AOA, AACOM, and the ACGME agree to unified accreditation system

[Postictal Raiden]

Most- but not all- of the residents at those types of places completed IM or FM residencies prior to starting the derm residency.

Just to play devil's advocate: Imagine you have a family physician who spent three years working exclusively with derm patients and treating exclusively derm cases, all the while reading up on dermatology just like any other dermatologist, to be proficient in treating dermatogical disease? I would. I wouldn't necessarily expect them to be as good with the zebras as someone who trained at a top university program, but I think they could be a fine community dermatologist. Now, I do think those residencies probably suffer from a lack of oversite, and there really should be standards as to how much they are paid. There should be careful monitoring of didactics and of case numbers and so on, but I think the fact that they are often funded directly by the program is interesting. For the program, it's kind of like hiring and training a PA.

My solution would be to formally turn these residencies into fellowships that must be completed following FM or IM, and to increase oversight, etc.

But aren't those "zebras" what separates true physicians from physician-wannabes NP's?

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[user3]

I've heard the same as well. I wouldn't be surprised if there were very few changes even with the OMM/NMM fellowships.

from my understanding, OMM/NMM is an option 2 residency program. But anyway, wouldn't ACGME be granting "accreditation" to programs heavy on something (OMM) that many in the allopathic community look upon with doubt and skepticism? Won't many complain that this will give OMM an undeserved (in their opinions) new level of "credibility"?

I don't want to jump to conclusions, but...just saying I'm not sure how smoothly that will go.

 

[Dr. Zombie]

from my understanding, OMM/NMM is an option 2 residency program. But anyway, wouldn't ACGME be granting "accreditation" to programs heavy on something (OMM) that many in the allopathic community look upon with doubt and skepticism? Won't many complain that this will give OMM an undeserved (in their opinions) new level of "credibility"?

I don't want to jump to conclusions, but...just saying I'm not sure how smoothly that will go.

I feel having OMM residencies with ACGME accreditation will pave a way for the amount of research needed to recognize it as a viable area of medicine (in allopathic eyes), especially now that OMM will be more MD-accessible than ever before. Even a single substantial OMM publication under an MD-driven journal can make strides.

 

[AlbinoHawk DO]

Most- but not all- of the residents at those types of places completed IM or FM residencies prior to starting the derm residency.

Just to play devil's advocate: Imagine you have a family physician who spent three years working exclusively with derm patients and treating exclusively derm cases, all the while reading up on dermatology just like any other dermatologist, to be proficient in treating dermatogical disease? I would. I wouldn't necessarily expect them to be as good with the zebras as someone who trained at a top university program, but I think they could be a fine community dermatologist. Now, I do think those residencies probably suffer from a lack of oversite, and there really should be standards as to how much they are paid. There should be careful monitoring of didactics and of case numbers and so on, but I think the fact that they are often funded directly by the program is interesting. For the program, it's kind of like hiring and training a PA.

My solution would be to formally turn these residencies into fellowships that must be completed following FM or IM, and to increase oversight, etc.

This is like the worst devil's advocate. If you're going to be a dermatologist, you have to have full dermatology training.

 

[NurWollen]

This is like the worst devil's advocate. If you're going to be a dermatologist, you have to have full dermatology training.

I know it's not ideal, but I see it as a possible alternative to just shutting down a bunch of programs that a lot of really bright people- some of the best a brightest DOs out there- have pinned their careers on. These graduates would have to meet strict case numbers and would have to pass the same board certification exams as traditional dermatologists.

I know nothing about derm and don't really know for sure if this is something that would work, but IMO it's worth considering. Not that the ACGME is asking me for advice, of course.

 

[hallowmann]

from my understanding, OMM/NMM is an option 2 residency program. But anyway, wouldn't ACGME be granting "accreditation" to programs heavy on something (OMM) that many in the allopathic community look upon with doubt and skepticism? Won't many complain that this will give OMM an undeserved (in their opinions) new level of "credibility"?

I don't want to jump to conclusions, but...just saying I'm not sure how smoothly that will go.

OMM already has some credibility among MDs. It isn't considered pure quackery to most MDs. Maybe it's because they don't know certain parts of it to the same depths that we do, but to be completely honest, I feel like current DOs are more embarrassed/annoyed with it than MDs. If you talk to MD physiatrists most would be all over it. Heck, MDs are already getting CMEs and certification in OMM from MD universities.

I'm honestly not worried about it giving undue credibility to the field. On the contrary, I agree with Dr. Zombie that maybe it'll actually bring some money and interest for more research in OMT, something that the field desperately needs.

Also, as far as OMM/NMM goes there are 3-4 different ways to complete it, among them are second option pathways as well as "fellowships" after completing traditional residencies.

 

[user3]

OMM already has some credibility among MDs. It isn't considered pure quackery to most MDs. Maybe it's because they don't know certain parts of it to the same depths that we do, but to be completely honest, I feel like current DOs are more embarrassed/annoyed with it than MDs. If you talk to MD physiatrists most would be all over it. Heck, MDs are already getting CMEs and certification in OMM from MD universities.

I'm honestly not worried about it giving undue credibility to the field. On the contrary, I agree with Dr. Zombie that maybe it'll actually bring some money and interest for more research in OMT, something that the field desperately needs.

Also, as far as OMM/NMM goes there are 3-4 different ways to complete it, among them are second option pathways as well as "fellowships" after completing traditional residencies.

Do you think it will help shift the OMM field to be more evidence-based, and finally shun things like cranial?

 

[hallowmann]

Do you think it will help shift the OMM field to be more evidence-based, and finally shun things like cranial?

I hope so. The thing is there is already some research on OMM, but it's on such a small scale that it can't even hope to be definitive. The money and interest is simply not there.

 

[AlbinoHawk DO]

I hope so. The thing is there is already some research on OMM, but it's on such a small scale that it can't even hope to be definitive. The money and interest is simply not there.

The money is there. The government is spending a lot of money on alternative medicine research (compared to decades past). The faculty of OMM simply doesn't want to do it because they know their horse**** will be uncovered.

 

[BurghStudent]

The money is there. The government is spending a lot of money on alternative medicine research (compared to decades past). The faculty of OMM simply doesn't want to do it because they know their horse**** will be uncovered.

Or, OMM could evolve. The parts that work will be validated, and the parts that I often hear don't, cranial, will be excised like a tumor.

 

[user3]

The faculty of OMM simply doesn't want to do it because they know their horse**** will be uncovered.

Unfortunate.

FWIW, from the ABIM Charter on Professionalism:

Commitment to scientific knowledge
Much of medicine’s contract with society is based on the integrity and appropriate use of scientific knowledge and technology. Physicians have a duty to uphold scientific standards, to promote research, and to create new knowledge and ensure its appropriate use. The profession is responsible for the integrity of this knowledge, which is based on scientific evidence and physician experience.

http://www.abimfoundation.org/Profe...er/Commitments-of-the-Charter.aspx#Scientific

 

[costales]

The money is there. The government is spending a lot of money on alternative medicine research (compared to decades past). The faculty of OMM simply doesn't want to do it because they know their horse**** will be uncovered.

FWIW The Osteopathic Research Center at TCOM received over $21 million for OMM research over the last several years. They did crank out quite a few papers e.g.
http://annfammed.org/content/11/2/122.full
http://www.ajog.org/article/S0002-9378(09)00843-6/abstract
http://www.om-pc.com/content/4/1/2

 

[SnowDoggy44]

The money is there. The government is spending a lot of money on alternative medicine research (compared to decades past). The faculty of OMM simply doesn't want to do it because they know their horse**** will be uncovered.

How do you know this about OMM field leaders? Or are you half joking?

 

[NeuroLAX]

Breaking News: ACGME-Proposed Requirements for Osteopathic Recognition and Osteopathic Neuromusculoskeletal Medicine Posted for Review and Public Comment
(11/14/14) Today, in another milestone in the transition to a Single GME Accreditation System, the ACGME posted proposed requirements for Osteopathic Recognition, drafted by the Osteopathic Principles Working Group, soon to be the Osteopathic Principles Committee (OPC). ACGME also posted program requirements for Osteopathic Neuromusculoskeletal Medicine, drafted by the Osteopathic Neuromusculoskeletal Medicine Working Group, soon to be the Osteopathic Neuromusculoskeletal Review Committee (ONMM).

The proposed requirements are available for public comment until December 29, 2014. Read the new requirements.

After the conclusion of the 45-day comment period, the OPC and ONMM review committees will evaluate comments received and determine which suggestions to incorporate into the proposed requirements for submission to the ACGME Committee on Requirements (CoR). Final recommendations will be forwarded to the ACGME Board of Directors for action during their February 2015 Board meeting. Learn more about the ACGME review process and requirements.

AACOM is in the process of analyzing these draft requirements. We would like to coordinate efforts to provide comments on these requirements with member constituencies, AOA and other osteopathic organizations. Please stay tuned for more communication on coordination for the commenting process.

For further updates and notifications, visit AACOM’s single GME web page, follow AACOM on twitter @aacommunities, or sign up for email updates at [email protected].

https://www.acgme.org/acgmeweb/tabid/157/ProgramandInstitutionalAccreditation/ReviewandComment.aspx

 

[SurgeDO]

Breaking News: ACGME-Proposed Requirements for Osteopathic Recognition and Osteopathic Neuromusculoskeletal Medicine Posted for Review and Public Comment
(11/14/14) Today, in another milestone in the transition to a Single GME Accreditation System, the ACGME posted proposed requirements for Osteopathic Recognition, drafted by the Osteopathic Principles Working Group, soon to be the Osteopathic Principles Committee (OPC). ACGME also posted program requirements for Osteopathic Neuromusculoskeletal Medicine, drafted by the Osteopathic Neuromusculoskeletal Medicine Working Group, soon to be the Osteopathic Neuromusculoskeletal Review Committee (ONMM).

The proposed requirements are available for public comment until December 29, 2014. Read the new requirements.

After the conclusion of the 45-day comment period, the OPC and ONMM review committees will evaluate comments received and determine which suggestions to incorporate into the proposed requirements for submission to the ACGME Committee on Requirements (CoR). Final recommendations will be forwarded to the ACGME Board of Directors for action during their February 2015 Board meeting. Learn more about the ACGME review process and requirements.

AACOM is in the process of analyzing these draft requirements. We would like to coordinate efforts to provide comments on these requirements with member constituencies, AOA and other osteopathic organizations. Please stay tuned for more communication on coordination for the commenting process.

For further updates and notifications, visit AACOM’s single GME web page, follow AACOM on twitter @aacommunities, or sign up for email updates at [email protected].

https://www.acgme.org/acgmeweb/tabid/157/ProgramandInstitutionalAccreditation/ReviewandComment.aspx

i've been looking at this for 30 minutes, and i still cannot fully wrap my head around it.

it looks like all the AOA programs that receive ACGME accreditation will be designated ACGME programs with "Osteopathic Recognition". MDs who want to apply to these programs will need to fulfill several OPP/OMM requirements.

from what i have gathered, it looks like the ACGME is being fairly accommodating of the AOA.

 

[SurgeDO]

it also looks like PDs will no longer need to have completed an ACGME residency in order to be appointed PD to an ACGME program which will keep a lot of AOA PDs in their positions.

 

[GUH]

i've been looking at this for 30 minutes, and i still cannot fully wrap my head around it.

it looks like all the AOA programs that receive ACGME accreditation will be designated ACGME programs with "Osteopathic Recognition". MDs who want to apply to these programs will need to fulfill several OPP/OMM requirements.

from what i have gathered, it looks like the ACGME is being fairly accommodating of the AOA.

it also looks like PDs will no longer need to have completed an ACGME residency in order to be appointed PD to an ACGME program which will keep a lot of AOA PDs in their positions.

Yes; it does look like they will allow AOA-trained PD's to remain in their positions, which is awesome news if we're interpreting the documents correctly.

As for the requirements for MDs to apply to the programs, there appears to be some vagueness, particularly with regards to the bolded part:

... Prior to matriculation, residents meeting the requirements for V.A.2. or V.A.3. above must be prepared to demonstrate competence in osteopathic principles and practice approaching that of a graduating fourth-year student as established by the American Association of Colleges of Osteopathic Medicine (AACOM), including the following knowledge, skills, or behaviors:
V.B.1. osteopathic philosophy, history, terminology and code of ethics;
V.B.2. anatomy and physiology related to osteopathic medicine;
V.B.3. indications, contraindications, and safety issues associated with the use of osteopathic manipulative treatment; and, palpatory diagnosis, osteopathic structural examination, and osteopathic manipulative treatment (OMT).
V.C. Competence must be demonstrated through achievement of prerequisite osteopathic principles and practice Milestones, including those specific to the specialty.

Can anyone here shed some light on with the "prerequisite milestones" would look like? Because the other material can quite frankly be taught in a classroom in a very short time frame with little hands-on training or testing in competency in actual osteopathic palpation and treatment.

 

[NurWollen]

Yes; it does look like they will allow AOA-trained PD's to remain in their positions, which is awesome news if we're interpreting the documents correctly.

As for the requirements for MDs to apply to the programs, there appears to be some vagueness, particularly with regards to the bolded part:

Can anyone here shed some light on with the "prerequisite milestones" would look like? Because the other material can quite frankly be taught in a classroom in a very short time frame with little hands-on training or testing in competency in actual osteopathic palpation and treatment.

I don't have any special insight, but I do agree the language regarding these 'prerequisite milestones' seems vague.

I will add that, while maybe I'm just not familiar enough with the current AOA program requirements, it seems the requirements new requirements for Osteopathic recognition are more extensive and specific than what already exists for AOA residencies.

 

[Siggy]

Screw EM... screw IM... I'm going to go into NMM so I can open up OPP classes for the unmatched Caribbean kids to scramble into unfilled osteopathic focused residencies.

 

[NurWollen]

Screw EM... screw IM... I'm going to go into NMM so I can open up OPP classes for the unmatched Caribbean kids to scramble into unfilled osteopathic focused residencies.

Just imagine the number of unfilled TRI spots every year. There's only like .4 applicants for every TRI spot every year. There have got to be thousands of FMGs who would be thrilled to get a TRI spot just so they can get a medical license.

 

[DrBowtie]

Just imagine the number of unfilled TRI spots every year. There's only like .4 applicants for every TRI spot every year. There have got to be thousands of FMGs who would be thrilled to get a TRI spot just so they can get a medical license.

With the exception of a few states, most require FMGs to complete 2+ years.

 

[NeuroLAX]

I have no interest in an OMM/NMM residency, but 40 hours of required cranial and required A.T. Still book club???

Those parts were not bolded (ACGME Common Program Requirements), so they are up for public comment until the middle of December. I wonder if they will be contested. Those requirements seem like a waste of time that could be better spent on other clinical or scholarly activities.

 

[Siggy]

With the exception of a few states, most require FMGs to complete 2+ years.

TRI followed by prelim surgery.

 

[GUH]

Screw EM... screw IM... I'm going to go into NMM so I can open up OPP classes for the unmatched Caribbean kids to scramble into unfilled osteopathic focused residencies.

You have very succinctly stated the reason why there should be high prerequisites for an MD to attend an osteopathic-focused residency.

 

[JimmyB123]

So by when will you see a majority of programs as single accreditation? 2018?

 

[SnowDoggy44]

So by when will you see a majority of programs as single accreditation? 2018?

I don't think any of us have the right crystal balls to see into the future. We can only speculate or comment on what rumors we hear from OPTI leaders and PDs. We may not know anything useful until April: https://www.acgme.org/acgmeweb/Portals/0/PDFs/Nasca-Community/Timeline.pdf

 

[hallowmann]

i've been looking at this for 30 minutes, and i still cannot fully wrap my head around it.

it looks like all the AOA programs that receive ACGME accreditation will be designated ACGME programs with "Osteopathic Recognition". MDs who want to apply to these programs will need to fulfill several OPP/OMM requirements.

from what i have gathered, it looks like the ACGME is being fairly accommodating of the AOA.

That's nothing new. All 3 parties have said this pretty much from the beginning.

It's good to get updates, and its good to know things are moving along as expected. Plus, the DO PD thing is a big plus, and should be a relief to a lot of people who were hesitant before.

Yes; it does look like they will allow AOA-trained PD's to remain in their positions, which is awesome news if we're interpreting the documents correctly.

As for the requirements for MDs to apply to the programs, there appears to be some vagueness, particularly with regards to the bolded part:

Can anyone here shed some light on with the "prerequisite milestones" would look like? Because the other material can quite frankly be taught in a classroom in a very short time frame with little hands-on training or testing in competency in actual osteopathic palpation and treatment.

I'm sure it was left intentionally vague. Each individual residency committee will have to devise requirements for their respective fields. The requirements for FM for example should obviously be greater than those for Rads.

 

[wjs010]

So could someone give an updated cliff note of the entire merger and what it entails, in no more than 15 lines? Thanks

 

[AlbinoHawk DO]

I have no interest in an OMM/NMM residency, but 40 hours of required cranial and required A.T. Still book club???

Those parts were not bolded (ACGME Common Program Requirements), so they are up for public comment until the middle of December. I wonder if they will be contested. Those requirements seem like a waste of time that could be better spent on other clinical or scholarly activities.

It will backfire on these idiots. If you meet ACGME w/Osteopathic focus standards, you also meet ACGME without Osteopathic focus, so eventually programs will be dropping out of this osteopathic thing and will be able to get more applicants.

 

[user3]

It will backfire on these idiots. If you meet ACGME w/Osteopathic focus standards, you also meet ACGME without Osteopathic focus, so eventually programs will be dropping out of this osteopathic thing and will be able to get more applicants.

oh no...will this be the beginning of the end of osteopathy?

 

[AlbinoHawk DO]

oh no...will this be the beginning of the end of osteopathy?

Doubt it. There's money to be made in being able to open schools and run them with requirements substandard to those of LCME. The only changes I really foresee is that as a DO you won't have to be justifying your post-graduate training because it'll be ACGME. It'll create much more parity and greater acceptance from both sides. It won't be until we start reaching capacity and most of the Caribbean is displaced that we'll maybe see the quality of DO programs increase.

 

[ChrisGriffen]

So could someone give an updated cliff note of the entire merger and what it entails, in no more than 15 lines? Thanks

Other than a lot of speculating, here is what we know

There will no longer be two separate accrediting bodies that oversee GME. the AOA is being absorbed by the ACGME. All AOA residencies will be accredited by solely the ACGME. That process begins in 2015, and will be 100% complete by 2020.

At some point between 2015 and 2020, MDs will be permitted to train in AOA residency programs, provided they complete some additional OMM training.


This is really all we know for sure.

It is pretty reasonable to assume that at some point during this process there will be a switch to one single match. This has never been formally announced though.

Also, COMLEX isnt going anywhere.

 

[hallowmann]

You guys posting that Osteopathic focus will disappear: do you really have that impression? It might reduce, but I'd honestly be surprised if it disappeared. There are plenty of programs and DOs that are gung-ho about OMM. There are also plenty of DO grads that want to go into it. Add to it that even now, some less desirable programs have utilized dual-accreditation to attract DO applicants. I doubt that'll change now that it would be even easier to be accredited with an osteopathic focus.

 

[user3]

How long it will take most osteopathic programs to receive full ACGME accreditation? The deadline is 2020, but I'm sure many will receive accred. before this date.

From what I have read, osteopathic programs will not be able to accept non-DO applicants until they have received complete ACGME accred.

 

[frappalino16]

How long it will take most osteopathic programs to receive full ACGME accreditation? The deadline is 2020, but I'm sure many will receive accred. before this date.

From what I have read, osteopathic programs will ONLY be able to accept non-DO applicants once they have received complete ACGME accred.

what.

 

[user3]

what.

oops...fixed my wording.

from AACOM:

• When will MD students be able to enter DO residencies?
  We anticipate that applications will be open to MDs as soon as there are ACGME-accredited osteopathic-focused programs. This could be as soon as July 2016 or as late as July 2020.

 

[wjs010]

Other than a lot of speculating, here is what we know

There will no longer be two separate accrediting bodies that oversee GME. the AOA is being absorbed by the ACGME. All AOA residencies will be accredited by solely the ACGME. That process begins in 2015, and will be 100% complete by 2020.

At some point between 2015 and 2020, MDs will be permitted to train in AOA residency programs, provided they complete some additional OMM training.


This is really all we know for sure.

It is pretty reasonable to assume that at some point during this process there will be a switch to one single match. This has never been formally announced though.

Also, COMLEX isnt going anywhere.

Lol. Thanks! They should makeMD students take 200 hours of OMM like us DO students do.

 

[ChrisGriffen]

Lol. Thanks! They should makeMD students take 200 hours of OMM like us DO students do.

Just one guy's opinion, but honestly I think it will initially be a one month course that equals around 200 hours.

20 days x 10 hours

 

[hallowmann]

Just one guy's opinion, but honestly I think it will initially be a one month course that equals around 200 hours.

20 days x 10 hours

Essentially a rotation in OMM.

 

[wjs010]

Just one guy's opinion, but honestly I think it will initially be a one month course that equals around 200 hours.

20 days x 10 hours

The question is, how many would be willing to do OMM for a residency spot. I think the requirement will be a deterrent for many applicants

 

[user3]

The question is, how many would be willing to do OMM for a residency spot. I think the requirement will be a deterrent for many applicants

US MD students wishing to augment their chances for a competitive specialty or particular location.

 

[GUH]

Just one guy's opinion, but honestly I think it will initially be a one month course that equals around 200 hours.

20 days x 10 hours

If the course actually requires 200 hours of in-class, hands-on training plus home study and includes standardized assessment of both knowledge and practical OMT skills then that would be comparable to the curriculum of most DO schools. While not ideal this does seem to be a pretty fair solution.

 

[IMDoc607]

I know we have all been wondering if this is a good or bad thing. I have always felt its both good and bad. However, recently I was emailing ACGME subspecialty programs that I want to apply for after I finish my fellowship. Since I am coming from an AOA program I asked them if they would accept applicants from an AOA fellowship. Their emails said "Now that there is going to be a single unified accreditation we now will accept applications from DO's in DO fellowships. Prior to this agreement, we did not accept DO's that did not train at ACGME fellowships. "

This is kind of the way I figured it would fall.