Common Paths in Medical Education: An Updated Look at the Training of Allopathic, Osteopathic, and Naturopathic Physicians.

Abstract

Context: Allopathic, osteopathic, and naturopathic medical education all prepare students to practice medicine yet diverge in certain respects. Despite the significant changes that have occurred in the education of each discipline, a more recent comparison and analysis of these three pathways hasn't been published.

Objective: The review intended to examine the five segments of the educational process common to all three pathways: admissions, preclinical education, clinical education, graduate medical education, and continuing medical education.

Design: The research team's evaluations and assessments of each pathway are based on publicly available data collected from each pathway's accrediting organizations and from accredited institutions, because these organizations and institutions accurately reflect the generally-accepted standards and practices within each pathway. The research team performed data collection for this study in 2019 to 2020, and the article reflects the changes in the literature up to that point.

Setting: The study took place at Rocky Vista University - Southern Utah in Ivins, Utah; the University of Texas at Austin Dell Medical School in Austin, Texas; the Albany Medical Center in Albany, New York; and the National University of Health Sciences in Lombard, Illinois.

Results: Naturopathic, allopathic, and osteopathic all undergo rigurous pre clinical training which highlights the basic sciences. Naturopathic schools generally have more in classroom hours and less in person clinical experience than osteopathic and allopathic training programs. All three professions have standardized board exams that cover the required curriculum. Many osteopathic students both take and pass the USMLE which highlights the similarities of their curriculum with the allopathic model. A similar comparison can not be made with naturopathic students as they do not take the USMLE. While all three education models have residency programs, naturopathic are more flexible and less standardized than ostopathic and allopathic residency programs.

Limitations: Some data points had to be drawn from conversations as they were not publicly avalable. Credit hours are not sufficient to compare the scope of the curriculum of each education pathway. The NPLEX needs to be compared to both COMLEX and USMLE.

Conclusions: Since 1997, the three major branches of educating physicians have continued to converge pedagogically. The currently most-notable similarity among the three pathways is the preclinical years and their basic-science curriculum. The combined match of allopathic and osteopathic residents, as well as increasing similarities and crossovers in curriculum and methods of practice, highlight this fact. Philosophy and methodologies of practice continue to distinguish these educational pathways, but their increasing similarities may lead to further convergence of practice and pedagogical models.