Letter to Hand surgical fellowship Directors - ACGME requirements

[Orthojoe]

Letter sent to Hand fellowship Directors from the American Society of Surgery for the Hand(ASSH) concerning new ACGME regulations. I think there will be more and more crackdown on this.. guess I'm going to register for USMLE 3 (glad I took step I and II in med school). I better rock it

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January 23, 2014

Dear Fellowship Director,

The ACGME has enacted several changes that will affect your ability to accept Doctors of Osteopathic Medicine (DOs) and International Medical Graduates (IMGs) into your hand fellowship program. This will not affect the 2014 Match, but will affect the 2015 Match.

Per the ACGME, effective July 1, 2016, all required clinical education for entry into ACGME-accredited fellowship programs must be completed in an ACGME-accredited residency program, or in an RCPSC-accredited or CFPC accredited residency program located in Canada. According to ACGME, DO’s and IMG’s will be allowed to participate only if the following conditions are met:


 For DOs:
o Satisfactory completion of the United States Medical Licensing Examination (USMLE) Steps 1 & 2, and, if the applicant iseligible Step 3.

o Currently, DOs do not routinely take USMLEs.

o Additional requirements as outlined in the Common Program Requirements


 For IMGs:

o Verification of Educational Commission for Foreign Medical Graduates (ECFMG) certification.

o The requirements for ECFMG certification have become more stringent.

o Additional requirements as outlined in the Common Program Requirements


The most up-to-date version of the Common Program Requirements is available for download on the ACGME website:
http://www.acgme.org/acgmeweb/Porta...nts/One_Year_CPRs_Categorization_07012016.pdf

We direct your attention to the requirements outlined in section 3A.


For further information, ACGME has also responded to a series of questions related to these changes. You may download a copy of that document from this link: https://assh.box.com/s/ydga6lp1xx65dc3tgetl


We are providing you with this information to make sure you are aware of these changes. In addition, we are providing you the same background that Council had during its December discussion of these issues: https://assh.box.com/s/56id1mduj4ar22z9ua0t


Please know that Council understands how critical these issues are to our future and will continue to work with A. Lee Osterman, MD and others to ensure our fellowship directors and coordinators have the most timely and accurate information possible.


While we do not believe these ACGME changes reflect our commitment to training all who have expressed an interest in hand surgery, we feel it is important to communicate to our fellowship directors the new requirements.


Sincerely,

Scott Kozin, MD

ASSH President

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[DrEnderW]

Thanks for sharing. Although a long way away, this is a path I've always had strong interest in.

 

[Spikebd]

Yes, thanks for sharing this. So do you think as long as DO's take all the USMLE's that we will be reasonably accommodated provided we do well on them? It looks like the writing is on the wall, ACGME wants to run the show and it looks like DO students interested in anything ACGME better play by their rules. I think any uncertainty that I had about taking the USMLE has disappeared.

 

[Orthojoe]

From talking to program directors and fellowship directors -- who you know, letters of recc and research is a lot more important than board scores. I dont think the competitive nature for fellowships will change at all for the DO community, except that we will be required to take step III..

work hard, make friends with attendings who have connections, get some good research and take the steps... s

 

[group_theory]

If I recall from reading the ACGME Common Program Requirements (proposed changes), the USMLE requirements for DOs only apply to DO applicants who are applying for ACGME fellowships and did not do an ACGME residency (ie AOA Ortho to ACGME Hand fellowship). In that case, in addition to completion of USMLE, the DO applicant must also be an "exceptionally qualified applicant" (whatever that means).

But if the DO did an ACGME residency, there is no additional requirement for ACGME fellowship (no USMLE required from ACGME perspective, individual programs may require)

http://www.acgme.org/acgmeweb/Portals/0/PFAssets/ProgramRequirements/CPRs_07012016.pdf
(Page 8-9 of the PDF file)

The above letter from ASSH seems to apply a blanket requirement for all DOs interested in ACGME hand fellowships that the USMLE must be completed in order to be eligible. Now there aren't a lot of DOs in ACGME ortho residency (35 as of Dec 31, 2013, and 4 DOs in ACGME hand fellowship) but even under the new proposal, those 35 ortho residents should be eligible for hand fellowship without having to complete the USMLE (unless I'm missing something). It's the AOA ortho residents who won't be eligible for acgme hand fellowships unless they complete all steps of the USMLE and be an exceptionally qualified applicant.

Source: Graduate Medical Education 2012-2013 Appendix II, Table 2, JAMA 310:21;p2330

But this process is so nebulous that I could be out-of-date, or misunderstanding this process.

 

[painmd87]

"If the applicant is eligible" for Step 3 -- if you don't take Step 2 CS, you're not eligible for Step 3. By that reading, does taking Step 1 and Step 2 CK cover your bases?

 

[QualityProcess]

Does anyone know the status of this rule with respect to other fellowships, like IR, cardiology, etc? Are all/most fellowships ACGME or are there AOA fellowships? Would the unified match resolve these concerns for a co2017 student? most importantly, where can I read about this stuff from a primary source?

 

[NontradCA]

Does anyone know the status of this rule with respect to other fellowships, like IR, cardiology, etc? Are all/most fellowships ACGME or are there AOA fellowships? Would the unified match resolve these concerns for a co2017 student? most importantly, where can I read about this stuff from a primary source?

There's no unified match. And I'm gonna guess it's the same for all ACGME fellowships.

 

[QualityProcess]

There's no unified match.

hence the "would" in would the unified match etc. Its my understanding that the parties didn't agree to never discuss it again...

 

[Spikebd]

hence the "would" in would the unified match etc. Its my understanding that the parties didn't agree to never discuss it again...

Yes and I have a feeling that the AOA is going to have to make concessions. Lets cross our fingers it works out somewhat in our favor. These seem like pretty strange times.