80 New Challenges and Opportunities the county in which the violation occurs, upon receipt of a complaint by an aggrieved student.” Similar language was developed for a second law protecting osteopathic physicians from discrimination in the state of California. In November 2009, ACGME implemented its rule change for the Next Accreditation System, which restructured educational outcomes in the six clinical core competencies in medical residencies. This was planned to be formally implemented in 2015. Unfortunately, ACGME announced a rule change in November 2011, which essentially stated that any osteopathic physician in the United States who had not completed an ACGME internship or residency was ineligible for ACGME residencies and fellowships, despite five states requiring an AOA-approved osteopathic residency. At this time, colleges of osteopathic medicine had 5,000 graduates yearly, but there were only 3,000 PGY-1 osteopathic internships. An AOA analysis stated that this rule change only affected 8% of the osteopathic medical student graduates. Unfortunately, in California, the longstanding osteopathic discrimination reemerged under the University of California and its five medical schools, with thousands of residency training positions now excluding osteopathic medical students. The image below presents a common experience for all osteopathic medical students in the state of California. The Osteopathic Physicians and Surgeons of California (OPSC) met with the attorney general for the state of California to enforce the Business and Professions Act 2064.24. The OPSC attorneys who were working with the state attorney general stated that since all osteopathic residencies discriminate against allopathic physicians, it would invalidate the state statute. The only path forward for California osteopathic medical students was to create parity for MDs to be able to access AOA programs. One week after the codification of the SAS at the July 2015 ACGME House of Delegates, the OPSC president and executive director, along with the attorney general of California, met with the vice chancellor of the University of California. This resulted in changing all the University of California residency websites and updating policies to allow osteopathic medical students to participate in these training programs. California, today, has more than 15,000 licensed osteopathic physicians in the state as opposed to the few hundred that were licensed in 1977. Further, medical students have had significant success in matching and placing in these ACGME residency training sites that previously excluded DO students.
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