This measure, among other things, would urge both private and public medical training institutions in the state to provide equal access to osteopathic and allopathic students to apply to training programs, would urge osteopathic medical schools, allopathic medical schools, and their training institutions to build on current successes of working toward greater collaboration and coordination of education and training for Californias future physicians, and would urge efforts by training institutions and allopathic and osteopathic medical schools to work toward greater acceptance and integration of osteopathic and allopathic students.

This measure, among other things, would urge both private and public medical training institutions in the state to provide equal access to osteopathic and allopathic students to apply to training programs, would urge osteopathic medical schools, allopathic medical schools, and their training institutions to build on current successes of working toward greater collaboration and coordination of education and training for Californias future physicians, and would urge efforts by training institutions and allopathic and osteopathic medical schools to work toward greater acceptance and integration of osteopathic and allopathic students.

This measure, among other things, would urge both private and public medical training institutions in the state to provide equal access to osteopathic and allopathic students to apply to training programs, would urge osteopathic medical schools, allopathic medical schools, and their training institutions to build on current successes of working toward greater collaboration and coordination of education and training for Californias future physicians, and would urge efforts by training institutions and allopathic and osteopathic medical schools to work toward greater acceptance and integration of osteopathic and allopathic students.

This measure would measure, among other things, would urge both private and public medical training institutions in the state to provide equal access to osteopathic and allopathic students to apply to training programs, would urge osteopathic medical schools, allopathic medical schools, and their training institutions to build on current successes of working toward greater collaboration and coordination of education and training for Californias future physicians, and would urge efforts by training institutions and allopathic and osteopathic medical schools to work toward greater acceptance and integration of osteopathic and allopathic students.

This measure would urge both private and public medical training institutions in the state to provide equal access to osteopathic and allopathic students to apply to training programs, would urge osteopathic medical schools, allopathic medical schools, and their training institutions to build on current successes of working toward greater collaboration and coordination of education and training for Californias future physicians, and would urge efforts by training institutions and allopathic and osteopathic medical schools to work toward greater acceptance and integration of osteopathic and allopathic students.

This measure would urge both private and public medical training institutions in the state to provide equal access to osteopathic and allopathic students to apply to training programs, would urge osteopathic medical schools, allopathic medical schools, and their training institutions to build on current successes of working toward greater collaboration and coordination of education and training for Californias future physicians, and would urge efforts by training institutions and allopathic and osteopathic medical schools to work toward greater acceptance and integration of osteopathic and allopathic students.

WHEREAS, California has a significant shortage and inequitable distribution of physicians throughout the state due to the aging population, current population growth, and the increasing number of insured; and

WHEREAS, According to a study by the Robert Graham Center in 2013, it was estimated that the state would need 8,243 more primary care physicians by 2030, a 32-percent increase of its current workforce; and

WHEREAS, The states ability to meet the need for primary care osteopathic physicians (DOs) and allopathic physicians (MDs) is directly affected by the number of medical residency slots available in physician training programs across the state, and the current number of graduate medical education slots must be increased substantially; and

WHEREAS, DOs are one of the fastest growing segments of health care professionals in the United States. By 2016, more than 100,000 DOs are expected to be in active medical practice; and

WHEREAS, Approximately 60 percent of practicing DOs specialize in primary care fields such as family medicine, internal medicine, and pediatrics, and many DOs fill a critical need by practicing in rural and other medically underserved areas; and

WHEREAS, Beginning in 2020, osteopathic (DO) and allopathic (MD) residency programs will be overseen by a single unified accrediting body; and

WHEREAS, Quality medical training for DO and MD students is critical to their success as fully trained and licensed physicians, and all medical schools should provide the support necessary for their students to receive the best possible medical training; and

WHEREAS, Many public and private institutions have provided equal access to the application process for their medical training programs by all students and physicians, and have trained exemplary DO and MD students by choosing those candidates who best suit their programs; and

WHEREAS, In many areas of the state there are outstanding examples of medical training programs that have been integrated effectively and are providing DO and MD students with exceptional training opportunities; and

WHEREAS, Section 2064.2 of the Business and Professions Code states that no medical school or clinical training program shall deny access to elective clerkships or preceptorships in any medical school or clinical training program in this state solely on the basis that a student is enrolled in an DO medical school; and

WHEREAS, Section 2453 of the Business and Professions Code states that it is the policy of the state that holders of MD degrees and DO degrees shall be accorded equal professional status and privileges as licensed physicians and surgeons; now, therefore, be it

Resolved by the Assembly of the State of California, the Senate thereof concurring, That the Legislature urges both private and public medical training institutions in the state to provide equal access to DO and MD students to apply to training programs while still maintaining the integrity and competitiveness of their application process and the need to first serve enrolled students; and be it further

Resolved, That the Legislature urges DO medical schools, MD medical schools, and training institutions to build on current successes of working toward greater collaboration and coordination of education and training for Californias future physicians and for these medical schools to develop a plan to adequately support medical training for their students and create positive partnerships with medical training programs that are open to both DO and MD students and graduates; and be it further

Resolved, That the Legislature urges efforts by training institutions and DO and MD medical schools to work toward greater acceptance and integration of DO and MD students in their medical training programs; and be it further

Resolved, That the Chief Clerk of the Assembly transmit copies of this resolution to the author for appropriate distribution.

WHEREAS, California has a significant shortage and inequitable distribution of physicians throughout the state due to the aging population, current population growth, and the increasing number of insured; and

WHEREAS, According to a study by the Robert Graham Center in 2013, it was estimated that the state would need 8,243 more primary care physicians by 2030, a 32-percent increase of its current workforce; and

WHEREAS, The states ability to meet the need for primary care osteopathic physicians (DOs) and allopathic physicians (MDs) is directly affected by the number of medical residency slots available in physician training programs across the state, and the current number of graduate medical education slots must be increased substantially; and

WHEREAS, DOs are one of the fastest growing segments of health care professionals in the United States. By 2016, more than 100,000 DOs are expected to be in active medical practice; and

WHEREAS, Approximately 60 percent of practicing DOs specialize in primary care fields such as family medicine, internal medicine, and pediatrics, and many DOs fill a critical need by practicing in rural and other medically underserved areas; and

WHEREAS, Beginning in 2020, osteopathic (DO) and allopathic (MD) residency programs will be overseen by a single unified accrediting body; and

WHEREAS, Quality medical training for DO and MD students is critical to their success as fully trained and licensed physicians, and all medical schools should provide the support necessary for their students to receive the best possible medical training; and

WHEREAS, Many public and private institutions have provided equal access to the application process for their medical training programs by all students and physicians, and have trained exemplary DO and MD students by choosing those candidates who best suit their programs; and

WHEREAS, In many areas of the state there are outstanding examples of medical training programs that have been integrated effectively and are providing DO and MD students with exceptional training opportunities; and

WHEREAS, Section 2064.2 of the Business and Professions Code states that no medical school or clinical training program shall deny access to elective clerkships or preceptorships in any medical school or clinical training program in this state solely on the basis that a student is enrolled in an DO medical school; and

WHEREAS, Section 2453 of the Business and Professions Code states that it is the policy of the state that holders of MD degrees and DO degrees shall be accorded equal professional status and privileges as licensed physicians and surgeons; now, therefore, be it

Resolved by the Assembly of the State of California, the Senate thereof concurring, That the Legislature urges both private and public medical training institutions in the state to provide equal access to DO and MD students to apply to training programs while still maintaining the integrity and competitiveness of their application process and the need to first serve enrolled students; and be it further

Resolved, That the Legislature urges DO medical schools, MD medical schools, and training institutions to build on current successes of working toward greater collaboration and coordination of education and training for Californias future physicians and for these medical schools to develop a plan to adequately support medical training for their students and create positive partnerships with medical training programs that are open to both DO and MD students and graduates; and be it further

Resolved, That the Legislature urges efforts by training institutions and DO and MD medical schools to work toward greater acceptance and integration of DO and MD students in their medical training programs; and be it further

Resolved, That the Chief Clerk of the Assembly transmit copies of this resolution to the author for appropriate distribution.

WHEREAS, California has a significant shortage and inequitable distribution of physicians throughout the state due to the aging population, current population growth, and the increasing number of insured; and

WHEREAS, According to a study by the Robert Graham Center in 2013, it was estimated that the state would need 8,243 more primary care physicians by 2030, a 32-percent increase of its current workforce; and

WHEREAS, The states ability to meet the need for primary care osteopathic physicians (DOs) and allopathic physicians (MDs) is directly affected by the number of medical residency slots available in physician training programs across the state, and the current number of graduate medical education slots must be increased substantially; and

WHEREAS, DOs are one of the fastest growing segments of health care professionals in the United States. By 2016, more than 100,000 DOs are expected to be in active medical practice; and

WHEREAS, Approximately 60 percent of practicing DOs specialize in primary care fields such as family medicine, internal medicine, and pediatrics, and many DOs fill a critical need by practicing in rural and other medically underserved areas; and

WHEREAS, Beginning in 2020, osteopathic (DO) and allopathic (MD) residency programs will be overseen by a single unified accrediting body; and

WHEREAS, Quality medical training for DO and MD students is critical to their success as fully trained and licensed physicians, and all medical schools should provide the support necessary for their students to receive the best possible medical training; and

WHEREAS, Many public and private institutions have provided equal access to the application process for their medical training programs by all students and physicians, and have trained exemplary DO and MD students by choosing those candidates who best suit their programs; and

WHEREAS, In many areas of the state there are outstanding examples of medical training programs that have been integrated effectively and are providing DO and MD students with exceptional training opportunities; and

WHEREAS, Section 2064.2 of the Business and Professions Code states that no medical school or clinical training program shall deny access to elective clerkships or preceptorships in any medical school or clinical training program in this state solely on the basis that a student is enrolled in an DO medical school; and

WHEREAS, Section 2453 of the Business and Professions Code states that it is the policy of the state that holders of MD degrees and DO degrees shall be accorded equal professional status and privileges as licensed physicians and surgeons; now, therefore, be it

Resolved by the Assembly of the State of California, the Senate thereof concurring, That the Legislature urges both private and public medical training institutions in the state to provide equal access to DO and MD students to apply to training programs while still maintaining the integrity and competitiveness of their application process and the need to first serve enrolled students; and be it further

Resolved, That the Legislature urges DO medical schools, MD medical schools, and training institutions to build on current successes of working toward greater collaboration and coordination of education and training for Californias future physicians and for these medical schools to develop a plan to adequately support medical training for their students and create positive partnerships with medical training programs that are open to both DO and MD students and graduates; and be it further

Resolved, That the Legislature urges efforts by training institutions and DO and MD medical schools to work toward greater acceptance and integration of DO and MD students in their medical training programs; and be it further

Resolved, That the Chief Clerk of the Assembly transmit copies of this resolution to the author for appropriate distribution.

WHEREAS, California has a significant shortage and inequitable distribution of physicians throughout the state due to the aging population, current population growth, and the increasing number of insured; and

WHEREAS, According to a study by the Robert Graham Center in 2013, it was estimated that the state would need 8,243 more primary care physicians by 2030, a 32 32-percent increase of its current workforce; and

WHEREAS, The states ability to meet the need for primary care osteopathic physicians (DOs) and allopathic physicians (MDs) is directly affected by the number of medical residency slots available in physician training programs across the state, and the current amount number of graduate medical education slots must be increased substantially; and

WHEREAS, DOs are one of the fastest growing segments of health care professionals in the United States. By 2016, more than 100,000 DOs are expected to be in active medical practice; and

WHEREAS, Approximately 60 percent of practicing DOs specialize in primary care fields such as family medicine, internal medicine, and pediatrics, and many DOs fill a critical need by practicing in rural and other medically underserved areas; and

WHEREAS, Beginning in 2020, osteopathic (DO) and allopathic (MD) residency programs will be overseen by a single unified accrediting body; and

WHEREAS, Quality medical training for DO and MD students is critical to their success as fully trained and licensed physicians; physicians, and all medical schools should provide the support necessary for their students to receive the best possible medical training; and

WHEREAS, Many public and private institutions have provided equal access to the application process for their medical training programs by all students and physicians, and have trained exemplary DO and MD students by choosing those candidates who best suit their programs; and

WHEREAS, In many areas of the state there are outstanding examples of medical training programs that have been integrated effectively and are providing DO and MD students with exceptional training opportunities; and

WHEREAS, Section 2064.2 of the Business and Professions Code states that no medical school or clinical training program shall deny access to elective clerkships or preceptorships in any medical school or clinical training program in this state solely on the basis that a student is enrolled in an DO medical school; and

WHEREAS, Section 2453 of the Business and Professions Code states that it is the policy of the state that holders of MD degrees and DO degrees shall be accorded equal professional status and privileges as licensed physicians and surgeons; now, therefore, be it

Resolved by the Assembly of the State of California, the Senate thereof concurring, That the Legislature urges both private and public medical training institutions in the state to provide equal access to DO and MD students to apply to training programs while still maintaining the integrity and competitiveness of their application process and the need to first serve enrolled students; and be it further

Resolved, That the Legislature urges DO medical schools, MD medical schools, and their training institutions to build on current successes of working toward greater collaboration and coordination of education and training for Californias future physicians and for these medical schools to develop a plan to adequately support medical training for their students and create positive partnerships with medical training programs that are open to both DO and MD students and graduates; and be it further

Resolved, That the Legislature urges efforts by training institutions and MD and DO DO and MD medical schools to work toward greater acceptance and integration of DO and MD students in their medical training programs; and be it further

Resolved, That the Chief Clerk of the Assembly transmit copies of this resolution to the author for appropriate distribution.

WHEREAS, California has a significant shortage and inequitable distribution of physicians throughout the state due to the aging population, current population growth, and the increasing number of insured; and

WHEREAS, According to a study by the Robert Graham Center in 2013, it was estimated that the state would need 8,243 more primary care physicians by 2030 2030, a 32 percent increase of its current workforce; and

WHEREAS, The states ability to meet the need for primary care osteopathic physicians (DOs) and allopathic physicians is directly affected by the number of medical residency slots available in physician training programs across the state, and the current amount of graduate medical education slots must be increased substantially; and

WHEREAS, Osteopathic physicians DOs are one of the fastest growing segments of health care professionals in the United States. By 2016, more than 100,000 osteopathic physicians (DOs) DOs are expected to be in active medical practice; and

WHEREAS, Approximately 60 percent of practicing DOs specialize in primary care fields such as family medicine, internal medicine, and pediatrics pediatrics, and many DOs fill a critical need by practicing in rural and other medically underserved areas; and

WHEREAS, Osteopathic Beginning in 2020, osteopathic (DO) and allopathic (MD) residency programs will soon be overseen by a single unified graduate medical education accrediting body; and

WHEREAS, Quality medical training for DO and MD students is critical to their success as fully trained and licensed physicians; and

WHEREAS, Many public and private institutions have historically provided equal access to the application process for their medical training programs by all students and physicians, and have trained exemplary DO and MD students by choosing those candidates who best suit their programs; and

WHEREAS, Section 2064.2 of the Business and Professions Code states that no medical school or clinical training program shall deny access to elective clerkships or preceptorships in any medical school or clinical training program in this state solely on the basis that a student is enrolled in an osteopathic DO medical school; and

WHEREAS, Section 2453 of the Business and Professions Code states that it is the policy of the state that holders of MD degrees and DO degrees shall be accorded equal professional status and privileges as licensed physicians and surgeons; now, therefore, be it

Resolved by the Assembly of the State of California, the Senate thereof concurring, That the Legislature urges both private and public medical training institutions in the state to provide equal access to DO and MD students to apply to training programs while still maintaining the integrity and competitiveness of their application process and the need to first serve enrolled students; and be it further

Resolved, That the Legislature urges osteopathic DO medical schools, allopathic MD medical schools, and their training institutions to build on current successes of working toward greater collaboration and coordination of education and training for Californias future physicians; and be it further

Resolved, That the Legislature urges efforts by training institutions and allopathic MD and osteopathic DO medical schools to work toward greater acceptance and integration of DO and MD students in their medical training programs; and be it further

Resolved, That the Chief Clerk of the Assembly transmit copies of this resolution to the author for appropriate distribution.

WHEREAS, California has a significant shortage and inequitable distribution of physicians throughout the state due to the aging population, current population growth, and the increasing number of insured; and

WHEREAS, According to a study by the Robert Graham Center in 2013, it was estimated that the state would need 8,243 more primary care physicians by 2030 a 32 percent increase of its current workforce; and

WHEREAS, Osteopathic physicians are one of the fastest growing segments of health care professionals in the United States. By 2016, more than 100,000 osteopathic physicians (DOs) are expected to be in active medical practice; and

WHEREAS, Approximately 60 percent of practicing DOs specialize in primary care fields such as family medicine, internal medicine, and pediatrics and many DOs fill a critical need by practicing in rural and other medically underserved areas; and

WHEREAS, Osteopathic (DO) and allopathic (MD) residency programs will soon be overseen by a single unified graduate medical education accrediting body; and

WHEREAS, Quality medical training for DO and MD students is critical to their success as fully trained and licensed physicians; and

WHEREAS, Many public and private institutions have historically provided equal access to the application process for their medical training programs by all students and physicians, and have trained exemplary DO and MD students by choosing those candidates who best suit their programs; and

WHEREAS, Section 2064.2 of the Business and Professions Code states that no medical school or clinical training program shall deny access to elective clerkships or preceptorships in any medical school or clinical training program in this state solely on the basis that a student is enrolled in an osteopathic medical school; and

WHEREAS, Section 2453 of the Business and Professions Code states that it is the policy of the state that holders of MD degrees and DO degrees shall be accorded equal professional status and privileges as licensed physicians and surgeons; now, therefore, be it

Resolved by the Assembly of the State of California, the Senate thereof concurring, That the Legislature urges both private and public medical training institutions in the state to provide equal access to DO and MD students to apply to training programs while still maintaining the integrity and competitiveness of their application process and the need to first serve enrolled students; and be it further

Resolved, That the Legislature urges osteopathic medical schools, allopathic medical schools, and their training institutions to build on current successes of working toward greater collaboration and coordination of education and training for Californias future physicians; and be it further

Resolved, That the Legislature urges efforts by training institutions and allopathic and osteopathic medical schools to work toward greater acceptance and integration of DO and MD students in their medical training programs; and be it further

Resolved, That the Chief Clerk of the Assembly transmit copies of this resolution to the author for appropriate distribution.

 THIRD READING 

Bill No: ACR 97

Author: Bonilla (D), et al.

Amended: 9/2/15 in Assembly

Vote: 21

ASSEMBLY FLOOR: Read and adopted, 9/2/15

SUBJECT: Medical training: osteopathic students

SOURCE: Author

DIGEST: This resolution urges both private and public medical training institutions to provide equal access to, and to work toward greater acceptance and integration of, training and education programs for both Osteopathic Physicians (DOs) and Allopathic Physicians (MDs).

ANALYSIS: This resolution makes the following legislative findings:

1. California has a significant shortage and inequitable distribution of physicians throughout the state due to the aging population, current population growth and the increasing number of insured.

2. According to a study by the Robert Graham Center in 2013, it was estimated that the state would need 8,243 more primary care physicians by 2030 – a 32% increase of its current workforce.

3. The state's ability to meet the need for primary care DOs and MDs is directly affected by the number of medical residency slots available in physician training programs across the state, and the current number of graduate medical education slots must be increased substantially.

4. DOs are one of the fastest growing segments of health care professionals in the United States: by 2016, more than 100,000 DOs are expected to be in active medical practice.

5. Approximately 60% of practicing DOs specialize in primary care fields such as family medicine, internal medicine, and pediatrics and many DOs fill a critical need by practicing in rural and other medically underserved areas.

6. Beginning in 2020, DO and MD residency programs will be overseen by a single unified accrediting body.

7. Quality medical training for DO and MD students is critical to their success as fully trained and licensed physicians and all medical schools should provide the support necessary for their students to receive the best possible medical training.

8. Many public and private institutions have provided equal access to the application process for their medical training programs by all students and physicians, and have trained exemplary DO and MD students by choosing those candidates who best suit their programs.

9. In many areas of the state there are outstanding examples of medical training programs that have been integrated effectively and are providing DO and MD students with exceptional training opportunities.

This resolution urges both private and public medical training institutions to provide equal access to, and to work toward greater acceptance and integration of, training and education programs for both DOs and MDs.

Background

Osteopathic Physicians. DOs are similar to MDs in that both are considered to be "complete physicians." A key difference between the two professions is that DOs have an additional dimension in their training and practice, one not taught in medical schools which grant MD degrees. Both DOs and MDs take the prescribed amount of pre-medical training, graduate from an undergraduate institution with an emphasis on science courses, and receive four years of training in medical school. Specifically, DOs must possess a Doctorate of Osteopathic Medicine Degree from an accredited osteopathic medical school, complete one year of post-graduate training, which includes at least four months of general medicine, and complete all levels of the National Board of Osteopathic Medical Examiners' Comprehensive Osteopathic Medical Licensing Examination.

The same laws govern the required training for DOs and MDs who are licensed in California. In recognition of this fact, Business and Professions Code (BPC) Section 2453 states: "…it is the policy of this State that holders of MD degrees and DO degrees shall be accorded equal professional status and privileges as licensed physicians and surgeons." Licensing examinations for DOs are also comparable in rigor and comprehensiveness to those given to MDs.

Training Programs. Prior to DO or MD students completing their medical school education and entering into residency programs, they must first complete the degree requirements for medical school which may include elective clerkships. As part of osteopathic medical school education, after successful completion of the first two years of classroom-based education, DO students are eligible to apply for elective clerkships as part of their medical school curriculum. These clerkships are often "hands-on" rotations which help inform many students about the area or areas of medicine in which they would like to practice. Many DO students will apply for these elective courses at training institutions outside of the two osteopathic medical schools in California. According to the author, in the last year, there have been a number of training institutions that have specifically excluded DO students from applying to their programs for elective clerkships or rotations. Further, the author notes that there was a fee differential for DO students who applied for these programs compared to their MD counterparts. Also, it was noted that DO student applicants were required to have a higher United States Medical Licensing Examination score compared to their MD counterparts.

BPC Section 2064.2 states that no medical school or clinical training program shall deny access to elective clerkships or training programs solely on the basis that a student is enrolled in an osteopathic medical school. While this does not require institutions to accept DO students, it makes it clear that DO students should not be denied access to these elective programs solely based on their choice of medical education.

In an effort to encourage equity for both allopathic and osteopathic medical students who are entering into training programs, this resolution simply urges both public and private medical training institutions to provide equal access to both osteopathic and allopathic students in applying for training programs and urges training institutions, along with allopathic and osteopathic medical schools, to work together toward greater acceptance and integration of its osteopath and allopath students.

FISCAL EFFECT: Appropriation: No Fiscal Com.: No Local: No

SUPPORT: (Verified 9/4/15)

American Osteopathic Association

California Medical Association

Osteopathic Physicians and Surgeons of California

OPPOSITION: (Verified 9/4/15)

None received

Prepared by: Melissa Ward / SFA / (916) 651-1520

9/4/15 16:42:37

**** END ****

ASSEMBLY THIRD READING

ATR Bill Id:ACR 97

Author:(Bonilla)

As Amended Ver:September 1, 2015

Majority vote

SUMMARY: Urges both private and public medical training institutions to provide equal access to, and to work toward greater acceptance and integration of, training and education programs for both Osteopathic Physicians (DOs) and Allopathic Physicians (MDs). Specifically, this bill:

1. Declares the following:

   1. California has a significant shortage and inequitable distribution of physicians throughout the state due to the aging population, current population growth and the increasing number of insured;

   2. According to a study by the Robert Graham Center in 2013, it was estimated that the state would need 8,243 more primary care physicians by 2030 – a 32% increase of its current workforce;

   3. The state's ability to meet the need for primary care DOs and MDs is directly affected by the number of medical residency slots available in physician training programs across the state, and the current number of graduate medical education slots must be increased substantially;

   4. DOs are one of the fastest growing segments of health care professionals in the United States: by 2016, more than 100,000 DOs are expected to be in active medical practice;

   5. Approximately 60% of practicing DOs specialize in primary care fields such as family medicine, internal medicine, and pediatrics and many DOs fill a critical need by practicing in rural and other medically underserved areas;

   6. Beginning in 2020, DO and MD residency programs will be overseen by a single unified accrediting body;

   7. Quality medical training for DO and MD students is critical to their success as fully trained and licensed physicians and all medical schools should provide the support necessary for their students to receive the best possible medical training;

   8. Many public and private institutions have provided equal access to the application process for their medical training programs by all students and physicians, and have trained exemplary DO and MD students by choosing those candidates who best suit their programs;

   9. In many areas of the state there are outstanding examples of medical training programs that have been integrated effectively and are providing DO and MD students with exceptional training opportunities;

   10. Business and Professions Code (BPC) Section 2064.2 states that no medical school or clinical training program can deny access to elective clerkships or preceptorships in any medical school or clinical training program in this state solely on the basis that a student is enrolled in an osteopathic medical school; and,

   11. BPC Section 2453 states that it is the policy of the state that holders of DO degrees and MD degrees shall be accorded equal professional status and privileges as licensed physicians and surgeons.

2. Resolves that the Legislature urges both private and public medical training institutions in the state to provide equal access to DO and MD students to apply to training programs while still maintaining the integrity and competitiveness of their application process and the need to first serve enrolled students.

3. Resolves that the Legislature urges osteopathic medical schools, allopathic medical schools, and training institutions to build on current successes of working toward greater collaboration and coordination of education and training for California's future physicians and for these medical schools to develop a plan to adequately support medical training for their students and create positive partnerships with medical training programs that are open to both DO and MD students and graduates.

4. Resolves that the Legislatures urges efforts by training institutions and DO and MD medical schools to work toward greater acceptance and integration of DO and MD students in their medical training programs.

5. Resolves the Chief Clerk of the Assembly transmit copies of this resolution to the author for appropriate distribution.

FISCAL EFFECT: None. This bill is keyed non-fiscal by the Legislative Counsel.

COMMENTS:

Purpose. This resolution is sponsored by the Osteopathic Physicians and Surgeons of California. According to the author, "California has a significant shortage and inequitable distribution of physicians throughout the state due to the aging population, population growth, and increasing number of insured. Because of this, it is imperative that the state's training institutions find ways to increase the accessibility and availability of their training programs for all medical students – working together with allopathic and osteopathic medical schools to grow and enhance access to the great programs they provide."

Osteopathic Physicians. DOs are similar to MDs in that both are considered to be "complete physicians." A key difference between the two professions is that DOs have an additional dimension in their training and practice, one not taught in medical schools which grant MD degrees. Both DOs and MDs take the prescribed amount of pre-medical training, graduate from an undergraduate institution with an emphasis on science courses, and receive four years of training in medical school. Specifically, DOs must possess a Doctorate of Osteopathic Medicine Degree from an accredited osteopathic medical school, complete one year of post-graduate training, which includes at least four months of general medicine, and complete all levels of the National Board of Osteopathic Medical Examiners' Comprehensive Osteopathic Medical Licensing Examination.

The same laws govern the required training for DOs and MDs who are licensed in California. In recognition of this fact, BPC Section 2453 states: "…it is the policy of this State that holders of MD degrees and DO degrees shall be accorded equal professional status and privileges as licensed physicians and surgeons." Licensing examinations for DOs are also comparable in rigor and comprehensiveness to those given to MDs.

Training Programs. Prior to DO or MD students completing their medical school education and entering into residency programs, they must first complete the degree requirements for medical school which may include elective clerkships. As part of osteopathic medical school education, after successful completion of the first two years of classroom-based education, DO students are eligible to apply for elective clerkships as part of their medical school curriculum. These clerkships are often "hands-on" rotations which help inform many students about the area or areas of medicine in which they would like to practice. Many DO students will apply for these elective courses at training institutions outside of the two osteopathic medical schools in California. According to the author, in the last year, there have been a number of training institutions that have specifically excluded DO students from applying to their programs for elective clerkships or rotations. Further, the author notes that there was a fee differential for DO students who applied for these programs compared to their MD counterparts. Also, it was noted that DO student applicants were required to have a higher United States Medical Licensing Examination score compared to their MD counterparts.

BPC Section 2064.2 states that no medical school or clinical training program shall deny access to elective clerkships or training programs solely on the basis that a student is enrolled in an osteopathic medical school. While this does not require institutions to accept DO students, it makes it clear that DO students should not be denied access to these elective programs solely based on their choice of medical education.

In an effort to encourage equity for both allopathic and osteopathic medical students who are entering into training programs, this resolution simply urges both public and private medical training institutions to provide equal access to both osteopathic and allopathic students in applying for training programs and urges training institutions, along with allopathic and osteopathic medical schools, to work together toward greater acceptance and integration of its osteopath and allopath students.

Analysis Prepared by: Elissa Silva / B. & P. / (916) 319-3301 FN: 0001899

ASSEMBLY THIRD READING

ATR Bill Id:ACR 97

Author:(Bonilla)

As Amended Ver:August 19, 2015

Majority vote

SUMMARY: Urges both private and public medical training institutions to provide equal access to, and to work toward greater acceptance and integration of, training and education programs for both Osteopathic Physicians (DOs) and Allopathic Physicians (MDs). Specifically, this bill:

1. Declares the following:

   1. California has a significant shortage and inequitable distribution of physicians throughout the state due to the aging population, current population growth and the increasing number of insured;

   2. According to a study by the Robert Graham Center in 2013, it was estimated that the state would need 8,243 more primary care physicians by 2030 – a 32% increase of its current workforce;

   3. The state's ability to meet the need for primary care DOs and MDs is directly affected by the number of medical residency slots available in physician training programs across the state, and the current amount of graduate medical education slots must be increased substantially;

   4. DOs are one of the fastest growing segments of health care professionals in the United States: by 2016, more than 100,000 DOs are expected to be in active medical practice;

   5. Approximately 60% of practicing DOs specialize in primary care fields such as family medicine, internal medicine, and pediatrics and many DOs fill a critical need by practicing in rural and other medically underserved areas;

   6. Beginning in 2020, DO and MD residency programs will be overseen by a single unified accrediting body;

   7. Quality medical training for DO and MD students is critical to their success as fully trained and licensed physicians;

   8. Many public and private institutions have provided equal access to the application process for their medical training programs by all students and physicians, and have trained exemplary DO and MD students by choosing those candidates who best suit their programs;

   9. Business and Professions Code (BPC) Section 2064.2 states that no medical school or clinical training program can deny access to elective clerkships or preceptorships in any medical school or clinical training program in this state solely on the basis that a student is enrolled in an osteopathic medical school; and,

   10. BPC Section 2453 states that it is the policy of the state that holders of DO degrees and MD degrees shall be accorded equal professional status and privileges as licensed physicians and surgeons.

2. Resolves that the Legislature urges both private and public medical training institutions in the state to provide equal access to DO and MD students to apply to training programs while still maintaining the integrity and competitiveness of their application process and the need to first serve enrolled students.

3. Resolves that the Legislature urges osteopathic medical schools, allopathic medical schools, and their training institutions to build on current successes of working toward greater collaboration and coordination of education and training for California's future physicians.

4. Resolves that the Legislatures urges efforts by training institutions and allopathic and osteopathic medical schools to work toward greater acceptance and integration of DO and MD students in their medical training programs.

5. Resolves the Chief Clerk of the Assembly transmit copies of this resolution to the author for appropriate distribution.

FISCAL EFFECT: None. This bill is keyed non-fiscal by the Legislative Counsel.

COMMENTS:

Purpose. This resolution is sponsored by the Osteopathic Physicians and Surgeons of California. According to the author, "California has a significant shortage and inequitable distribution of physicians throughout the state due to the aging population, population growth, and increasing number of insured. Because of this, it is imperative that the state's training institutions find ways to increase the accessibility and availability of their training programs for all medical students – working together with allopathic and osteopathic medical schools to grow and enhance access to the great programs they provide."

Osteopathic Physicians. DOs are similar to MDs in that both are considered to be "complete physicians." A key difference between the two professions is that DOs have an additional dimension in their training and practice, one not taught in medical schools which grant MD degrees. Both DOs and MDs take the prescribed amount of pre-medical training, graduate from an undergraduate institution with an emphasis on science courses, and receive four years of training in medical school. Specifically, DOs must possess a Doctorate of Osteopathic Medicine Degree from an accredited osteopathic medical school, complete one year of post-graduate training, which includes at least four months of general medicine, and complete all levels of the National Board of Osteopathic Medical Examiners' Comprehensive Osteopathic Medical Licensing Examination.

The same laws govern the required training for DOs and MDs who are licensed in California. In recognition of this fact, BPC Section 2453 states: "…it is the policy of this State that holders of MD degrees and DO degrees shall be accorded equal professional status and privileges as licensed physicians and surgeons." Licensing examinations for DOs are also comparable in rigor and comprehensiveness to those given to MDs.

Training Programs. Prior to DO or MD students completing their medical school education and entering into residency programs, they must first complete the degree requirements for medical school which may include elective clerkships. As part of osteopathic medical school education, after successful completion of the first two years of classroom-based education, DO students are eligible to apply for elective clerkships as part of their medical school curriculum. These clerkships are often "hands-on" rotations which help inform many students about the area or areas of medicine in which they would like to practice. Many DO students will apply for these elective courses at training institutions outside of the two osteopathic medical schools in California. According to the author, in the last year, there have been a number of training institutions that have specifically excluded DO students from applying to their programs for elective clerkships or rotations. Further, the author notes that there was a fee differential for DO students who applied for these programs compared to their MD counterparts. Also, it was noted that DO student applicants were required to have a higher United States Medical Licensing Examination score compared to their MD counterparts.

BPC Section 2064.2 states that no medical school or clinical training program shall deny access to elective clerkships or training programs solely on the basis that a student is enrolled in an osteopathic medical school. While this does not require institutions to accept DO students, it makes it clear that DO students should not be denied access to these elective programs solely based on their choice of medical education.

In an effort to encourage equity for both allopathic and osteopathic medical students who are entering into training programs, this resolution simply urges both public and private medical training institutions to provide equal access to both osteopathic and allopathic students in applying for training programs and urges training institutions, along with allopathic and osteopathic medical schools, to work together toward greater acceptance and integration of its osteopath and allopath students.

Analysis Prepared by: Elissa Silva / B. & P. / (916) 319-3301 FN: 0001565

Date of Hearing: August 25, 2015

ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS

Susan Bonilla, Chair

ABPCA Bill Id:ACR 97

Author:Bonilla – As Amended Ver: August 19, 2015

SUBJECT: Medical training: osteopathic students.

SUMMARY: Urges both private and public medical training institutions to provide equal access to, and to work toward greater acceptance and integration of, training and education programs for both Osteopathic Physicians (DOs) and Allopathic Physicians (MDs).

EXISTING LAW:

1. Establishes the Osteopathic Medical Board of California (OMB), by the Osteopathic Initiative Act, which licenses and regulates DOs in this state. (Business and Professions Code (BPC) Section 2450)

2. Specifies the requirements for licensure as a DO and MD. (BPC Sections 2080, 2103, 2099.5)

3. States that it is the policy of this state that holders of MD and DO degrees are accorded equal professional status and privileges as licensed physicians and surgeons. (BPC Section 2453(a))

4. Prohibits a specified health facility, health care service plan, nonprofit hospital service plan, policy of disability insurance, self-insured employer welfare benefit plan, or an agency of the state or of any city, county, city and county, or district from discriminating with respect to employment, staff privileges, or the provision of, or contracts for, professional services against a licensed physician and surgeon based on whether the physician and surgeon holds a DO or MD degree. (BPC Section 2453(b))

5. States that a regularly matriculated student undertaking a course of professional instruction in a medical school approved by the American Osteopathic Association or the OMB is eligible for enrollment in elective clerkships or preceptorships in any medical school or clinical training program in this state. (BPC Section 2064.1)

6. Prohibits a medical school or clinical training program from denying access to elective clerkships or preceptorships, in any medical school or clinical training program in this state, solely on the basis that a student is enrolled in an osteopathic medical school. (BPC Section 2064.2)

THIS BILL:

1. Declares the following:

   1. California has a significant shortage and inequitable distribution of physicians throughout the state due to the aging population, current population growth and the increasing number of insured;

   2. According to a study by the Robert Graham Center in 2013, it was estimated that the state would need 8,243 more primary care physicians by 2030 a 32 percent increase of its current workforce;

   3. The state's ability to meet the need for primary care DOs and MDs is directly affected by the number of medical residency slots available in physician training programs across the state, and the current amount of graduate medical education slots must be increased substantially;

   4. DOs are one of the fastest growing segments of health care professionals in the United States: by 2016, more than 100,000 DOs are expected to be in active medical practice;

   5. Approximately 60 percent of practicing DOs specialize in primary care fields such as family medicine, internal medicine, and pediatrics and many DOs fill a critical need by practicing in rural and other medically underserved areas;

   6. Beginning in 2020, DO and MD residency programs will be overseen by a single unified accrediting body;

   7. Quality medical training for DO and MD students is critical to their success as fully trained and licensed physicians;

   8. Many public and private institutions have provided equal access to the application process for their medical training programs by all students and physicians, and have trained exemplary DO and MD students by choosing those candidates who best suit their programs;

   9. Section 2064.2 of the BPC states that no medical school or clinical training program can deny access to elective clerkships or preceptorships in any medical school or clinical training program in this state solely on the basis that a student is enrolled in an osteopathic medical school; and,
      
      

   10. Section 2453 of the BPC states that it is the policy of the state that holders of DO degrees and MD degrees shall be accorded equal professional status and privileges as licensed physicians and surgeons.
       
       

2. Resolves that the Legislature urges both private and public medical training institutions in the state to provide equal access to DO and MD students to apply to training programs while still maintaining the integrity and competitiveness of their application process and the need to first serve enrolled students.
   
   

3. Resolves that the Legislature urges osteopathic medical schools, allopathic medical schools, and their training institutions to build on current successes of working toward greater collaboration and coordination of education and training for California's future physicians.

4. Resolves that the Legislatures urges efforts by training institutions and allopathic and osteopathic medical schools to work toward greater acceptance and integration of DO and MD students in their medical training programs.

5. Resolves the Chief Clerk of the Assembly transmit copies of this resolution to the author for appropriate distribution.

FISCAL EFFECT: None. This bill is keyed "non-fiscal" by the Legislative Counsel.

COMMENTS:

Purpose. This resolution is sponsored by the Osteopathic Physicians and Surgeons of California. According to the author, "California has a significant shortage and inequitable distribution of physicians throughout the state due to the aging population, population growth, and increasing number of insured. Because of this, it is imperative that the state’s training institutions find ways to increase the accessibility and availability of their training programs for all medical students—working together with allopathic and osteopathic medical schools to grow and enhance access to the great programs they provide."

Osteopathic Physicians. The OMB is responsible for the licensing and enforcement of DOs in California. DOs are similar to MDs in that both are considered to be “complete physicians.” A key difference between the two professions is that DOs have an additional dimension in their training and practice, one not taught in medical schools which grant MD degrees. Osteopathic medicine gives particular recognition to the musculoskeletal system which comprises over 60 percent of body mass. DOs may refer to himself or herself as a “Doctor” or “Dr.” but in doing so, must clearly state that he or she is a DO or osteopathic physician and surgeon. He or she may not state or imply that he or she is a MD while being licensed in California as a DO.

Both DOs and MDs take the prescribed amount of pre-medical training, graduate from an undergraduate institution with an emphasis on science courses, and receive four years of training in medical school. Specifically, DOs must possess a Doctorate of Osteopathic Medicine Degree from an accredited osteopathic medical school, complete one year of post-graduate training, which includes at least four months of general medicine, and complete all levels of the National Board of Osteopathic Medical Examiners' Comprehensive Osteopathic Medical Licensing Examination. There are two approved osteopathic medical schools in California, 1) Touro University California, College of Osteopathic Medicine, and 2) Western University of Health Sciences, College of Osteopathic Medicine of the Pacific-Northwest. Currently, there are over 7,000 licensed DOs in California.

The same laws govern the required training for DOs and MDs who are licensed in California. In recognition of this fact, BPC § 2453 states: “…it is the policy of this State that holders of MD degrees and DO degrees shall be accorded equal professional status and privileges as licensed physicians and surgeons.” Licensing examinations for DOs are also comparable in rigor and comprehensiveness to those given to MDs. According to the Bureau of Labor Statistics, the employment of physicians and surgeons, including DOs, is projected to grow 18 percent from 2012 to 2022, faster than the average for all occupations.

Training Programs. DOs are required to complete a year of post-graduate training, e.g. residency or rotating internship, in a hospital with an approved post-graduate training program. DOs utilize all scientifically accepted methods of diagnosis and treatment, including the use of drugs and surgery and are licensed in all fifty states to perform surgery and prescribe medication in accredited and licensed hospitals and medical centers.

Prior to DO or MD students completing their medical school education and entering into residency programs, they must first complete the degree requirements for medical school which may include elective clerkships. As part of osteopathic medical school education, after successful completion of the first two years of classroom-based education, DO students are eligible to apply for elective clerkships as part of their medical school curriculum. These clerkships are often "hands-on" rotations which help inform many students about the area or areas of medicine in which they would like to practice. Many DO students will apply for these elective courses at training institutions outside of the two osteopathic medical schools in California, such as University of California medical schools or other private institutions. According to the author, in the last year, there have been a number of training institutions that have specifically excluded DO students from applying to their programs for elective clerkships or rotations. Further, the author notes that there was a fee differential for DO students who applied for these programs compared to their MD counterparts. Also, it was noted that DO student applicants were required to have a higher U.S. Medical Licensing Examination score compared to their MD counterparts.

BPC Section 2064.2 states that no medical school or clinical training program shall deny access to elective clerkships or training programs solely on the basis that a student is enrolled in an osteopathic medical school. While this does not require institutions to accept DO students, it makes it clear that DO students should not be denied access to these elective programs solely based on their choice of medical education. The number of available elective clerkships is determined by each educational institution and acceptance varies depending on resources available at each institution. Currently, the two osteopathic medical schools in California have approximately 350 students enrolled in osteopathic medical programs.

In an effort to encourage equity for both allopathic and osteopathic medical students who are entering into training programs, this resolution simply urges both public and private medical training institutions to provide equal access to both osteopathic and allopathic students in applying for training programs and urges training institutions, along with allopathic and osteopathic medical schools, to work together toward greater acceptance and integration of its osteopath and allopath students.

ARGUMENTS IN SUPPORT:

The Osteopathic Physicians and Surgeons of California write in support, "Section 2064.2 of the [BPC] provides protections for DO students stating that no medical school or clinical training program can deny access to training programs solely on the basis that a student is enrolled in an osteopathic medical school. In addition, Section 2453 of the [BPC] states that it is the policy of the state that holders of MD and DO degrees will be accorded equal professional status and privileges as licensed physicians and surgeons. We are pleased to support [this resolution] because it will remind and encourage training institutions to not discriminate against a DO or MD student based solely on their chosen medical school."

ARGUMENTS IN OPPOSITION:

None on file.

REGISTERED SUPPORT:

Osteopathic Physicians and Surgeons of California (sponsor)

American Osteopathic Medical Association

California Medical Association

REGISTERED OPPOSITION:

None on file.

Analysis Prepared by: Elissa Silva / B. & P. / (916) 319-3301