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Two weeks after announcement of the AOA/AACOM unified residency accreditation system with the Accreditation Council for Graduate Medical Education (ACGME), the ACOFP Congress of Delegates passed a Resolution – AOA/AACOM Unified Residency Accreditation System – seeking greater disclosure of the agreement’s terms and equality for osteopathic certification in program director requirements and standards for residency program certification exam pass rates.
The resolution also seeks recognition of COMLEX-USA as being equivalent for meeting admission criteria into residency programs under the consolidated residency accreditation system, and that osteopathic medical school graduates will remain eligible for entry into all ACGME programs on an equal basis with allopathic graduates of United States and Canadian medical schools.
The resolution passed at the March 13, 2014 ACOFP Congress and will be submitted for action at the July 18- 20, 2014 AOA House of Delegates meeting in Chicago. The ACOFP Congress consisted of 257 Delegates representing ACOFP state societies at last week’s meeting in Philadelphia, and it serves as the highest policy-making body in the ACOFP governance structure.
ACOFP DIALOG WITH AOA/AACOM LEADERSHIP
The resolution originated in the ACOFP Board of Governors following its own deliberations and subsequent dialog with AOA and AACOM leadership. I want to thank AOA President Norman Vinn, DO, FACOFP, AOA President- elect Robert Juhasz, DO,FACOI, AOA Trustee Boyd Buser, DO, FACOFP, and AACOM President Stephen Shannon, DO for their extended time and willingness to engage in meaningful discussions at the ACOFP Annual Convention with the ACOFP Board, with 235 attendees at the ACOFP Programs Directors Workshop, with ACOFP members at an Open Forum, and with students during a briefing session.
PERSPECTIVES – PRO & CON
Comments expressed at Congress Reference Committees and these venues expressed both the perceived benefits and possible pitfalls of the unified residency accreditation system.
Those speaking in favor of a unified system tout greater choice for osteopathic students, including expanded access to specialty fellowships. Those opposing a unified system believe that osteopathic students already can choose to match into allopathic residencies, although presently there are fewer osteopathic fellowships for those seeking specialty residencies.
It is possible that more osteopathic students will match into residency slots in allopathic programs. However, it is also possible that more allopathic and international medical students could match into residency slots that are now available only to osteopathic students.
RECOGNITION OF AOA CERTIFICATION
Of concern to the ACOFP Congress and Board is the way that osteopathic certification applies in program director qualifications and residency program pass rate requirements under terms of the Memorandum of Understanding that have been publicly released.
The unified system will recognize only ABMS certification for all program directors, although those holding only AOA certification can be co-directors or faculty, but can be program directors only on an exception basis if approved by the Residency Review Committee. The ACOFP resolution seeks equal recognition of AOA and ABMS certification for program director qualifications.
The current ACGME rules require all residents – DOs and MDs – to take the ABMS certification examination to meet the pass rate requirement in the Basic Standards. The ACOFP resolution seeks to have AOA certification recognized on an equal basis with AMBS certification when calculating the pass rate requirement.
AFFIRMATION OF NON-NEGOTIABLE PRINCIPLES
The ACOFP Congress Resolution – AOA/AACOM Unified Residency Accreditation System will be submitted to the July 2014 AOA House of Delegates. It seeks release of the complete Memorandum of Understanding, if it has not been released prior to the AOA House meeting.
It is important to note that the ACOFP Congress and Board of Governors have not taken a position in favor or opposition to the unified residency accreditation system. The resolution requests that the AOA affirm to its membership that it will withdraw from the Memorandum of Understanding by December 31, 2015 if any of the principles considered to be “non-negotiable items” are not included in the MOU or any subsequent amendments to the MOU.
Just as the ACOFP Congress and Board seek more information, I encourage you to become educated on all aspects – pro and con – of the unified residency accreditation system. I welcome your comments at president@acofp.org.
View the Resolution on pages 12-13
FINAL RESOLUTION AFTER CONGRESS SESSION II ON MARCH 13, 2014 - APPROVED
Resolution 13 - AOA/AACOM Unified Residency Accreditation System
WHEREAS, for more than a year, the American Osteopathic Association (AOA) and the American Association of Colleges of Osteopathic Medicine (AACOM) have been engaged in negotiations with the Accreditation Council for Graduate Medical Education (ACGME) in an attempt to reach an agreement on a framework for creating a single unified system for the accreditation of Graduate Medical Education (GME) in the United States; and
WHEREAS, from the outset of the negotiations, the AOA/AACOM outlined five “non-negotiable items” that included:
The discussion is limited to GME and does not extend backward to undergraduate medical education or forward to licensing or certification,
The osteopathic medicine licensing examination, Comprehensive Osteopathic Medical Licensure Examination of the United States (COMLEX-USA) remains in place and viable,
Osteopathic board certification remains in place and viable,
Osteopathic physicians must be given an equal opportunity to participate in all training programs under any unified accreditation system, and
Any unified accreditation system must not adversely affect primary care programs in community- based settings; and
WHEREAS, at the 2013 AOA House of Delegates meeting, the AOA announced it had rejected a Memorandum of Understanding (MOU) stating that it failed to satisfactorily address several of the AOA’s non-negotiable items; and
WHEREAS, on February 26, 2014 the AOA announced that it had reached agreement with the ACGME on the terms of a MOU to create a single unified system for the accreditation of GME in the United States; and
WHEREAS, the full contents of this new MOU have yet to be publically disclosed; and WHEREAS, the announced details of the MOU do not grant equal recognition of and respect for Osteopathic Certification; and
WHEREAS, the ACOFP has previously raised serious concerns regarding the concept of a single unified GME accreditation system; and
WHEREAS, the ramifications of the implementation of a such a system are far reaching and have the potential to significantly impact the future of the osteopathic profession; now, therefore be it
Resolution 13 - AOA/AACOM Unified Residency Accreditation System
RESOLVED, that the American College of Osteopathic Family Physicians (ACOFP) calls on the American Osteopathic Association (AOA), The American Association of Colleges of Osteopathic Medicine (AACOM) and the Accreditation Council for Graduate Medical Education (ACGME) to immediately release to the osteopathic community (if not released prior to the 2014 AOA House of Delegates) the entire Memorandum of Understanding (MOU); and be it further
RESOLVED, that the AOA affirms to its membership that it will withdraw from the MOU by December 31, 2015 if any of the principles listed below that are considered to be non-negotiable items are not included in the MOU, or by an amendment to the MOU:
A requirement that all Graduate Medical Education (GME) programs recognize the Comprehensive Osteopathic Medical Licensure Examination of the United States (COMLEX-USA) results as equivalent to meet examination criteria for admission into the new consolidated and unified Graduate Medical Education (GME) programs,
That graduates of Colleges of Osteopathic Medicine accredited by the AOA Commission on Osteopathic College Accreditation (COCA) will remain eligible for entry into all ACGME programs on an equal basis with U.S. and Canadian graduates of Colleges of Medicine accredited by the Liaison Committee on Medical Education (LCME) or the Committee on Accreditation of Canadian Medical Schools (CACMS),
A requirement that if osteopathic physicians in the new unified GME accreditation programs take osteopathic board certification examinations, those osteopathic board certification examinations be recognized as equivalent to the American Board of Medical Specialties (ABMS) certification examinations and be counted equally with allopathic certification toward the required certification examination pass rate in the Basic Residency Standards.
That the new unified GME accreditation programs recognize AOA Board Certification on an equal basis with ABMS certification for the positions of program director, director of medical education, and designated institutional officer without requiring an exception be granted by the applicable Residency Review Committee (RRC); and, be it further.
RESOLVED, that this resolution be submitted to the 2014 AOA House of Delegates, and be considered the policy of the AOA as defined by its constitution, for action; and by January 9, 2015 report to the ACOFP Board of Governors on the actions taken by the AOA.