The Fair Access to Residency Act (FAIR Act) could be among the first set of bills to face the next edition of the U.S. Congress. The bill was introduced in September 2022 by Diana Harshbarger (R) of Tennessee’s First Congressional District, a largely rural area along the eastern-Tennessee, western-Virginia border. The bill, which would help level the residency match for osteopathic students, has since been passed to the Subcommittee on Health for review.

Read more about this bill and what a new-look U.S. congress might mean for its future.

What makes the FAIR Act fair?

Currently, osteopathic students and graduates face a more difficult time securing residency positions than their allopathic counterparts. According to the 2022 NRMP Residency Director Survey, 80 percent of D.O. Graduates and 32 percent of D.O. Seniors are seldom or never interviewed by residency directors.

Additionally, 32 percent of residency programs require applicants from osteopathic schools to take the USMLE exam. This has led to more work for more osteopathic students, as nearly 60 percent of D.O. students now take both the COMLEX and USMLE exams despite both exams granting physicians the right in all 50 U.S. states.

The FAIR Act aims to reduce these discrepancies by expanding the recognition of D.O. education in the U.S. residency process.

First, the FAIR Act will reduce the interview barrier by requiring residency programs to report the number of applicants they receive from osteopathic and allopathic schools and require reporting the number of applicants accepted from each type of medical school.

Secondly, the bill will reduce the additional workload and financial costs osteopathic students have had to take on studying for both the USMLE and COMLEX exams. The FAIR Act will require residency programs to accept applicants from osteopathic and allopathic schools. In doing so, the bill will also require programs to recognize COMLEX scores equal to that of USMLE scores.

Read the full proposed bill.


What’s Next?

If the FAIR Act passes the Subcommittee on Health, it will head to the U.S. House of Representatives for a vote. This could happen as soon as 2023. However, after the 2022 midterm elections, this means the bill will face a new-look Congress. While Democrats retained control of the U.S. Senate, Republicans took control of the House of Representatives. Because the bill will have to pass both chambers, divided congressional control could be a barrier.

A divided congress has been the downfall of many pieces of legislation whose vote falls along party lines. While there have been no public comments from Congress, state-level bills supporting medical education have historically received bipartisan support.

You can track the progress of this bill at


The FAIR Act has been formally supported by the American Association of Colleges of Osteopathic Medicine (AACOM). Read AACOM’s statement here.