Beginning of the End to AOA Board Certification

[Solodyn]

https://certification.osteopathic.org/about/aoa-osteopathic-board-certification-realignment/

I am surprised to find this published at the AOA website on December 20. I did not find any discussion at SDN on this.

I simply don't see how AOA Board Certification will survive at this rate. AOA Board will never out compete ABMS Board simply by removing the Osteopathic component. Add to the decoupling of membership to board certification, I don't see how anyone will pay additional $900 a year just to stay member. Perhaps they will make the exam easier than ABMS board so borderline grads who failed ABMS can pass AOA as backup?

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[joeception]

I just read some of the links anyone care to summarize it all for someone out of the loop.

 

[BorntobeDO?]

https://certification.osteopathic.org/about/aoa-osteopathic-board-certification-realignment/

I am surprised to find this published at the AOA website on December 20. I did not find any discussion at SDN on this.

I simply don't see how AOA Board Certification will survive at this rate. AOA Board will never out compete ABMS Board simply by removing the Osteopathic component. Add to the decoupling of membership to board certification, I don't see how anyone will pay additional $900 a year just to stay member. Perhaps they will make the exam easier than ABMS board so borderline grads who failed ABMS can pass AOA as backup?

Actually, I think the AOA is trying to redefine itself. Undercutting the unpopular ABIM is a great place to start. Being a national physician groups opposed to mid-level expansion is another (AMA certainly isn't). I give them as much crap as anyone, but I need to be somewhat fair and say they are trying some stuff.

 

[AlbinoHawk DO]

We shouldn't celebrate its death. Having a "competition" will keep prices in check. Otherwise they can charge whatever they please

 

[deleted950463]

If AOA opens up its board certification to MDs with no osteopathic training or recognition but promise an equally rigorous onboarding requirement WITHOUT MOC i can see it being attractive to physicians.

 

[alprazoslam]

If AOA opens up its board certification to MDs with no osteopathic training or recognition but promise an equally rigorous onboarding requirement WITHOUT MOC i can see it being attractive to physicians.

Yes because people like to pay for stuff that is rigorous with no benefit to them.

 

[deleted950463]

Yes because people like to pay for stuff that is rigorous with no benefit to them.

Not having to deal with MOC is a big benefit. I wouldn’t expect you to know what MOC is though. Most don’t know what that means until they are attendings.

 

[Solodyn]

I am surprised that this topic didn't get more discussion. This is essentially about the survival of osteopathic medicine as a profession.

To clarify, there is going to be MOC in the AOA Board certification. It is called OCC (Osteopathic Continued Certification). From that stand point, AOA BC offers no advantage in avoiding MOC.

What AOA is giving up is its "osteopathic identity" in the AOA Board Certification. What is the point of even having an entire osteopathic profession, when to AOA itself, OMM is now a mere optional "add-on". AOA has pretty much de-legitimize its own existence.

From another point of view.. with the ACGME merger, 95%+ of the DO will take the ABMS board. Why would you take AOA Board when you can take ABMS? There is no more DO Residencies! With no one to take AOA Board, the entire Board Certification System within AOA is going to be unsustainable financially. Furthermore, if there is not enough people to take these test, how can the Board write psychometrically valid tests?

I think the logic of AOA is this. If we have 2000 DOs taking Board Exam, we are likely pick up only the 5% of DOs who failed ABMS board who will take AOA board as a back up plan. 2000 x 5% = 100 people to take the test. AOA Board will not survive with only 100 people taking the test each year.

So AOA is probably thinking.. let us separate out the osteopathic component for the "elite DO" who want special osteopathic recognition. Then we will create another test with NO osteopathic components. This way both MDs and DOs who failed ABMS exam can take ours as a back up board. (see FAQ in the original post.. this is clearly stated by the AOA for MD to take the modified exam). we are now looking at 10000 MDs and DOs taking the ABMS test, 5% of failure is 10000 x 0.5 = 500. With 500 people or more taking the AOA test instead of 100, AOA board may just survive. Of course, AOA can't say their tests are "easier" The buzz word they will use will be the test is more "clinically relevant" or more "applicable to practicing physicians". They hope to pick up diplomats from bigger pool of people who failed ABMS.

I personally know DO graduating residents who signed up for both ABMS and AOA board exam after they come out of the newly minted, initially accredited, ex-DO, ACGME Program. After he find out he passed the ABMS, he simply skipped out taking the AOA board. Who can blame him? why would you need 2 board certification with 2 MOC/OCC requirement to sustain? With the ACGME merger, AOA is accelerating its own destruction.

I do not believe the AOA strategy will work. I think most people will simply try to retake ABMS next year then to settle for AOA board certification. The outcome of AOA decision remains to be seen.

I think it is possible for AOA to lose its total relevance or even cease to exist within 10 years time. I know this is a bold statement, but heck, just look at 10 years ago, I would never have imagined that I am now an ACGME residency program faculty. But here we are. We may all be MDs in 10 years time. AOA is taking away our reason to exist as a profession and made OMM simply an "add-on" to allopathic training.

 

[Angus Avagadro]

I think the AOA is searching for a way to keep all DOs in the mainstream. If this evolves into merging the credentials to all MDs then how do DOs using OMT regularly in their practice not become fringe practitioners, like Homeopaths? I guess this new credential of Osteopathic Distinction is their attempt to prevent that. Guess we will have to wait and see how it all plays out.

 

[deleted950463]

I am surprised that this topic didn't get more discussion. This is essentially about the survival of osteopathic medicine as a profession.

To clarify, there is going to be MOC in the AOA Board certification. It is called OCC (Osteopathic Continued Certification). From that stand point, AOA BC offers no advantage in avoiding MOC.

What AOA is giving up is its "osteopathic identity" in the AOA Board Certification. What is the point of even having an entire osteopathic profession, when to AOA itself, OMM is now a mere optional "add-on". AOA has pretty much de-legitimize its own existence.

From another point of view.. with the ACGME merger, 95%+ of the DO will take the ABMS board. Why would you take AOA Board when you can take ABMS? There is no more DO Residencies! With no one to take AOA Board, the entire Board Certification System within AOA is going to be unsustainable financially. Furthermore, if there is not enough people to take these test, how can the Board write psychometrically valid tests?

I think the logic of AOA is this. If we have 2000 DOs taking Board Exam, we are likely pick up only the 5% of DOs who failed ABMS board who will take AOA board as a back up plan. 2000 x 5% = 100 people to take the test. AOA Board will not survive with only 100 people taking the test each year.

So AOA is probably thinking.. let us separate out the osteopathic component for the "elite DO" who want special osteopathic recognition. Then we will create another test with NO osteopathic components. This way both MDs and DOs who failed ABMS exam can take ours as a back up board. (see FAQ in the original post.. this is clearly stated by the AOA for MD to take the modified exam). we are now looking at 10000 MDs and DOs taking the ABMS test, 5% of failure is 10000 x 0.5 = 500. With 500 people or more taking the AOA test instead of 100, AOA board may just survive. Of course, AOA can't say their tests are "easier" The buzz word they will use will be the test is more "clinically relevant" or more "applicable to practicing physicians". They hope to pick up diplomats from bigger pool of people who failed ABMS.

I personally know DO graduating residents who signed up for both ABMS and AOA board exam after they come out of the newly minted, initially accredited, ex-DO, ACGME Program. After he find out he passed the ABMS, he simply skipped out taking the AOA board. Who can blame him? why would you need 2 board certification with 2 MOC/OCC requirement to sustain? With the ACGME merger, AOA is accelerating its own destruction.

I do not believe the AOA strategy will work. I think most people will simply try to retake ABMS next year then to settle for AOA board certification. The outcome of AOA decision remains to be seen.

I think it is possible for AOA to lose its total relevance or even cease to exist within 10 years time. I know this is a bold statement, but heck, just look at 10 years ago, I would never have imagined that I am now an ACGME residency program faculty. But here we are. We may all be MDs in 10 years time. AOA is taking away our reason to exist as a profession and made OMM simply an "add-on" to allopathic training.

That’s why they should try to approach this from a different angle and just try to emulate the NBPAS thing. A lot of physicians are fed up with MOC. If they can do away with MOC or make it into something extremey clinically relevant and instructive rather than punitive like the regular 10 year MOC.

For example, they can do away with it or have like one question per month, open book with a day to complete.

This will legit get them some ACGME trained people.

 

[DrWBD]

I think the AOA is searching for a way to keep all DOs in the mainstream. If this evolves into merging the credentials to all MDs then how do DOs using OMT regularly in their practice not become fringe practitioners, like Homeopaths? I guess this new credential of Osteopathic Distinction is their attempt to prevent that. Guess we will have to wait and see how it all plays out.

At best, only 20% of DOs use OMT regularly in their practice which already makes them “the fringe”.

The AOA is circling the drain into irrelevance and maneuvers like this are sad attempts to preserve its revenue stream as long as possible.

 

[Neopolymath]

Not having to deal with MOC is a big benefit. I wouldn’t expect you to know what MOC is though. Most don’t know what that means until they are attendings.

I don't expect you to understand that most of the AOA continuing education is worse than the MD counterparts for fields like FM if someone like Cabinbuilder is to be believed.

 

[Angus Avagadro]

At best, only 20% of DOs use OMT regularly in their practice which already makes them “the fringe”.

The AOA is circling the drain into irrelevance and maneuvers like this are sad attempts to preserve its revenue stream as long as possible.

Now sure I would define 1 in 5 DOs as fringe, but I get your point.

 

[Neopolymath]

Now sure I would define 1 in 5 DOs as fringe, but I get your point.

I think it was closer to 5% in a report posted on here years ago?

 

[Solodyn]

I imagine most people on this thread probably did not get the chance to read over the voluminous FAQ at the AOA website. I am going to provide some highlights...

1. AOA is eliminating "osteopathic content" from their own certifying exams.

2. "Why is the AOA not sharing this information openly and widely and seeking input from all DOs?"
"We received the final recommendations from the research only in early November. We needed to share and discuss it with AOA certifying boards before sharing it more broadly, with appropriate background and context. It began circulating prematurely, without context. We always intended to share it as soon as we could. As plans evolve in what will be an ongoing and iterative process, we will continue to do so."

(Commentary: sounds like AOA BOT was discussing this and rumor got out... so they had to let the cat out of the bag... this does not inspire my confidence about how well this is thought out.)

3. "Is there a concern that the loss of osteopathic content may undermine our push for encouraging all programs to gain ACGME Osteopathic Recognition?"
"The osteopathic content is not lost, but rather strengthened and amplified in additional certification signaling skill and competency, just as Osteopathic Recognition is a marker of additional, specialized training in residency."

(Commentary: this makes no logical sense. It is saying that osteopathic philsophy is deemed by the AOA as an "add-on" training to the MDs. Of course it undermines the entire profession. How can you now justify the existence of an entire AOA and entire DO degree if all we are are an "add-on" certification process?)

4. "Have you considered that this plan might backfire and prompt current AOA members to depart from the organization?"
"Yes, we have considered the impact on membership, and analysis indicates we will not see a significant loss in membership. By decoupling membership and board certification, and investing in and strengthening the value of both, we have the opportunity to gain in both segments."

(Commentary: Do you hear how crazy it sounds? How can the decoupling of the AOA membership with board certification actually increase number of membership? This is totally delusional thinking or very very illogical spin)

The FAQ is all over the place and seems like AOA is trying to put out fires. They lack vision and adequate plan to deal with this crisis.

I read Dr. Norman Gevitz's book "The DOs: Osteopathic Medicine in America" about 20 years ago when I was applying to DO school. I have tremendous respect for him on his knowledge and dedication to our profession. When he warned everyone about the danger of ACGME merger and people think he is being an alarmist. I think he is going to be right on many of his prediction. The sky IS falling and we are just refuse to see it.

 

[hallowmann]

I think it was closer to 5% in a report posted on here years ago?

Now I'm going purely off of memory, but I believe 5% are those that use it on >50% of their patients. 20% or so use it "regularly," but that includes people who use it on less than 25% of their patients when clinically appropriate (think the guy with tension headaches that you do a suboccipital release on).

 

[DO2015CA]

Is there a reason to not cut the losses and merge degrees now rather than deal with this whole drawn out process? You can still offer the additional training with some letters at the end of your name (god knows people love extra letters) but just let the thing die. Have one standardized accreditation body with better standards of training.

 

[Neopolymath]

Is there a reason to not cut the losses and merge degrees now rather than deal with this whole drawn out process? You can still offer the additional training with some letters at the end of your name (god knows people love extra letters) but just let the thing die. Have one standardized accreditation body with better standards of training.

That's a lot of HR people and executives not making the gravy. It cant happen just like we will never abolish the PE/CS exams. Medicine, like all business in America, is held back tremendously by one thing: people with jobs that shouldn't be jobs... death to middle management and death to the AOA and death to jobs that exist to perpetuate themselves bro. That's my radicalism for the evening.

 

[alprazoslam]

That's a lot of HR people and executives not making the gravy. It cant happen just like we will never abolish the PE/CS exams. Medicine, like all business in America, is held back tremendously by one thing: people with jobs that shouldn't be jobs... death to middle management and death to the AOA and death to jobs that exist to perpetuate themselves bro. That's my radicalism for the evening.

Add car sales men to that list

 

[Neopolymath]

Add car sales men to that list

The only reason I am rooting for Tesla is there elimination of the dealership model. If you can build a car to spec on the manufacturer's website, you should be able to actually purchase said car not play games with salesmen over allotments etc. It's getting bad.

 

[Solodyn]

Here is the latest on the AOA Board Certification Saga...

AOA Certification Board Services Changes

Apparently there will be a coup at the House of Delegates. There are several resolutions submitted to try to reverse these changes.

 

[thumbz]

Caveat - I skimmed the thread and didn't read the links.

I took the AOA IM exam in September and it had a grand total of 0 osteopathic questions on it. One question had an OMT answer as a distractor. So I'm not sure how they're phasing out the OMT portion when it wasn't there previously.

 

[Neopolymath]

Here is the latest on the AOA Board Certification Saga...

AOA Certification Board Services Changes

Apparently there will be a coup at the House of Delegates. There are several resolutions submitted to try to reverse these changes.

"We only make our students and residents sit through this OMM bull**** but now that we don't have you by the balls anymore we will relinquish the right to put you through it as an attending"

 

[Angus Avagadro]

Here is the latest on the AOA Board Certification Saga...

AOA Certification Board Services Changes

Apparently there will be a coup at the House of Delegates. There are several resolutions submitted to try to reverse these changes.

This is why I quit sending money to these chuckleheads years ago. This is all about money. If people dont take the AOA board exam, they lose money. It they have to study OMT, in addition to the specialty material, whose exam do you think people will spend money on? The AOA has been acting in a self destructing manner ever since they first got kicked out of the ACGME.