how many such applicants that were accepted from each respective type of school; and

Affirm annually that they accept applicants from both osteopathic and allopathic medical schools, and that if an examination score is required for acceptance, both the COMLEX-USA (DO) and USMLE (MD) licensing exams will be equally accepted.

Background:

Physicians must complete GME training in a particular specialty -- such as family medicine or anesthesiology -- after four years of medical school before they can practice medicine independently. During their training, residents work under supervision of other physicians to gain experience caring for patients. Residents often train in their chosen specialty for at least 3 years, but some residents choose specialties with a longer residency training period.

The Federal government is the largest source of federal financial support for the U.S. healthcare workforce, and contributes more than $16 billion per year to GME medical residency training programs, the bulk of which is Medicare-funded GME for physicians.

The FAIR Act would address the problem of GME programs often excluding or imposing burdensome requirements for Doctors of Osteopathic Medicine (DOs). According to National Resident Matching Program data, 36 percent of residency program directors never or seldom interview DO candidates. Furthermore, the American Medical Association's Fellowship and Residency Electronic Interactive Database Access shows that 32 percent of residency programs mandate that osteopathic medical students take the MD licensing exam, even though the DO licensing exam grants physicians unrestricted practice rights in all 50 states.

Osteopathic medicine is one of the fastest growing health professions in the United States and colleges of osteopathic medicine are now educating 25 percent of all medical students. DOs are meeting our nation's health care needs, prioritizing primary care specialties, and practicing in rural and underserved areas at notably high rates. Physician distribution is influenced by training location, and more than 73 percent of DOs practice in the state where they do their residency training. Unnecessary and unfair residency criteria negatively impact physician distribution leading to disparities in health care access.

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