Acgme

[agonzalez06]

---

Members do not see this ad.

Why do residency programs put up with it? Is it money? In my opinion, the new work hours requirements will be terrible.

As a 4th year medical student, the ACGME certification has no bearing on the programs I would choose to apply to. I'm sure many other 4th year applicants agree.

 

[NotAProgDirector]

Really?

If you complete a residency that is not ACGME (or AOA) approved, you will be unable to use any of that time to get a license nor get board certified. So, basically, you'd be wasting your time.

Also, it is about the money. Only ACGME or AOA approved programs can claim medicare training funds.

All residency programs are either ACGME or AOA approved. And you are welcome to google what happened to the many residents at King/Drew when the ACGME pulled the plug on their program.

 

[Smurfette]

aPD is right. You can't be board certified (or eligible) unless you complete an ACGME residency program. And most hospitals will not hire someone new who is not board eligible or board certified. Patients are increasingly aware of the importance of certification and can look up your credentials online.

To the OP, are you trying to mess with other applicants into thinking that they could look at non-ACGME spots?

 

[Samoa]

Most 4th years haven't really investigated the licensure process beyond whether step 2 will be required for ranking at the places they've interviewed. So they may not be aware of the ACGME certification requirement for their residency to count toward licensure. And why would they need to be, when any program they apply to through ERAS will already be certified? As long as they stay on the well-worn training path, all the painful details are taken care of automatically.

 

[JackADeli]

...As a 4th year medical student, the ACGME certification has no bearing on the programs I would choose to apply to. I'm sure many other 4th year applicants agree.

Really?...

I must echo what aPD has said, "really?". I don't know many HS grads that search and apply to unaccredited universities for undergrad. I can not imagine any 4th year med-students beyond yourself ignoring accreditation AND accreditation history. To say, "I'm sure many other 4th year applicants agree", IMHO is hyperbole and shows a great deal of ignorance on the reality. And, I am not saying that to be mean, just basing that on the facts.

Both as a med-student interviewing many years ago and subsequently a resident meeting with applicants, the issue of accreditation was ALWAYS brought up. Applicants would consistently ask about accreditation status, i.e. how long and when is next site visit/re-evaluation. If a program was given a short term accreditation, applicants would ask, "what were the citations leading to this...". But, even if they didn't ask, the PDs always brought up their compliance with ACGME/RRC and what changes they have made since previous site visit. Almost all, if not all, residency web pages include a statement about their accreditation.

HS students either conciously or just out of the well worn path seek out accredited colleges and universities. Undergrads, more conciously seek out accredited med schools and are often aware of the difficulties of going the foreign medical school route. I just don't see someone that has spent any kind of time getting that far, then ignoring accreditation of the final hurdles to unrestricted licensure.

 

[Samoa]

I always thought of accreditation as more of educational quality issue, I.e. Will I get the training I need to pass my specialty board exam, and do they at least give lip service to the duty hour requirements. Not, will I be able to get a license after training there? That particular aspect of the accreditation issue is rarely mentioned. Programs usually dissolve if they're denied accreditation, so the licensure aspect is really a non-issue.

Also, can a residency even get funded through CMS without accreditation? I haven't checked, but I doubt it.

 

[JackADeli]

I always thought of accreditation as more of educational quality issue, ...Not, will I be able to get a license after training there? That particular aspect of the accreditation issue is rarely mentioned...

Maybe, but I doubt it really being so invisible to medical students.

All med students have at least done Steps 1 and are working on Step 2 when applying to residency. Those are US Medical Licensing Examinations. It is hard to not even consider what it is going to take to move on and complete Step 3. Also, most med-students I knew/know are talking about moonlighting and what it will take to be able to moonlight somewhere in their 4th year of medical school. All which requires a license.

 

[Samoa]

Just found the answer to my question: yes, CMS does require ACGME certification of the institution and each of the residency programs it sponsors in order to provide funding.

So, in essence, it's all tied together. The residency depends on accreditation to obtain its funding, and residents depend on accreditation to be eligible for licensure and board certification.

 

[Samoa]

Maybe, but I doubt it really being so invisible to medical students.

All med students have at least done Steps 1 and are working on Step 2 when applying to residency. Those are US Medical Licensing Examinations. It is hard to not even consider what it is going to take to move on and complete Step 3. Also, most med-students I knew/know are talking about moonlighting and what it will take to be able to moonlight somewhere in their 4th year of medical school. All which requires a license.

Trust me, it's pretty invisible. Very few 4th years delve into that much detail about licensure requirements (other than getting a training license). They may have investigated the requirements for step 3, but you can easily register for it in some state (like CA) that requires only a medical degree and not any residency--even if you don't live there, didn't go to medical school there and aren't training there. I only read in detail about it because I tend to think five or six steps ahead of wherever I am. But I know plenty of people who only think one or two steps ahead, and I'm not at all surprised that someone would ask the question that started this thread.

 

[JackADeli]

Trust me, it's pretty invisible. Very few 4th years delve into that much detail about licensure requirements (other than getting a training license). They may have investigated the requirements for step 3, but you can easily register for it in some state (like CA) that requires only a medical degree and not any residency--even if you don't live there, didn't go to medical school there and aren't training there. I only read in detail about it because I tend to think five or six steps ahead of wherever I am. But I know plenty of people who only think one or two steps ahead, and I'm not at all surprised that someone would ask the question that started this thread.

That's fine. My experience and on-going involvement [with students] has been different then that impression. While they don't study in depth on the topic, they have generally been adequately familiar that they:

a. [usually] require some duration of accredited residency to take step 3
b. require step 3 to obtain unrestricted license

I can not speak to all students or all states. But, the above is my general experience with all I have dealt with to date. When the time comes, they then proceed to identify any additional state particulars.

 

[Samoa]

a. [usually] require some duration of accredited residency to take step 3
b. require step 3 to obtain unrestricted license

My disagreement is solely over the "accredited" part. I don't think most students make that distinction. They just know they need X years of residency.

 

[Smurfette]

State medical licensing is a different ballgame altogether. Every state has a slightly different set of rules and documentation requirements. I don't think a non-accredited residency affects licensure in a majority of states, so long as you can prove you were in a residency program, but I could be wrong. But having a license is worthless if you can't find a place to work because your training background is sketchy.

Not to put words in JAD's mouth, but I think he was trying to point out that most med students know that there is a 'path' to full licensure and practice, and that most med students would realize that a non-accredited program is not on the well traveled path, but one filled with unknown obstacles. Thus, most med students would try to avoid this path altogether; med students are very leery of something that is clearly very different from the rest. While they want a residency, they also realize that accredited is better than non-accredited.

I think most MS4s realize very quickly that accreditation is important, because:
1. the vast majority of programs that they are researching via FREIDA and other sites are accredited and advertise this.
2. non-accredited programs will 'look' different to them and set off warning bells--for example, really high turnover rates, residents who seem sketchy, program details are sketchy, too-good-to-be-true promises, etc. etc.
3. when seeking advice from others, are told to avoid these programs

 

[JackADeli]

...Not to put words in JAD's mouth, but I think he was trying to point out that most med students know that there is a 'path' to full licensure and practice, and that most med students would realize that a non-accredited program is not on the well traveled path, but one filled with unknown obstacles. Thus, most med students would try to avoid this path altogether; med students are very leery of something that is clearly very different from the rest. While they want a residency, they also realize that accredited is better than non-accredited...

I think generally yes. But, I do believe, based on experience [anecdote], most med-students have far more awareness then suggested. If nothing else, med-schools themselves are judged on match rates (accredited programs). The match rate is often a cited point of quality when applicants are interviewing and such. The match rate into accredited programs is one of the driving forces that will get the laziest career counselor to at least steer med-students to something accredited.

Further, med-students within a program generally have some sort of guidance, ?counselor or ?specialty mentor. If nothing else, they have the current residents around them. During residency, med-students always asked about "when are you taking step 3?...(leads to) what is required to take Step 3?" and "what do you need to do in order to moonlight?", etc... In many programs the answer of Step 3 timing is usually, "our program requires you take it by the end of year "x" ".

In my experience the topic of accreditation and full licensure where not so invisible and/or viewed as disconected independent entities. Again, I can not speak for all med-students or all schools or all states. I have never known a US med-student to actively seek a non-accredited primary residency/training program. I can not imagine any med-school that would not strongly discourage such a choice.

 

[turquoiseblue]

If you're a DO you have a choice to enter into DO programs away from the ACGME i think, but im not sure about that.

I found out that nonACGME can count toward licensure but you can't be board certified or board eligible with it. you can't become a full fledged doctor with nonACGME programs for MD's. the way it is set up, you could only accept cash-only patients, no insurance companies would cover your services or you could just do what a non BE/BC licensed doctor does, which is not much, not even as much as a family doctor does. you would just be called a general physician.

Maybe one day someone could create another accreditation much better than ACGME where you could be BE/BC, but that hasn't happened yet as far as I know.

 

[JackADeli]

...Maybe one day someone could create another accreditation much better than ACGME where you could be BE/BC, but that hasn't happened yet as far as I know.

BE/BC standards are set by individual boards in conjunction with ACGME. Many boards now no longer acknowledge or confirm a Board Eligible status. You are either certified or you are not. A "new" accreditation is not going to be coming anytime soon.