ATSU-KCOM DEI Demographics Data Request 
A.T. Still University-Kirksville College of Osteopathic Medicine is accredited by the Commission on Osteopathic College Accreditation (COCA). 

To comply with the 2023 COCA Accreditation Standards, ATSU-KCOM is providing this form for the public to request student, faculty & staff demographic information. Use this form to request information for the following areas:
  1. COCA Standard 5.2 Diversity: three years of student, faculty, and staff demographics, including race/ethnicity and gender.
  2. COCA Standard 11.3 Student Debt Outcomes: four years of student debt load and student loan default rates including race/ethnicity and gender demographics.
  3. COCA Standard 11.4b GME Placement Rates: four years of data including race/ethnicity and gender demographics.
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