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GME accreditation: further details from the AOA!

By: Reza Karimianpour

In July of 2013, after many years of contemplation and months of active deliberation, the ACGME and AOA disagreed on pursuing a unified accreditation system for graduate medical education (GME). However, a few days ago both organizations announced their official agreement on a unified GME system in a landmark joint press release. Although the agreement has been reached, there is lot of footwork left to actually transition all osteopathic residency programs to receive ACGME accreditation. Certainly, many details must be hammered out over the next few years. 

In an effort to deliver further details regarding this matter to our readers, I contacted the American Osteopathic Association in order to obtain some key facts in a five question interview with the AOA director of media relations.

1) Will pre-graduate board examinations (COMLEX & USMLE) remain separate and unchanged?

COMLEX-USA will continue to be the required examination series and the pathway to licensure for osteopathic physicians. It is widely recognized and universally accepted as the valid examination for osteopathic physician competency assessment for licensure. It is also required by accreditation standards established by the Commission on Osteopathic College Accreditation (COCA), and is a requirement for graduation from all colleges of osteopathic medicine. COMLEX-USA is regarded by residency program directors of AOA and ACGME accredited residency programs as an important and useful assessment tool as part of evaluation of DO residency applicants for their programs.

2) The transition will start in mid-2015, but when will allopathic graduates be able to actually apply for the newly ACGME accredited residencies?

We anticipate that applications will be open to MDs as soon as there are ACGME osteopathic-focused programs. This could be as soon as July 2016 or as late as July 2020.

3) Will ECFMG (Educational Commission for Foreign Medical Graduates) certified students/graduates be qualified to enter the newly ACGME accredited residencies?

DO and MD graduates would have access to ACGME accredited training programs including those with an osteopathic principles dimension. Prerequisite competencies (recommended by the new Osteopathic Principles Review Committee) and a recommended program of training for MD graduates may be required for entry into programs that have an osteopathic principles dimension. The same would apply for IMGs.

4) What are the additional requirements for allopathic applicants to enter these previously osteopathic residencies?

Prerequisite competencies and a recommended program of training for MD graduates may be required to apply for entry into programs that have an osteopathic principles dimension. (No further details were provided as to what these pre-requisites consist of).

5) What are the qualification criteria for current osteopathic residents seeking to enter allopathic fellowships in this new system?

AOA will cease providing GME accreditation in July 2020. A single accreditation system will preserve access to training programs for DOs, including access to fellowship programs.

DOs training now wishing to enter into an ACGME training program after AOA training, whether a residency or fellowship program, will be able to do so from July 1, 2015, until June 30, 2020, as long as their OGME training program has applied for initial accreditation by the ACGME.

An interesting point I discovered while reviewing documentation online is that the ACGME plans to mandate that all subspecialty programs must be dependent. For example, a hematology-oncology fellowship must also have an in-house internal medicine residency. Currently, many subspecialty programs are independent (do not have an in-house corresponding residency program). Therefore, enforcement of this future mandate (and many other forecasted changes) may become severely convoluted in conjunction with the transition to the new accreditation system.

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