Canadian DOs: International Expansion of Osteopathic Medical Education North of the Border.
BACKGROUND
The growth of osteopathic medicine in the United States has led to a vibrant expansion of the profession internationally. Canadian students represent the majority of international applicants and matriculants to US colleges of osteopathic medicine (COMs); however, to our knowledge, no studies have explored this population.


OBJECTIVE
To gain a better understanding of Canadian students attending US colleges of osteopathic medicine by examining their residency training preference, visa preference, intent to practice in the United States or Canada, receptiveness to incorporating osteopathic manipulative medicine into practice, specialty preference, estimated debt incurred, and effect of debt on specialty choice.


METHODS
A 10-question electronic survey was sent to Canadian osteopathic medical students in the 17 COMs and branch campuses that accept international applicants. The initial survey pool consisted of frst-, second-, third-, and fourth-year medical students (classes of 2014-2017) compiled from a database managed by the Canadian Osteopathic Medical Student Association.


RESULTS
Of the 102 students contacted, 66 (65%) completed the survey. Respondents had a strong desire to practice in Canada (44 [67%]) but were considering an Accreditation Council on Graduate Medical Education (ACGME) or dually accredited residency program in the United States (46 [70%] and 15 [23%], respectively) that would sponsor an H1B visa. Respondents were receptive to incorporating osteopathic manipulative medicine into practice (44 [67%]). Most respondents chose non-primary care specialties (40 [61%]) and incurred a debt of more than $200,000 (44 of 65 [68%]); however, debt had a limited infuence on respondents' choice of specialty (χ23=1.911; P=.591).


CONCLUSIONS
Most respondents planned to complete ACGME training, to return to Canada to practice medicine, and to practice in a non-primary care specialty. As a growing population that will play a large role in the expansion and reception of the profession internationally, Canadian osteopathic medical students and US-trained Canadian DOs merit further examination.
Sevan
S
Evren
Pranay
P
Chander
Julia
J
Kim
Andrew
A
Bi
Dennis
D
Fiddler
Emily
E
Wayent
Howard S
HS
Teitelbaum
D000068:Accreditation; D002170:Canada; D002321:Career Choice; D004503:Education, Medical, Graduate / Q000706:statistics & numerical data*; D006282:Health Personnel / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D010021:Osteopathic Medicine / Q000193:education*; D013337:Students, Medical / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires