Communication, certification, support for medical students are crucial for AOA

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The new president of the American Osteopathic Association (AOA) said he hope to refresh communications among the organization, its member physicians and medical students.

Communication also will be vital to clarifying the certification process for new doctors, and to support medical students on their journey into the profession, said President Robert G.G. Piccinini, DO, D.FACN.

Installed in summer 2025, Piccinini is the first psychiatrist to take the AOA’s top post. He spoke with Medical Economics about his background and a number of issues involving the association and contemporary health care.

This transcript has been edited for length and clarity.

Medical Economics: In your inaugural address, you mentioned specifically about wanting to improve communication among AOA and its member physicians. How do you intend to follow through with that?

Robert G.G. Piccinini, DO, D.FACN
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Robert G.G. Piccinini, DO, D.FACN: The other thing I spoke about in my inaugural speech was minding the gap. And that is a something that if you're familiar with the London subway, you see the signs and you hear the statement, mind the gap, and it speaks the distance between the train and the platform, and not to fall in between or have a misoccurrence. And I think as osteopathic medicine has rapidly grown — which is wonderful — sometimes when we grow with speed, we forget some of the things that we necessarily need to do to make sure that our growth is sustainable and on firm footing, so to speak. So I think at times we assume, and this is both an association trait and a human trait, we assume that somebody else is hearing our message or understand our message, but we never circle back to make sure, well, did they hear the message? Did they get the message? And do they have questions about the message? So I think as an association, it behooves us to make sure we're circling back and making sure all members feel connected to the association, that they're hearing the message, and that they have input into the message, so that it is a collective, where we want to go, not just where few people want to go, and trying to bring everybody else along. Is there a shared vision of our membership as a whole, of where we need to go?

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Medical Economics: as part of the issues mentioned about addressing the certifying board services reform, how does the certification process happen now, and what would you like to see in improvements?

Robert G.G. Piccinini, DO, D.FACN: The certification is very similar, both on the allopathic side and the osteopathic side, in that you take a series of exams at designated times and in the past, obviously, the osteopathic boards and tests look at the distinctiveness and have questions of distinctiveness within the osteopathic profession and how we approach patients, the whole-person treatment of patients, and how our principles and practices integrate into our board exams. But again, circling back to the communication aspect of that is, I think we can do so much more in preparing our students and residents for the process, by informing them more so, than what we are doing currently. In the past, it's sort of — at least, when I was a student and resident, you asked the next person, what's the process? And then you kind of try to find it out. We need to step up our communication to the students and residents so that they don't have a question, and if they do have a question, it's very clear to them where they can turn for the answers and make that process easier for them. More so than any time before there's a lot of stress in medical school and residency. There's a lot of things happening in their lives. Any way we can make it easier, that that's one less anxiety point, we should be doing it. So that's where I think we can step up our certifying board services, our communication and helping them educate exactly what the boards are for. Sometimes there's misconceptions that as medical students you have to score a certain number on a test to be able to be considered for X, Y and Z, when that really isn't what it was designed to do. Your board certification as a resident wasn't designed to get you a job. It was to certify that you've reached a position of excellence so that the states could give you a license, not necessarily that you would get a job at X, Y and Z facility.

Medical Economics: Can you discuss your own experience as a first-generation American and the first doctor of osteopathic medicine in your family, and why is that so influential in your presidential initiative to really nurture those first generation DO students?

Robert G.G. Piccinini, DO, D.FACN: I remember a time in my life very clearly where we were at home and it was a summer day and my parents called me out to the backyard. And my mom only had a high school education, my dad a sixth-grade education in Italy. And they said, we know you want to be a physician, and we don't know how to help you, we don't know how to guide you. We'll always be there to love you and support you, but that's something you're going to have to figure out the other half on your own. Were there some missteps? Yeah. Was it difficult? Definitely, and possibly by focusing on what the first-generation students go through, and making that pathway smoother with a lot less bumps, is something that is important to me, because I don't want them to necessarily go through the same bumps I went through. Being the first osteopath in my family — it's funny, when I go to Italy for a while there explaining to them when an osteopathic physician was, because they have osteopaths, which only do manipulation in Italy, but they don't have osteopathic physicians at the time who are trained in the American form of medicine and so explaining, no, I'm not an osteopath, I'm an osteopathic physician and explaining those things to them. But then also taking pride in the fact that I was charting a new course, like my parents did, my father as an immigrant, my mother as a first-generation American in her family and doing the things that they had to do. So, as hard as it was for me, so much harder for them coming over to a country with no language, and I often think of a pure first-generation student who, English may not have been their first language, those things that they have to go through, can we make it easier so that they can succeed and take that skill set back to their family and their homeland or even their community where they're living and really providing health to that group in an osteopathic way.