Trends in the development of new private colleges of osteopathic medicine (COMs) described by the author in 2003 have accelerated in the ensuing decade. During 2003 to 2013, 10 new COMs as well as 2 remote teaching sites and 4 new branch campuses at private institutions were accredited, leading to a 98% increase in the number of students enrolled in private COMs. The key features of the private COM educational model during this period were a reliance on student tuition, the establishment of health professions education programs around the medical school, the expansion of class size, the creation of branch campuses and remote teaching sites, an environment that emphasizes teaching over research, and limited involvement in facilities providing clinical services to patients. There is institutional ownership of preclinical instruction, but clinical instruction occurs in affiliated hospitals and medical institutions where students are typically taught by volunteer and/or adjunct faculty.Between 2003 and 2013, this model attracted smaller universities and organizations, which implemented the strategies of established private COMs in initiating new private COMs, branch campuses, and remote teaching sites. The new COMs have introduced changes to the osteopathic profession and private COM model by expanding to new parts of the country and establishing the first for-profit medical school accredited in the United States in modern times. They have also increased pressure on the system of osteopathic graduate medical education, as the number of funded GME positions available to their graduates is less than the need.