American Osteopathic Association

Advancing the distinctive philosophy and practice of osteopathic medicine

What is Osteopathic Graduate Medical Education?

Announcement: The AOA, ACGME and AACOM have agreed to a single accreditation system for graduate medical education programs in the U.S., with AOA-accredited training programs transitioning to ACGME accreditation between July 1, 2015 and June 30, 2020. Read more and view Frequently Asked Questions.

Osteopathic Graduate Medical Education is designed to provide trainees with progressive, supervised opportunities to obtain high quality preparation for the independent practice of medicine. Although osteopathic medicine focuses heavily on primary care, osteopathic GME programs prepare DOs to practice in all medical and surgical specialties. 

The continuum of osteopathic graduate medical education includes internships, residencies and fellowships.


At one time, most graduates of colleges of osteopathic medicine spent their first year of training (OGME-1) in a traditional osteopathic internship. The internship is a one year program that provides broad-based training in core disciplines such as family medicine, internal medicine, general surgery, obstetrics and gynecology, pediatrics and emergency medicine. In 2008, the internship year was restructured to provide alternative first year training options. Many specialties now offer an initial training year that combines a broad-based curriculum with specialty training. Each osteopathic specialty has selected one of three OGME-1 training options for trainees to pursue. 


Residency programs build on the broad-based education students receive in colleges of osteopathic medicine and their OGME-1 year. An osteopathic residency is an AOA-approved formal, full-time program that provides advanced, concentrated training in a designated medical specialty. Upon successful completion of a residency, the trainee is awarded a certificate and is eligible to seek board certification in the appropriate osteopathic specialty.    


A fellowship is a formal, full-time training period in a designated medical specialty that goes beyond the requirements for eligibility for the first board certification in the core specialty. Completion of an AOA approved fellowship may constitute eligibility for a Certificate of Added Qualification (CAQ) or Certificate of Special Qualification (CSQ).        

Osteopathic GME programs provide a community-based clinical education that is recognized throughout the United States in federal and state laws, rules and regulations.