Single Accreditation System Progress

Corresponding Author: Kevin de Regnier, DO, FACOFP dist. 2015 ACOFP President Email: president@acofp.org

As I write this, the AOA House of Delegates has just concluded and the single accreditation system (SAS) was front and center.As you may recall, the 2014 ACOFP Congress of Delegates expressed serious concerns about the impact a single GME accreditation system would have on our family medicine residencies and on the profession as a whole. These sentiments were conveyed to the AOA in 2014 ACOFP Resolution 13 which requested the AOA;

(to) withdraw from the MOU (memorandum of understanding between the AOA/AACOM & ACGME) 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); 1

  At the just completed AOA House of Delegates, ACGME CEO Tom Nasca, MD and AOA Trustee Boyd Buser, DO, FACOFP, reported on the progress that has been made toward resolving many, though not all of our concerns. They reported:

• The COMLEX exam will continue to be accepted for entry into ACGME programs

• ACGME created a pre-accreditation status for AOA programs applying for ACGME accreditation to allow residents unimpeded access to all ACGME residency and fellowship programs

• A new Osteopathic Neuromusculoskeletal Medicine Review Committee (RC) has been established and residency standards produced and approved

• A new Osteopathic Principles Committee has been established and standards have been produced and approved

• 20 of 24 review committees have announced that they will accept AOA certification for program directors, one committee has not yet met to discuss this issue

• Osteopathic representatives have been added to ACGME review committees for which there are AOA training programs

• Institutions began formal application processes on 4/1/2015

• Individual Programs began application process on 7/1/2015

  • 29 institutions have applied for ACGME accreditation; six have been awarded initial accreditation

  • Two AOA programs have submitted applications for ACGME accreditation

  • A recent survey shows 83% of program directors are considering osteopathic recognition for their programs

  • Current ACGME programs have inquired about application to achieve osteopathic recognition

  • ACGME has instructed RCs to develop language consistent with the expectation that DOs will take AOA certifying board examinations. 2

As you can see, there has been great progress made in addressing many of the concerns raised by the ACOFP Congress of delegates.

But it hasn't just been the AOA, AACOM, and the ACGME doing all the work, the ACOFP has been doing its part

to ensure a successful transition to the SAS. We have nominated and had three members appointed to the family medicine review committee. A member nominated by the ACOFP has been appointed to the osteopathic neuromusculoskeletal medicine RC and four ACOFP members serve on the osteopathic principals committee.

Additionally, the ACOFP has reviewed and submitted comments on proposed changes to the ACGME FM standards, the OPC standards, and the ONMM standards. On each occasion we joined with the AOA and or the American Academy of Osteopathy in submitting our comments.

The ACOFP will continue to monitor the progress of the development and implementation of the single accreditation system to ensure that the concerns raised by our Congress of Delegates are fully addressed and the profession is preserved.

REFERENCE

1. http://www.acofp.org/ACOFPIMIS/acofporg/PDFs/About/ Past_Resolutions/2014/Res_13_AOA-AACOM_Unified_Residency_ Accreditation_System.pdf, accessed July 23, 2015

2. http://www.osteopathic.org/inside-aoa/single-gme-accreditation- system/Pages/2015-HOD-single-gme-update.aspx accessed July 23, 2015