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Am I missing something here. The AMA and ACGME aren't in agreement? I thought they kinda went hand in hand, at least unofficially.

Originally Posted by Wolverines83

Am I missing something here. The AMA and ACGME aren't in agreement? I thought they kinda went hand in hand, at least unofficially.

I'd imagine its the AAMC that is strongly pursuing this in conjunction with the ACGME.

Originally Posted by DrBowtie

I'd imagine its the AAMC that is strongly pursuing this in conjunction with the ACGME.

The ACGME consists of representatives from various organizations, including the AMA and AAMC.

I would think the AAMC has more authority over it than the AMA, but I'm not sure of the specific break down.

Originally Posted by johnnydrama

The ACGME consists of representatives from various organizations, including the AMA and AAMC.

I would think the AAMC has more authority over it than the AMA, but I'm not sure of the specific break down.

I guess I'm just surprised that part of an organization would be publicly opposed to a proposal by the organization it's a part of. Weird.

Originally Posted by Wolverines83

I guess I'm just surprised that part of an organization would be publicly opposed to a proposal by the organization it's a part of. Weird.

maybe it's because the AMA wants to keep the number of fellows being churned out while the ACGME is more interested in cost-cutting stimulated by the govt. more fellows for the ama, means more members. means more money for the lobby org. idk just a thought.

Originally Posted by donkeykong1

So lets say worst-case scenario this dumb proposal does pass. then what happens to all those unfilled fellowship spots that DOs with AOA residency training and IMGs with prior training used to fill. Wouldn't it make sense for there to be cuts to funding first before passing this restriction?

There is a phasing in, if it were passed, so that it would impact no one currently in or applying for pgy2/fellowship. (so no impact on interns, senior residents, or current fellows at whatever time it would go into effect.)

Originally Posted by johnnydrama

Funding cuts are already underway.

I don't believe many (if any) fellowship programs receive full Medicare funding anyway.

Very few have full funding.

Sylvanthus knows what my face looks like.... I have to destroy him. (alternatively it was cool to run into an sdner)

Originally Posted by DocEspana

Sylvanthus knows what my face looks like.... I have to destroy him. (alternatively it was cool to run into an sdner)

Lol, where did you two cross paths?

AMA annual meeting.

update?

Originally Posted by Dharma

update?

nope.

http://www.osteopathic.org/inside-ao...t.aspx?ID=2741

Originally Posted by Dharma

update?

I learned nothing not already posted here. it was apparently discussed briefly at the student section of the a m a.... but I was at the house of delegates, where this issue was not addressed it all

Originally Posted by DocEspana

Sylvanthus knows what my face looks like.... I have to destroy him. (alternatively it was cool to run into an sdner)

Hehe shoulda gotten a beer, but I was wiped out after the house of delegates ran overtime. On the plus side, I know longer think you are a girl hah!

http://www.osteopathic.org/inside-ao...t.aspx?ID=2756
AOA Daily Blog:
"The American Medical Association’s House of Delegates, whose meeting in Chicago concluded today, has approved a resolution related to the Accreditation Council for Graduate Medical Education’s (ACGME) proposed Common Program Requirements. While the ACGME’s proposal would limit DOs’ ability to train in their programs, the resolution calls upon the AMA to partner with stakeholder organizations, including the ACGME and the AOA, to develop and revise residency and fellowship accreditation standards in order to recognize the alignment of the educational experience of allopathic and osteopathic residents. The AMA is a parent organization of the ACGME, but this resolution will not compel the ACGME to withdraw its proposed Requirements. However, the AOA sees this resolution as a positive action in support of our efforts to resolve the ACGME crisis and preserve access to ACGME programs for DO graduates."
Not sure what to make of this...

Ehh sounds like a whole lot of nothing.

this must have passed since I left chicago. it was a huge deal among both students in residents. we didn't think it was gonna pass thoygh. I'm glad to see it did.

from the point of view of someone who is involved with the organization, this is a big deal. *if* it is prioritize properly, this can lead to a pretty nice review of both accreditation standards for gme. it basically suggest they should all get there programs I'm the same set of standards. might be a great way to dodge the bullet and generally strengthen aoa residencies

There was an interesting write-up on this by the EM folks last month:

http://download.journals.elsevierhea...4412002582.pdf
ACGME Tightens Postgraduate Training Entry Requirements:
Doctors of Osteopathic Medicine, International Medical Graduates Most Affected

... Nasca stressed that whatever changes are made, they will be phased in slowly. “I think the time frame is going to change, based on the comments, but I can't speak for the board. The time frame for the fellowships was initially 2015. I think it's likely that may be pushed back.” Implementation also depends on the specialty. “For instance, in internal medicine, the training is 3 years, so the start date might be [2015] or [2016]. But in surgery, where the training is 5 years, we may have to push that back to [2017] or [2018] to be fair to trainees in osteopathic surgical programs who are already in that pipeline.”

Ultimately, over time, could the changes lead not to division, but increased cooperation? “One country with 2 medical systems is a bit of an oddity, to say the least,” Dr. Cohen said, “and I think there ought to be as much effort to coordinate the 2 and to learn from one another.” Indeed, Dr. Suter said, the hubbub around the proposed changes could actually lead to an improved relationship and “might be the best thing that's ever happened between the AOA and the ACGME.”

Originally Posted by costales

There was an interesting write-up on this by the EM folks last month:

http://download.journals.elsevierhea...4412002582.pdf
ACGME Tightens Postgraduate Training Entry Requirements:
Doctors of Osteopathic Medicine, International Medical Graduates Most Affected

... Nasca stressed that whatever changes are made, they will be phased in slowly. “I think the time frame is going to change, based on the comments, but I can't speak for the board. The time frame for the fellowships was initially 2015. I think it's likely that may be pushed back.” Implementation also depends on the specialty. “For instance, in internal medicine, the training is 3 years, so the start date might be [2015] or [2016]. But in surgery, where the training is 5 years, we may have to push that back to [2017] or [2018] to be fair to trainees in osteopathic surgical programs who are already in that pipeline.”

Ultimately, over time, could the changes lead not to division, but increased cooperation? “One country with 2 medical systems is a bit of an oddity, to say the least,” Dr. Cohen said, “and I think there ought to be as much effort to coordinate the 2 and to learn from one another.” Indeed, Dr. Suter said, the hubbub around the proposed changes could actually lead to an improved relationship and “might be the best thing that's ever happened between the AOA and the ACGME.”

I think this can only be a good thing. Am I wrong?

Originally Posted by Flemon

http://www.osteopathic.org/inside-ao...t.aspx?ID=2756
AOA Daily Blog:
"The American Medical Association’s House of Delegates, whose meeting in Chicago concluded today, has approved a resolution related to the Accreditation Council for Graduate Medical Education’s (ACGME) proposed Common Program Requirements. While the ACGME’s proposal would limit DOs’ ability to train in their programs, the resolution calls upon the AMA to partner with stakeholder organizations, including the ACGME and the AOA, to develop and revise residency and fellowship accreditation standards in order to recognize the alignment of the educational experience of allopathic and osteopathic residents. The AMA is a parent organization of the ACGME, but this resolution will not compel the ACGME to withdraw its proposed Requirements. However, the AOA sees this resolution as a positive action in support of our efforts to resolve the ACGME crisis and preserve access to ACGME programs for DO graduates."
Not sure what to make of this...

basically don't go AOA IM, Neuro, or Rads as your fellowship opportunities will be severely limited.

Originally Posted by donkeykong1

basically don't go AOA IM, Neuro, or Rads as your fellowship opportunities will be severely limited.

You really should aim for this regardless.

Originally Posted by donkeykong1

basically don't go AOA IM, Neuro, or Rads as your fellowship opportunities will be severely limited.

I think it might turn out to be a good thing. I see no issue with ACGME and the AOA working together to make all residences equal, in terms of requirements. If that is indeed what they are considering.

I recently completed an osteopathic TRI (sponsored by a dually-accredited MD/DO FP program) and am being shunted into flight surgery with the USAF. Are you guys telling me that in 3 years when my obligation is up and I want to do a PGY-2/CA-1 start for anes, I will have no choice but to repeat internship and do a 1+3 or 4 year program..?

I thought this garbage was shot down.

Originally Posted by MaximusD

I recently completed an osteopathic TRI (sponsored by a dually-accredited MD/DO FP program) and am being shunted into flight surgery with the USAF. Are you guys telling me that in 3 years when my obligation is up and I want to do a PGY-2/CA-1 start for anes, I will have no choice but to repeat internship and do a 1+3 or 4 year program..?

I thought this garbage was shot down.

It refers to fellowships, not residencies, although I believe you may have some licensing issues in some states with a DO internship + ACGME residency.

Originally Posted by Flemon

I think it might turn out to be a good thing. I see no issue with ACGME and the AOA working together to make all residences equal, in terms of requirements. If that is indeed what they are considering.

Work together is putting things nicely. The ACGME has more spots, more money and more power than the AOA. I think it will go more like "Shape up or go play in your own sandbox for good"

Originally Posted by johnnydrama

It refers to fellowships, not residencies, although I believe you may have some licensing issues in some states with a DO internship + ACGME residency.

Thanks for the clarification. And that is not a problem with my specialty of choice.

Originally Posted by johnnydrama

It refers to fellowships, not residencies, although I believe you may have some licensing issues in some states with a DO internship + ACGME residency.

Actually, that's not completely correct. While most people do their intern year in the program they match into, one part of it is if you do a separate intern year your intern year has to be ACGME. So if you do TRI, you can't apply to ACGME residencies that start with PGY1. Of course there's always the option of repeating PGY1.

Forgot about this for a while... So basically this means it passed? I am considering osteo ortho programs.. so basically ACGME fellows are now closed off to me? Ugh.

I dont think anyone has heard dick, so im guessing it passed and will be implemented. Since ERAS is just opening to us DOs it makes me very tempted to just ignore the DO match and get ready for the MD match.

Originally Posted by sylvanthus

I dont think anyone has heard dick, so im guessing it passed and will be implemented. Since ERAS is just opening to us DOs it makes me very tempted to just ignore the DO match and get ready for the MD match.

If you have the stats for it, this is absolutely the right call.

AoA posted this on the 9th
"AOA Trustee Boyd R. Buser, DO, and John B. Bulger, DO, Chair of the AOA Program and Trainee Review Council, led the AOA delegation at a Joint Task Force meeting with leadership of the Accreditation Council of Graduate Medical Education (ACGME) at AOA headquarters in Chicago today. This meeting continues our advocacy to amend or withdraw the proposed Common Program Requirements that would limit DOs’ ability to train in ACGME residency and fellowship programs. Our Joint Task Force aims to form consensus between our organizations on scenarios of interaction between the two GME accreditation organizations that would preserve DOs’ access to ACGME programs."

So, basically, by the time any of this **** is figured out it will be essentially too late to change our minds if we are 4th years and matching. Would hate to match DO and then find out that the change goes through. So, think it is much safer to go MD. Ahh well.

JD- I do have the stats thankfully.

Originally Posted by sylvanthus

So, basically, by the time any of this **** is figured out it will be essentially too late to change our minds if we are 4th years and matching. Would hate to match DO and then find out that the change goes through. So, think it is much safer to go MD. Ahh well.

JD- I do have the stats thankfully.

i think someone from soma probably skimmed some posts made in the pre-DO thread the past few days and decided to notify the aoa make a weightless update

I'll be at the Chicago conferences next week (both AOA and SOMA) on behalf of my chapter (as I'm sure a few of you will be as well). I'm hoping to hunt down more information on this while I'm there. I'll keep everyone up to date.

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This will be entertaining, back in the spring they sent out that video reassuring us, now we'll see how it worked out.

Originally Posted by frankyazz

Forgot about this for a while... So basically this means it passed? I am considering osteo ortho programs.. so basically ACGME fellows are now closed off to me? Ugh.

Originally Posted by sylvanthus

I dont think anyone has heard dick, so im guessing it passed and will be implemented. Since ERAS is just opening to us DOs it makes me very tempted to just ignore the DO match and get ready for the MD match.

Nope. Still under debate with no formal decision made. This nonsense is, like every single ACGME policy, years in the making and I wouldnt be surprised to see it without any action for another 6 months still until closer to november.

The ACGME has postponed its decision on this matter until September. That is because of the progress of a joint task force between the AOA and ACGME in meeting in the middle ground somewhere. I type this while I am in Executive Session of the AOA Board of Trusteesand skimmed this thread.

We are making some progress and are confident we will reach some form of an agreement/understanding.

Your SGA Presidents will be given an update to this as well. Ask them for additional updates as they return from the Chicago House.

Mansoor A. Jatoi, D.O.
AOA Board of Trustee National Student Representative

Been very concerned about all this as I am currently applying to AOA TRI and ACGME PM&R fellowships (2012-2013 match)....I just read through all 7 pages of this thread and I have a question that no one has raised....

WHAT MATCH CLASS WILL ACTUALLY BE AFFECTED BY THIS? If this proposal passes as written it will be implemented on July 1, 2014 as stated in a document someone posted in this thread. Does this mean that someone applying THIS YEAR can do a TRI next year (in 2013) then start an advanced ACGME PGY-2 spot on July 1, 2014? But that is the date that TRI will no longer be recognized for a ACGME PGY-2 program....I'm having these visions of showing up for my first day of residency as a PGY-2 and being told the entire previous year isn't recognized. How do you guys interpret this?! I e-mailed the AOA. I'll let you know if I ever hear anything, but since I've already submitted apps for TRI I'm quite anxious....thoughts?

PS: just to throw my opinion into the ring....as stated, people who are currently doing (or hopefully will do next year too) TRI then ACGME residency are still eligible for any and all acgme fellowships. The intern year has nothing to do with fellowships...

By delaying a decision the class graduating in 2013 really has no idea wtf to do. Its all dandy that they are still working on it but come on lets come to a decision so that students can make residency choices. All this delay does is make it more obvious that it is wise to avoid the DO match entirely.

Also wanted to add that kicking the can down the road is not making progress.

Why does it matter what they finally decide?

Either way, you should aim for ACGME residencies over AOA residencies.

If you can't get an ACGME spot, you weren't going to get one if the decision had been different, so it doesn't matter to you.

My main goal is an MD residency obviously and whatever the AOA/ACGME does is not going to change that no matter what the final decision.

More worried that others going to DO residencies may get screwed and may falsely be putting their hopes in the AOA. So more pissed off at this whole mess because of that. I do tend to look out for other people sometimes, Im not a total selfish D bag even though I may come across that way sometimes.

Regardless, the AOA ****ed up plain and simple. This shouldnt have occurred in the first place. Even if they somehow manage to reverse it, it isn't because the AOA Is awesome and did a good job. They just may be able to prevent a catastrophe of their own making. Averting disaster is not making progress. Yet, somehow, I imagine that the above AOA lackey will try to spin it in a fashion that makes the AOA look like they are an amazing institution, when they are clearly doing a piss poor job.

You should tell them to aim for ACGME residencies too and only use the AOA as a last resort - doesn't need to be selfish.

People should only worry about things that are within their power to change - pretend you're in AA instead of DO.

Originally Posted by johnnydrama

You should tell them to aim for ACGME residencies too and only use the AOA as a last resort - doesn't need to be selfish.

People should only worry about things that are within their power to change - pretend you're in AA instead of DO.

lots of things are within our power. Tomorrow 7/17 is a big day. If I weren't in first year orientation. I would be in chicago

Originally Posted by donkeykong1

lots of things are within our power. Tomorrow 7/17 is a big day. If I weren't in first year orientation. I would be in chicago

I'm in Chicago, doesn't mean I know anything more about this than what is in this thread. Sure would be nice to hear about this type of stuff from my school instead of a public Internet forum, I mean I'm paying them $51,000+ this year

Originally Posted by TeamZissou

I'm in Chicago, doesn't mean I know anything more about this than what is in this thread. Sure would be nice to hear about this type of stuff from my school instead of a public Internet forum, I mean I'm paying them $51,000+ this year

try speaking to your student gov. people

Why was today supposed to be a big day?

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If i recall correctly, and someone more willing to read the original document can confirm my memory being correct or slightly flawed, class of 2013 is entirely safe. They have a delayed enforcement so that anyone within a rising cycle or the next cycle will not be impacted for the internship-residency end of it. So 2013 would be rising into internship this cycle and would be exempted from the internship --> residency rules if it were enacted today.

The people who might get screwed on this are current 2nd AOA year residents who were looking for a fellowship in ACGME 2 years from enactment.

but all of that is predicated on this being passed. There has been a ton of dissent on this including the AMA coming out against it by suggesting to instead re-examine post-grad training regiments to unify them across the board more rather than taking the ACGME's stance. (funny as the AMA is a major partner member of the ACGME)

Originally Posted by DocEspana

If i recall correctly, and someone more willing to read the original document can confirm my memory being correct or slightly flawed, class of 2013 is entirely safe. They have a delayed enforcement so that anyone within a rising cycle or the next cycle will not be impacted for the internship-residency end of it. So 2013 would be rising into internship this cycle and would be exempted from the internship --> residency rules if it were enacted today.

The people who might get screwed on this are current 2nd AOA year residents who were looking for a fellowship in ACGME 2 years from enactment.

but all of that is predicated on this being passed. There has been a ton of dissent on this including the AMA coming out against it by suggesting to instead re-examine post-grad training regiments to unify them across the board more rather than taking the ACGME's stance. (funny as the AMA is a major partner member of the ACGME)

It's not that shocking since the AMA has a % of DO members. The AMA is a quite diverse group (many left the org with their position on the healthcare act). MDs have no AOA equivalent that governs in varying degrees both UME and GME.

I suspect the strongest push for this is coming from the AAMC. I suspect the AAMC will push even harder for more restricted access to ACGME residencies to protect the students at the schools it represents.

Perhaps the ABMS in efforts to try to shunt more people to MD board certs rather than DO board certs is also lobbying for it.

Originally Posted by DocEspana

If i recall correctly, and someone more willing to read the original document can confirm my memory being correct or slightly flawed, class of 2013 is entirely safe. They have a delayed enforcement so that anyone within a rising cycle or the next cycle will not be impacted for the internship-residency end of it. So 2013 would be rising into internship this cycle and would be exempted from the internship --> residency rules if it were enacted today.

The people who might get screwed on this are current 2nd AOA year residents who were looking for a fellowship in ACGME 2 years from enactment.

but all of that is predicated on this being passed. There has been a ton of dissent on this including the AMA coming out against it by suggesting to instead re-examine post-grad training regiments to unify them across the board more rather than taking the ACGME's stance. (funny as the AMA is a major partner member of the ACGME)

This makes sense...I would be SHOCKED if a) this passed as currently written and/or b) there wasn't some grandfather clause-type action taken to protect the class of 2013 and current residents/interns. I'm actually surprised the acgme hasn't eased fears by stating something to this effect. I just happen to be a skeptical and conservative person who prefers to know what i'm getting into. It seems absurdly unfair if this affected 4th yr students/interns/residents in any way. It would be terrible if this affected any student in the future, but at least they would have the information to make sound choices. That's all I'm really asking for...

Well the delayed enforcement is right in the wording of the recommendation. So while the ACGME did not formally point that out, it is right there in the recommended policy in (Relatively) plain english.

and i dont say that to insult anyone in any way. Reading these documents is an arduous task. this just happened to be a part that is rather straightforwardly written among all the other clauses.