Pre-accreditation and wasted auditions

[LookOutFox]

According to our dean of clinical education, the AOA has implemented a policy that 5-year residency programs who have not received pre-accreditation status from the ACGME are not allowed to invite students for interviews, presumably because those students would not finish residency before the 2020 deadline for achieving accreditation. (Not having received pre-accreditation essentially means they haven't applied for accreditation. At this point if they haven't applied yet, what's holding them back? Will they ever apply?). This policy has already affected at least one of my classmates who not only had spent the money in ERAS to apply there (now wasted and non-refundable), but was in the middle of an audition rotation at that program when they found out they would not be accepting students in this year's match. (Another of my classmates had an EM audition rotation canceled on him because the program was closing due to the merger, although that wouldn't fall under this policy [yet].)

Now I'm wondering, is there a centralized way to find out which programs have/have not received pre-accreditation status? Or do we just have to call each program individually?

Also, will this policy affect 4 year programs next year? And 3 year programs the year after that? (Because of the approaching 2020 deadline.)

Does anybody have a good idea of how many DO programs will be closed because of accreditation issues? I'm speculating/hoping that those that are closing are for the most part closing because the paperwork involved with the new accreditation exceeds their personnel time, rather than because their caseload/teaching quality isn't good enough.

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[NurWollen]

According to our dean of clinical education, the AOA has implemented a policy that 5-year residency programs who have not received pre-accreditation status from the ACGME are not allowed to invite students for interviews, presumably because those students would not finish residency before the 2020 deadline for achieving accreditation. (Not having received pre-accreditation essentially means they haven't applied for accreditation. At this point if they haven't applied yet, what's holding them back? Will they ever apply?). This policy has already affected at least one of my classmates who not only had spent the money in ERAS to apply there (now wasted and non-refundable), but was in the middle of an audition rotation at that program when they found out they would not be accepting students in this year's match. (Another of my classmates had an EM audition rotation canceled on him because the program was closing due to the merger, although that wouldn't fall under this policy [yet].)

Now I'm wondering, is there a centralized way to find out which programs have/have not received pre-accreditation status? Or do we just have to call each program individually?

Also, will this policy affect 4 year programs next year? And 3 year programs the year after that? (Because of the approaching 2020 deadline.)

Does anybody have a good idea of how many DO programs will be closed because of accreditation issues? I'm speculating/hoping that those that are closing are for the most part closing because the paperwork involved with the new accreditation exceeds their personnel time, rather than because their caseload/teaching quality isn't good enough.

Really interesting development. Deserves a bump and a discussion.

I'm not sure how this policy make sense... AOA programs still have AOA accreditation, which is a valid, recognized accreditation until 2020. So if a five year program gets pre-accreditation with the ACGME in two years, and full accreditation maybe 1 year after that, it's graduates will still be graduating from an accredited program each year along that time period. I'm not saying it would be a good idea to apply to such a program, but technically and theoretically speaking, there shouldn't be any issues.

 

[Anatomyjane0410]

When I spoke to a residency director from an Ortho AOA program they hinted that if the AOA program did not get pre accredited by this July 1,2015 deadline then it's highly unlikely that they ever will thus that program will be no longer by the end of the merger. This director also highly recommended not wasting audition rotations and not applying to programs that did not meet the pre accred deadline as its a risky chance they may never become accredited. I am also interested to see if somewhere will publish the data anytime in the next year of who achieved pre accred and who did not as it plays a big role in scheduling rotations/applying to the match...

 

[NurWollen]

When I spoke to a residency director from an Ortho AOA program they hinted that if the AOA program did not get pre accredited by this July 1,2015 deadline then it's highly unlikely that they ever will thus that program will be no longer by the end of the merger. This director also highly recommended not wasting audition rotations and not applying to programs that did not meet the pre accred deadline as its a risky chance they may never become accredited. I am also interested to see if somewhere will publish the data anytime in the next year of who achieved pre accred and who did not as it plays a big role in scheduling rotations/applying to the match...

If that is the case, there are going to be a lot of programs closing
http://www.acgme.org/ads/Public/Reports/Report/18

http://www.acgme.org/ads/Public/Reports/ReportRun?ReportId=18&CurrentYear=2015&SpecialtyId=42

 

[NurWollen]

Unashamed bump. Merger discussion>>>what is the true meaning of chief residentness

 

[LookOutFox]

Since I posted this thread, our clinical education dean sent this email out to our class:
"As we discuss at the Dean's Forum just before you left campus, I would avoid starting any residency which will not be completed before June 30, 2020IF they do not plan to apply for, and obtain ACGME accreditation before that date. The AOA has decided to hold these programs to even greater responsibility, requiring said programs to apply for ACGME accreditation no later thanJune 30, 2016 in order to accept residents (and therefore recruit) for any program which would not be completed by the June 30, 2020 date. There is much uncertainty about conversion to ACGME training in some disciplines, and resultant apprehension by Program Directors. This AOA mandate is recent, and I do not think any programs were intentionally misleading students prior to this new information. Rather, this demonstrates responsibility on behalf of the programs as they would not want any student to begin a training program that could not be finished. Hopefully further clarity is forthcoming on this matter, and programs of all lengths will have a better understanding of how to best proceed. "

I'm speculating/hoping that those that are closing are for the most part closing because the paperwork involved with the new accreditation exceeds their personnel time, rather than because their caseload/teaching quality isn't good enough.

I've also discussed this ^ with a friend who has been on auditions at some of these "apprehensive" programs. He reassured me that at least anecdotally those programs had excellent caseload and quality of teaching. Apparently there is a new rule that Program Directors must be employed full-time as Program Directors and spend full time amount of hours working on things directly pertaining to Program Director duties, which is a big problem for some of these programs because up to now the Program Director has been in private practice and their Program Director duties have been on a volunteer basis. They are reasonably choosing to continue their practice rather than continue their residency program when forced to make that choice. This may be going off on a tangent but if anyone knows more about such a rule it would be nice to hear more.

 

[LookOutFox]

If that is the case, there are going to be a lot of programs closing
http://www.acgme.org/ads/Public/Reports/Report/18

http://www.acgme.org/ads/Public/Reports/ReportRun?ReportId=18&CurrentYear=2015&SpecialtyId=42

Wow that is crazy!! I just ran the report for All Specialties, and there are only 4 EM, 3 FM, 3 IM, 1 optho, 1 ENT, 3 rads, 6 gen surg, and 1 urology programs that have pre-accreditation status. I'm not sure that's enough spots for even my class by itself, not to mention all the other osteopathic schools.

 

[NurWollen]

Wow that is crazy!! I just ran the report for All Specialties, and there are only 4 EM, 3 FM, 3 IM, 1 optho, 1 ENT, 3 rads, 6 gen surg, and 1 urology programs that have pre-accreditation status. I'm not sure that's enough spots for even my class by itself, not to mention all the other osteopathic schools.

Luckily, according to your post, even programs finishing after 2020 (5-year programs) have until June 2016 to a apply. Hopefully many, many more programs will do so. I can see why a program might want to wait until next year to apply. Yes, pre-accreditation is automatically granted with application, but it also sets the review process rolling for full accreditation. I can see why programs might want to delay their application until 2016 to give themselves more time to get their ducks all lined up.

 

[SurgeDO]

Since I posted this thread, our clinical education dean sent this email out to our class:
"As we discuss at the Dean's Forum just before you left campus, I would avoid starting any residency which will not be completed before June 30, 2020IF they do not plan to apply for, and obtain ACGME accreditation before that date. The AOA has decided to hold these programs to even greater responsibility, requiring said programs to apply for ACGME accreditation no later thanJune 30, 2016 in order to accept residents (and therefore recruit) for any program which would not be completed by the June 30, 2020 date. There is much uncertainty about conversion to ACGME training in some disciplines, and resultant apprehension by Program Directors. This AOA mandate is recent, and I do not think any programs were intentionally misleading students prior to this new information. Rather, this demonstrates responsibility on behalf of the programs as they would not want any student to begin a training program that could not be finished. Hopefully further clarity is forthcoming on this matter, and programs of all lengths will have a better understanding of how to best proceed. "

I've also discussed this ^ with a friend who has been on auditions at some of these "apprehensive" programs. He reassured me that at least anecdotally those programs had excellent caseload and quality of teaching. Apparently there is a new rule that Program Directors must be employed full-time as Program Directors and spend full time amount of hours working on things directly pertaining to Program Director duties, which is a big problem for some of these programs because up to now the Program Director has been in private practice and their Program Director duties have been on a volunteer basis. They are reasonably choosing to continue their practice rather than continue their residency program when forced to make that choice. This may be going off on a tangent but if anyone knows more about such a rule it would be nice to hear more.

your dean sounds insane. it is way too early in the process to make such bold claims. sounds like fear mongering to me: "be a good little osteopath and settle down into a nice, safe family med residency."

there is no way that the ACGME will slash all these programs. we are currently facing a physician shortage and there is enough bitching about lack of GME that it would be political and financial suicide for them to make such cuts. the ACGME wants AOA programs to survive.

residents in programs that do not receive ACGME accreditation prior to 2020 will just become board certified by their respective AOA specialty board. if you are accepted in 2019 to a 5 year AOA surgery program that is denied accreditation by the ACGME in 2020, you will most likely just become AOA board certified in 2024.

 

[NurWollen]

your dean sounds insane. it is way too early in the process to make such bold claims. sounds like fear mongering to me: "be a good little osteopath and settle down into a nice, safe family med residency."

there is no way that the ACGME will slash all these programs. we are currently facing a physician shortage and there is enough bitching about lack of GME that it would be political and financial suicide for them to make such cuts. the ACGME wants AOA programs to survive.

residents in programs that do not receive ACGME accreditation prior to 2020 will just become board certified by their respective AOA specialty board. if you are accepted in 2019 to a 5 year AOA surgery program that is denied accreditation by the ACGME in 2020, you will most likely just become AOA board certified in 2024.

While I agree that the ACGME knows it's in everyone's best interest for AOA programs to survive, as it stands right now, the AOA can't accredit residencies after 2020. We can't just assume that the merger will be modified to allow those programs to continue operating until 2024. There's absolutely no basis to think that will happen other than the fact that it might be a good idea.

I think Fox's dean is being prudent. He's not discouraging people from pursuing anything but FM, he's just very specifically warning against a subset of surgical programs that aren't on track to get ACGME accreditation in time according to the current timeline.

 

[SurgeDO]

While I agree that the ACGME knows it's in everyone's best interest for AOA programs to survive, as it stands right now, the AOA can't accredit residencies after 2020. We can't just assume that the merger will be modified to allow those programs to continue operating until 2024. There's absolutely no basis to think that will happen other than the fact that it might be a good idea.

I think Fox's dean is being prudent. He's not discouraging people from pursuing anything but FM, he's just very specifically warning against a subset of surgical programs that aren't on track to get ACGME accreditation in time according to the current timeline.

i have not read anything that says AOA residencies will cease to exist in 2020. the only thing i have read is that the AOA will stop accrediting new AOA residencies in June/July of 2020. if there is something that i am not aware of, please direct me.

it sounds like you are implying that residents of non-ACGME accredited residencies who do not complete their residencies by 2020 will simply be told to go **** themselves. i do not have a source for my beliefs, but i can say with confidence that there is absolutely no way in hell that this would happen. until i read a source that says otherwise, i will remain more confident in my assumption than yours.

it is absolutely, 100% fear mongering at this point. i would wait to see an official statement by the AOA/ACGME before following the advice of "don't apply surgery lol" by somebody who has a motive to put you into primary care. if i was a 4th year medical student at this person's school who just got a statement from my dean telling me that i may not be able to become a residency trained physician if i choose to pursuit any field of surgery in the AOA, i would be ****ting my pants.

 

[Siggy]

Wow that is crazy!! I just ran the report for All Specialties, and there are only 4 EM, 3 FM, 3 IM, 1 optho, 1 ENT, 3 rads, 6 gen surg, and 1 urology programs that have pre-accreditation status. I'm not sure that's enough spots for even my class by itself, not to mention all the other osteopathic schools.

One thing that is not counted is the hospitals with dual accredited or parallel residencies. If I have both an AOA and ACGME IM program (not dual accredited), why should I switch my AOA program to ACGME? Wouldn't it be easier to just kill the AOA program and move those spots to ACGME?

 

[Anatomyjane0410]

In regards to the lists of already pre accred programs I am sure it is small now because pre accred just opened for them to apply July 2015 consider the loads of paperwork and physical walk throughs necessary to pre accredit a residency- at least from the Ortho conference I attended there were at least 8 different program directors suggesting their respective programs would be submitting in July for pre accred so my thought is many of the programs have prob applied but as with any governing body there is going to be lag time between their applying and actual approval - this time next year will be more telling of how many current AOA programs will go through with becoming ACGME accredited. Also these residency directors mentioned an important point someone hinted at- it takes a tremendous amount of time, energy and MONEY to open a new program so if the ACGME can help it they will try and improve programs before just shutting down. They are no strangers to the concept of the physician shortage so I am sure programs that meet requirements are up to par (or can be fixed) and have the necessary staffing to train residents will remain.

 

[GUH]

If what the dean said is true then that would mean that the real deadline for switching over to ACGME is 2017 rather than 2020 for most programs since you can't have residency without residents.

That would be huge. I would love to see any actual evidence of the dean's assertion from the AOA. I suspect that it does not exist.

Also, just because a program has not applied already does not mean that they never will. That's a silly assertion. They wouldn't give programs years to apply if the actual deadline was in two months. And there is no way they are going to allow a majority of AOA PGY-5 surgery residents just disappear into the abyss in 2020.

 

[costales]

it sounds like you are implying that residents of non-ACGME accredited residencies who do not complete their residencies by 2020 will simply be told to go **** themselves. i do not have a source for my beliefs, but i can say with confidence that there is absolutely no way in hell that this would happen.

Yep. An unlikely scenario, considering there are now AOA reps on the ACGME board.

 

[LookOutFox]

The ACGME simply doesn't have the manpower to magically pre-accredit all these programs at once. It takes time to do the review and requires a site visit.

I think you guys may be misinterpreting what pre-accreditation means. Pre-accreditation is instantly and automatically granted as soon as the program applies for accreditation. Walk throughs / site inspections are for getting accreditation, not pre-accreditation.

 

[mesmerazopam]

If I were a student in my 1st or 2nd year, I’d absolutely be taking the USMLE. If I didn’t think I could pass it, then I’d reevaluate my study methods and maybe double my efforts.

There is some concerning stuff coming out of the mouth of the DME at my hospital and they are not unsupportive of the merger (no axe to grind). It sounds like there is going to be a culling of some programs in the coming years. It seems the administrative burdens for some of these hospitals is going to be insurmountable without some new investment. We were told that the very solid and well-established programs with a history of osteopathic involvement in the hospital’s management will probably survive. It will also be specialty dependent, so take that for what it’s worth. I guess some specialty programs have embraced the merger in different ways and/or have specific accreditation requirements that make it more/less likely that their current structure will be modifiable to meet accreditation.

I think some people on here need to take a second look at how costly it can be to dedicate faculty to these programs. If you’re in the C-Suite of a hospital system, then you have to sit down and run the numbers. How integral are residents to the care of patients in your facility? What additional salary outlays are there going to be to meet the ACGME requirements? What additional support staff do I have to hire? Some DO programs have part-time directors who may have to sell or greatly reduce their footprint in their own private practices. So, if these individuals choose not to do this, then you now experience an additional payroll outlay for little added productivity. That decision doesn’t even take into account the hurt feelings of everyone involved. Would you want to lose your job because you have to make a choice between a passion for teaching or keeping your business?

Also, my understanding is as above: pre-accreditation means the paperwork was filed. I think it’s still very early to make any big decisions based on the paucity of programs right now, but it’s something to look at. Many programs are probably trying to firmly establish a commitment from their hospitals, make some needed hires, etc. and will then file to merge.

 

[abolt18]

i have not read anything that says AOA residencies will cease to exist in 2020. the only thing i have read is that the AOA will stop accrediting new AOA residencies in June/July of 2020. if there is something that i am not aware of, please direct me.

it sounds like you are implying that residents of non-ACGME accredited residencies who do not complete their residencies by 2020 will simply be told to go **** themselves. i do not have a source for my beliefs, but i can say with confidence that there is absolutely no way in hell that this would happen. until i read a source that says otherwise, i will remain more confident in my assumption than yours.

it is absolutely, 100% fear mongering at this point. i would wait to see an official statement by the AOA/ACGME before following the advice of "don't apply surgery lol" by somebody who has a motive to put you into primary care. if i was a 4th year medical student at this person's school who just got a statement from my dean telling me that i may not be able to become a residency trained physician if i choose to pursuit any field of surgery in the AOA, i would be ****ting my pants.

You really don't seem to know what you're talking about. It's not that ACGME will slash all these programs. It's that they can't continue if they don't APPLY for accreditation. And the AOA will cease to be an accrediting body-at all-come June 30, 2020. If a program has not received pre-accreditation, and subsequently initial accreditation by that date, it will cease to be accredited. Period.
"When will the AOA stop accrediting GME programs?
AOA programs are expected to complete the transition to ACGME accreditation before July 1, 2020. The AOA will cease to provide GME accreditation on June 30, 2020. " from http://www.osteopathic.org/inside-aoa/single-gme-accreditation-system/Pages/faq-timeline.aspx

"What will happen to programs that do not become ACGME-accredited by June 30, 2020?
The AOA will cease accrediting programs after July 2020. Programs that do not achieve ACGME accreditation will either close at that date or, we expect, continue working toward ACGME accreditation. In the past, the AOA has usually worked with residents in closing programs to transition them to open slots. In July 2020, we will have to work out details with the ACGME on how to handle any programs that might be closing. Neither the AOA nor the ACGME wants to see any GME programs close; our shared goal throughout this process is to increase the number of quality GME programs available for all physicians." From http://www.osteopathic.org/inside-a...system/Pages/faq-accreditation-processes.aspx
Also I've been given similar instructions as a class of 2017 that unless I'm going for a 3 year program, I should try for an accredited ACGME program because of the 2020 deadline.

And just to clarify again one more time for those who missed it, AOA will no longer be an accrediting body after June 30, 2020.

 

[phenobb]

Just want to clear up some things here.

1. There is no need for the program director at any program to be fully employed as a program director. The requirement- at least in my speciality- is that the PD must receive a salary from the school/hospital to compensate him/her for the amount of time they spend being PD. This does NOT mean they have to stop practicing etc.

2. Programs that are not accredited by 2020 will in all likelihood cease to exist. The ACGME has already recognized as equivalent training in all fields but Urology and Neurosurgery so they are actually being quite flexible.

3. The question DO applicants need to be asking is this: what will happen to the MATCH and COMLEX?

 

[Mad Jack]

According to our dean of clinical education, the AOA has implemented a policy that 5-year residency programs who have not received pre-accreditation status from the ACGME are not allowed to invite students for interviews, presumably because those students would not finish residency before the 2020 deadline for achieving accreditation. (Not having received pre-accreditation essentially means they haven't applied for accreditation. At this point if they haven't applied yet, what's holding them back? Will they ever apply?). This policy has already affected at least one of my classmates who not only had spent the money in ERAS to apply there (now wasted and non-refundable), but was in the middle of an audition rotation at that program when they found out they would not be accepting students in this year's match. (Another of my classmates had an EM audition rotation canceled on him because the program was closing due to the merger, although that wouldn't fall under this policy [yet].)

Now I'm wondering, is there a centralized way to find out which programs have/have not received pre-accreditation status? Or do we just have to call each program individually?

Also, will this policy affect 4 year programs next year? And 3 year programs the year after that? (Because of the approaching 2020 deadline.)

Does anybody have a good idea of how many DO programs will be closed because of accreditation issues? I'm speculating/hoping that those that are closing are for the most part closing because the paperwork involved with the new accreditation exceeds their personnel time, rather than because their caseload/teaching quality isn't good enough.

Go to the AOA Opportunities website and find any programs you are interested in. It has boxes that will list whether they have applied for ACGME recognition, and if not, when they will do so.

 

[phenobb]

Go to the AOA Opportunities website and find any programs you are interested in. It has boxes that will list whether they have applied for ACGME recognition, and if not, when they will do so.

This isn't fool proof though. Any idiot can mail in an application. Talk to a PD in the field to see what the challenges are for your specialty ( primary care, anesthesia, etc should sail through) and think about whether your program will be approved. Nothing worse than being stranded.

 

[Mad Jack]

your dean sounds insane. it is way too early in the process to make such bold claims. sounds like fear mongering to me: "be a good little osteopath and settle down into a nice, safe family med residency."

there is no way that the ACGME will slash all these programs. we are currently facing a physician shortage and there is enough bitching about lack of GME that it would be political and financial suicide for them to make such cuts. the ACGME wants AOA programs to survive.

residents in programs that do not receive ACGME accreditation prior to 2020 will just become board certified by their respective AOA specialty board. if you are accepted in 2019 to a 5 year AOA surgery program that is denied accreditation by the ACGME in 2020, you will most likely just become AOA board certified in 2024.

While programs have until 2020 to apply, those that do not do so before 2017 are in a tight spot, as the AOA will not allow them to participate in the AOA match due to their inability to guarantee their graduates will be certified upon completion of training. July was the first time for them to actually be able to apply, so most are still scrambling to get their apps together. It's only been just over two months, after all.