Their idea gained supporters who also believed a medical school in Paintsville would eliminate the shortage of primary care physicians in the region.

[6] By August 1995, it became apparent that there was insufficient financial support to construct a school of osteopathic medicine in Paintsville.

PCSOM received accreditation from the American Osteopathic Association Bureau of Professional Education on July 11, 1997.

[6] The founding convocation of Pikeville College School of Osteopathic Medicine was held on September 11, 1997, shortly after the matriculation of the first class of 60 students.

The third and fourth years of the medical school student are mainly spent away from the medical school as students observe and practice under trained and registered physicians and surgeons to develop an understanding of where they might specialize and apply for residency training programs upon completion of their education at KYCOM.

The rotation sites for students range from counties in Kentucky to other states such as Arkansas, Alabama, Michigan, Mississippi, Ohio, Pennsylvania, and Virginia.

[9] The Osteopathic Medical Scholars Program (OMSP) offers accepted incoming undergraduate freshmen at the University of Pikeville both a bachelor's degree, followed by matriculation into the Doctor of Osteopathic Medicine program at KYCOM upon completion of undergraduate course work.

[17] The Coal Building is a nine-story, 84,000 square foot building,[18] which consists of a clinical skills training and evaluation center, high fidelity robot simulators, research and teaching labs, a gross anatomy laboratory, an Osteopathic Manipulative Medicine lab, lecture halls and classrooms, and a campus cafeteria.

Funding for its construction was provided by a $26.5 million direct loan obtained via the American Recovery and Reinvestment Act of 2009, $10 million from the New Market Tax Credit (part of the National Community Investment Fund),[13] and from two $500,000 grants, one from the Appalachian Regional Commission and one from the James Graham Brown Foundation.