News from the AACOM
By Steven C. Shannon, DO, MPH
Reprinted with permission from the AACOM
Steven C. Shannon, DO, MPH
One important element of the agreement was the establishment of a mechanism for ACGME-accredited specialty programs to seek Osteopathic Recognition (OR). Programs seeking this designation would be accredited normally by the ACGME Review Committee overseeing that specialty, but would also provide a curriculum that included and incorporated newly-adopted ACGME standards for OR. For example, ACGME-accredited programs in family medicine, internal medicine, pediatrics, or any other specialties could choose to seek OR. The standards for OR would be established and adherence reviewed by a new committee—the ACGME Osteopathic Principles Committee (OPC)—that has been up-and-running since last fall, preparing for implementation.
Medical education for DOs in both medical school and in AOA-accredited residency and fellowship programs is based upon foundational osteopathic principles and practices. These same principles guided the ACGME’s OPC in the development of its standards for OR, and will enable the continuity of osteopathic medical education to take place within the SAS. In addition, under the SAS, these specialty programs will be available to MDs as well as DOs. This will enable a broadening of the training opportunities for all physicians—MDs and DOs—in residency and fellowship training.
One key question being raised in planning the implementation of the SAS is: “Should our program seek to become an ACGME osteopathically-recognized program in the Single Accreditation System?” This is an issue for both programs as well as the institutions in which they are housed. It is a concern of programs that are currently dually accredited by both AOA and ACGME (of which there are several hundred); those programs only accredited by AOA; and those programs only accredited by ACGME. While there are a lot of specific “in the weeds”—type of issues surrounding any decisions along these lines, I want to provide some of my thoughts on this issue.
First, I think DO graduates will prioritize ACGME specialty programs that have osteopathic recognition. There are around 24,500 osteopathic medical students in the nation’s growing DO schools today, of which over 5,000 will graduate in 2015 and 7,000 or more are expected to graduate in 2020. These students chose to pursue an osteopathic medical education pathway to become a physician, and I believe most would like to continue to do so during their GME training. What evidence, you might ask, gives me the justification to say that? In a survey of all senior osteopathic medical students (with an 80 percent response rate) a little over a decade ago, 72 percent of graduating seniors responded yes to the statement, “Are dually-accredited (AOA/ACGME) residency programs in your field more appealing than are residency programs accredited by ACGME only?” I don’t believe there is any evidence to suggest that this sentiment has changed. AACOM conducted a survey in late March of current third-year osteopathic medical students which confirmed that a majority (70.55 percent) would prefer an ACGME-accredited program with osteopathic recognition over one without osteopathic recognition; see full survey results.
I believe that the appropriate conclusion to draw is that if institutions want to be the most competitive for the best, brightest, and most appropriate DO graduates for their residency programs, then they should obtain osteopathic recognition of their ACGME program as they transition into the Single Accreditation System. While the standards for osteopathic recognition have been adopted by ACGME, and the logistics of this process involve several steps, I think that those ACGME programs already dually accredited by AOA should have a clear pathway to maintain that alignment. Likewise, those AOA programs that will be transitioning through ACGME accreditation should have few problems maintaining an osteopathic focus in their programs, since they are already doing so. I encourage all programs and the institutions in which they operate to consider this important issue as they plan their transition in the Single Accreditation System.
Of course there are a number of other reasons why it makes sense to pursue OR as well, and here are a few:
In a recent column, AOA President Robert S. Juhasz, DO, provided a number of thoughts on this very topic. I thought the following particularly noteworthy:
“Market forces in this country are aligning in ways that are driving the value of osteopathic medicine. The significant shortage of primary care physicians; patients seeking our high-touch, high-empathy brand of care; our distinctive training and practice of medicine, which aligns neatly with the national demand to deliver high-quality care in a cost-effective way—all of these factors underscore the need for more DO training.”
Clearly, we are living through interesting times. Our profession and its education model are undergoing change. We are provided with the opportunity to engage on a larger stage to deliver the best we have to offer for the health of our country’s residents.
In March 2015, AACOM conducted a survey of third-year students at colleges of osteopathic medicine (COMs) who are starting the process of choosing their residency training program. In this survey, third-year students were asked if they would prefer an ACGME program with osteopathic recognition over one without osteopathic recognition and how important osteopathic recognition would be in their rank order of preference for GME programs.
This data brief, Appeal of GME Programs with Osteopathic Recognition, reports on the survey data and examines the relevance of “osteopathic recognition” status of ACGME-accredited program among DO students.
Among the key findings from this survey: