As colleges and universities around the country cut back, merge and even close, one sector is growing — osteopathic medical schools.
The increasing acceptance of osteopathic medicine’s holistic patient-centered approach is attracting more students to the profession.
“It’s a steady and progressive growth. We have about 40,000 students. That’s an increase of 10,000 students since 2019,” says Robert A. Cain, DO, president of the American Association of Colleges of Osteopathic Medicine.
Many of the graduates become primary care providers, pediatricians and internists, filling a significant gap in health care access, he says.
Since 2019, when Cain took office, the number of osteopathic medical schools has grown from 38 main campuses operating in 59 locations to 44 schools at 71 locations in 36 states, Cain says.
Among the new schools:
- Burrell College of Osteopathic Medicine opened a campus in Melbourne, Fla., this year
- D’Youville University College of Osteopathic Medicine in Buffalo, N.Y., to open in 2026
- Lake Erie College of Medicine at Jacksonville University in Florida, to open in 2026
- University of Northern Colorado in Greeley, Colo., to open in 2026
- Illinois College of Osteopathic Medicine in Chicago to open in 2026
- Indiana University of Pennsylvania School of Osteopathic Medicine in Indiana, Penn., to open in 2027
- University of Dubuque’s John and Alice Butler School of Osteopathic Medicine in Dubuque, Iowa, to open in 2028
Cain says several factors have contributed to the expansion, including the increasing acceptance of osteopathic medicine. Since the mid-1990s, the number of practicing DOs has more than quadrupled. Today 30% of all physicians are osteopaths.
“Growth leads to growth,” Cain says. “We use a more community-based model. We have been able to operate well in a non-university setting. The MD schools have been classic, large research and teaching institutions.”
For many years, osteopathic medical schools were concentrated in the Midwest. However, as they expanded into more locations, communities observed the success of the schools and sought to understand how they could replicate the change, Cain says.
“We look at places where health care needs aren’t being met,” Cain says. “If we think we have the resources, we consider opening a DO school.”
AACOM has investigated the impact of establishing an osteopathic school in a medically underserved area.
“The shortage drops off in a significant way,” Cain says. “Those colleges recruit doctors to teach, but they also continue to practice. Many of our graduates also stay in the area after graduation. We continue to open schools in areas where communities are working to address their problems. We’re willing to work in those spaces.”
Filling a gap in Kentucky
Dr. Joe Kingery is the dean of the Kentucky College of Osteopathic Medicine, which opened in 1997 in Pikeville, a rural area in eastern Kentucky. The area has a high incidence of heart disease, cancer, diabetes, health disparities and a lack of health care.
“The school was a kind of a venture of local business people. They said, We’re struggling. Can we have a medical school here? If we were to train people here, would they stay and practice medicine?” Kingery says.
The answer was yes. The school has graduated 2,200 students since 2001, with 70% pursuing careers in primary care, internal medicine and pediatrics, and 30% practicing in rural, underserved areas, Kingery says.
Pike County is no longer considered medically underserved, although the surrounding counties still are.
Expanding to a medical hub
Not all new osteopathic colleges are in rural areas. Lake Erie College of Osteopathic Medicine is opening its fifth campus next year at Jacksonville University in Florida.
Jacksonville, a city of 1 million in Northeast Florida, is a medical hub with five health care systems, including the Mayo Clinic. The nearest medical school is at the University of Florida in Gainesville, 75 miles south.
Northeast Florida has a shortage of doctors in the largely rural counties outside Jacksonville. And the fast-growing city has a shortage of primary care and inadequate access to health care in its urban areas.
Richard Terry, DO, LECOM associate dean of regional clinical education, oversees LECOM’s campuses in Erie, Penn., Greensburg, Penn., Elmira, N.Y., and Bradenton, Fla.
The Jacksonville school has been in the planning phase for four years. It is scheduled to open next July with 75 students and is expected to expand to 150 students within five years.
“JU is a magnificent campus,” Terry says. “We’re building a brand-new 72,000-square-foot medical school, and our students will have all the amenities of a college campus.”
The LECOM school will be part of JU’s Medical Mall, which includes the Health Sciences Complex, School of Orthodontics and Occupational Therapy teaching facility and Dolphin Pointe Health Care, a 146-bed skilled nursing and rehabilitation facility.
Terry says that LECOM has received a flood of applicants, with a majority from the Jacksonville area.
“This is an opportunity to attend medical school and live at home. We have the least expensive tuition at about $39,000 a year,” Terry says. “Economically, it is an excellent proposition.”
Terry says LECOM has the largest residency network, including one at Baptist Medical Center, with plans to expand to other health care systems in the region.
Another thing that sets LECOM apart is its problem-based learning system.
Instead of lectures, students are given a case, such as a 55-year-old male presenting with right flank pain. The students work in small groups with a faculty facilitator to determine the diagnosis and treatment through independent research.
“It’s much more akin to the way Gen Z learns,” Terry says.
The approach helps students develop problem-solving and collaborative skills that they wouldn’t get in a lecture hall.
“We’re excited to be in Jacksonville,” Terry says. “The school will train the next generation of physicians, strengthen the health care workforce in Northeast Florida and improve access to quality care.”
The FAIR Act
One challenge graduates of osteopathic medical schools face is difficulty in being accepted into residency programs because their training, curriculum and board exams differ from those of allopathic medical schools.
Kingery says that 100% of students from the Pikeville school are placed in residencies. But that’s not always the case.
“There’s a bias against DOs,” Kingery says. “It has gotten better through advocacy and awareness.”
Legislation in Congress, known as the FAIR Act, would require residency programs that receive Medicare dollars to report the number of MDs and DOs, creating transparency, Kingery says.
The FAIR Act would also recognize the DO licensing process.
“Students too often have to take a second licensure exam, jump through another hoop — misuse of the exam,” Cain says. “The exams are designed differently. It’s an extra student cost and the stress. Our students do it. They are successful. But we want that extra step removed.”
“It’s a challenging problem,” says Cain. “What we think should go into creating physicians is different. The two medical degrees both lead to the equal practice of medicine.
“Publicly funded residencies should be open to everyone. Our students fit in really well with the system. We’re proud of that. Some programs, despite national messaging, outright refuse to do so,” Cain says. “The Fair Act would open the door.”