The recruitment and retention of osteopathic medical students by osteopathic medical institutions is arguably the most important priority facing the profession today. Residencies accredited by the Accreditation Council on Graduate Medical Education are now the major competitors for osteopathic medical students; osteopathic residency graduates are readily accepted at most hospitals; and osteopathic medical faculty are regularly appointed to university and government positions. As a result, many osteopathic medical institutions are having difficulty in filling their training programs and recruiting faculty and medical staff physicians. These recruitment problems can be resolved by the development of graduate medical education (GME) programs that are competitive with their allopathic GME counterparts, but hospitals and colleges must do so by developing a new approach to osteopathic GME. Osteopathic GME must sell academic quality by developing a university-like environment in the hospitals conducting training programs. Osteopathic training hospitals should consider requiring their directors of medical education to develop strategic plans for GME which result in the development of competitive programs.