A FAIR chance for all future doctors 

This summer, thousands of new medical students donned their white coats, marking the beginning of a journey that will lead to service in communities across the country.  

As our nation grapples with primary care shortages in rural and underserved areas, this influx of future doctors should be a cause for celebration. Instead, we find ourselves with a graduate medical education system that places unnecessary hurdles in front of 25 percent of these students before they even have a chance to prove their abilities.  

This is not only unfair but counterproductive for a medical world desperately in need of more doctors, and it’s an issue we must address now. 

Currently, more than 36,000 students are enrolled in colleges of osteopathic medicine, representing a quarter of all medical students in the United States. By 2030, this number is expected to grow to one-third. These future doctors of osteopathic medicine (DOs) are critical to our healthcare system, filling important roles in primary care specialties like family medicine or pediatrics, where more than half go to practice.  

Yet, when it comes to securing residency placements, the playing field is tilted against them. DOs are often overlooked by residency program directors, who favor students with MDs, even though the former are just as qualified to practice medicine. The primary distinction is that DOs take a more holistic approach to assessing a patient, focusing on prevention and the body’s capacity for self-healing. 

According to National Resident Matching Program data released last month, 29 percent of residency program directors report that they never or seldom interview osteopathic medical students. Since an interview is essential to securing a residency slot, this effectively closes the door on a significant portion of our future physician workforce.  

For those osteopathic medical students who do receive interviews, 73 percent of program directors require them to take the U.S. Medical Licensing Examination, the licensing exam for MD students, even though DO students already test on the Comprehensive Osteopathic Medical Licensing Examination of the United States, a licensing exam recognized in all 50 states. This additional requirement imposes unnecessary financial burdens — more than $2,000 for the exam alone — and significant stress on students who must typically spend hundreds of hours preparing for a second test that was not designed with their education in mind. 

This is why we, as members of Congress, have introduced the Fair Access In Residency (FAIR) Act (H.R. 751), bipartisan legislation aimed at eliminating these arbitrary burdens faced by osteopathic medical students in federally funded residency programs. This legislation does not impose undue quotas but instead provides transparency and ensures that all residency programs receiving taxpayer dollars evaluate candidates on a level playing field. 

The transition to a single accreditation system for residency programs, which was intended to promote equality and was completed in 2020, has not improved the situation. The number of DOs matching to their preferred surgical specialties has declined, and the percentage of DOs taking the U.S. Medical Licensing Examination has increased dramatically, reaching 53 percent this year. The osteopathic profession has spent many years trying to resolve the issue within the house of medicine but to no avail. While legislation is a last resort, it is now time for Congress to act.

As stewards of the public trust, we have a responsibility to ensure that all medical students — whether MD or DO — have an equal opportunity to contribute to our healthcare system. The challenges we face today, from the strains on our healthcare workforce to the pressing needs of rural and underserved communities, demand a physician training system that rewards competence and experience over privilege. 

With more than 8,200 osteopathic medical students graduating this year, we cannot afford to wait for internal change. The bipartisan FAIR Act represents a necessary and measured step toward achieving parity and ensuring that all qualified medical students can pursue their careers without arbitrary regulations. This is not just a matter of fairness for osteopathic students; it’s a matter of ensuring that every community in America has access to the healthcare professionals they need. 

Congress must act decisively to address this issue. The future of our healthcare system and the wellbeing of our citizens depends on it. 

Rep. Diana Harshbarger, a Republican, has served Tennessee’s 1st district since 2021. Rep. Chellie Pingree, a Democrat, has served Maine’s 1st congressional district since 2009.