AOA Board Resolutions with potential impact on resolution 42

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JayneCobb

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Here are a few interesting proposed changes to AOA approval of DOs who take ACGME residency positions.



RES. NO. 2
I/07
SUBJECT: REVISIONS TO RESOLUTION 42 (A/00) “APPROVAL OF ACGME TRAINING AS AN AOA-APPROVED INTERNSHIP”
SUBMITTED BY: Bureau of Osteopathic Education / Council on Postdoctoral Training
REFERRED TO: AOA Board of Trustees
________________________________________________________________________________
WHEREAS, the American Osteopathic Association (AOA) has had a mechanism for granting approval of Accreditation Council for Graduate Medical Education (ACGME) training as an AOA-approved internship since the late 1980s, and
WHEREAS, the current mechanism to accomplish this is Resolution 42 (A-2000), and
WHEREAS, under Resolution 42, applicants must provide a evidence of a special circumstance why they could not complete AOA accredited training and then must complete the curricula specified by the AOA as required for an osteopathic internship, and
WHEREAS, current data suggest that ninety-nine percent of applicants have their special circumstance approved, and
WHEREAS, current data suggests that over eighty percent of applicants that apply eventually have their entire training approved, and
WHEREAS, the current geographic diversity of AOA accredited programs is limited, and
WHEREAS, the AOA does not currently have training programs in several specialties (i.e., Pathology) and has very limited programs in others (i.e., Psychiatry and Internal Medicine/Pediatrics), and
WHEREAS, one goal of AOA accredited training is to provide a broad base of knowledge under the supervision of osteopathic physicians, and
WHEREAS, the AOA, through Resolution 56, provides a simplified pathway for ABMS certified osteopathic physicians to become AOA board certified, and
WHEREAS, changes in the current osteopathic internship structure make amendment of Resolution 42 necessary to create an objective process, therefore be it
RESOLVED, that Resolution 42 (A/00) "Approval of ACGME Training as an AOA-Approved Internship" be substituted and revised as follows:


A. All training submitted for review under this resolution must have been received in an ACGME-approved program.
B. Application: A D.O. who wishes to obtain AOA OGME-1 internship approval for training taken in an ACGME-approved training program may request the opportunity to do so under the following special circumstances:
1. There will be no special fees assessed to the applicant throughout the approval review.
2. Application is made to the Secretary to the AOA Council on Postdoctoral Training.
C. Eligibility Criteria: A D.O. participating in an ACGME program or who has completed an ACGME program is eligible to apply for approval of that training as AOA OGME-1 internship training when the applicant complies with the following criteria PROGRAM REQUIREMENTS LISTED IN D.

D. Program Requirements: To complete the approval process, the eligible D.O. must comply with the following criteria:
1. For those currently enrolled in an ACGME-approved program,

a. THE APPLICANT MAINTAINS TRAINEE MEMBERSHIP STATUS IN THE AOA.
b. THE APPLICANT MUST APPLY TO THE AOA FOR SPECIAL CONSIDERATION DURING HIS OR HER ACGME RESIDENCY TRAINING, WITH NOTICE TO THE APPROPRIATE AOA-RECOGNIZED SPECIALTY COLLEGE.
c. COMPLETE ALL THE ROTATIONAL CURRICULAR REQUIREMENTS OF AOA-APPROVED OGME-1 YEAR WITHIN THE ACGME PROGRAM. THIS MAY BE THE REQUIREMENTS OF A TRADITIONAL INTERNSHIP (OPTION 3), A PRELIMINARY INTERNSHIP (OPTION 2) OR OTHER OGME-1 YEAR (OPTION 1).
d. PARTICIPATE IN AN AOA-APPROVED OSTEOPATHIC TRAINING PROGRAM OFFERED BY A REGIONAL OPTI OR AOA-ACCREDITED HOSPITAL, TO INCLUDE OPP/OMT TRAINING VIA CLINICAL ELECTIVE ROTATIONS, OR CLINICAL/OMM-OPP TRAINING MODULES.

e. ATTEND A REGIONAL OR NATIONAL MEETING OF THE AOA, AN AOA-AFFILIATED SPECIALTY SOCIETY OR AND AOA-AFFILIATED STATE SOCIETY.
f. DEVELOP AND PRESENT A LECTURE ON OSTEOPATHIC MEDICINE OR OSTEOPATHIC PRINCIPLES AND PRACTICE IN THEIR HOME TRAINING PROGRAM.

2. THOSE WHO HAVE COMPLETED AN ACGME-APPROVED FIRST YEAR OF POSTGRADUATE TRAINING PRIOR TO JULY 1, 2008 MUST APPLY FOR APPROVAL UNDER THE PROVISIONS OF RESOLUTION 42 (A/00).
3. THOSE WHO MATRICULATED INTO AN ACGME-APPROVED FIRST YEAR OF POSTGRADUATE TRAINING AFTER JULY 1, 2008 AND DID NOT COMPLETE THE FOLLOWING REQUIREMENTS FROM
D.1.b. (APPLY TO THE AOA FOR SPECIAL CONSIDERATION DURING HIS OR HER ACGME RESIDENCY TRAINING, WITH NOTICE TO THE APPROPRIATE AOA-RECOGNIZED SPECIALTY COLLEGE);
D.1.d. (PARTICIPATE IN AN AOA-APPROVED OSTEOPATHIC TRAINING PROGRAM OFFERED BY A REGIONAL OPTI OR AOA-ACCREDITED HOSPITAL, TO INCLUDE OPP/OMT TRAINING VIA CLINICAL ELECTIVE ROTATIONS, OR CLINICAL/OMM-OPP TRAINING MODULES);
D.1.e. (ATTEND A REGIONAL OR NATIONAL MEETING OF THE AOA, AN AOA-AFFILIATED SPECIALTY SOCIETY OR AND AOA-AFFILIATED STATE SOCIETY); AND


D.1.f. (DEVELOP AND PRESENT A LECTURE ON OSTEOPATHIC MEDICINE OR OSTEOPATHIC PRINCIPLES AND PRACTICE IN THEIR HOME TRAINING PROGRAM);
MUST COMPLETE THE FOLLOWING REQUIREMENTS:
a. MAINTAIN MEMBERSHIP STATUS IN THE AOA.
b. SHOW EVIDENCE OF COMPLETION OF ALL THE CURRENT ROTATIONAL CURRICULAR REQUIREMENTS OF AOA-APPROVED OGME-1 YEAR WITHIN THE ACGME PROGRAM. THIS MAY BE THE REQUIREMENTS OF A TRADITIONAL INTERNSHIP (OPTION 3), A PRELIMINARY INTERNSHIP (OPTION 2) OR OTHER OGME-1 YEAR (OPTION 1).
c. USE AN ALTERNATIVE PATHWAY (RESOLUTION 56) TO OBTAIN AOA BOARD CERTIFICATION IN THEIR PRIMARY SPECIALTY; AND BE IT FURTHER
RESOLVED, that the COPT and its subcommittees, and staff, shall review and update the approved activities listed in D.3 D.1.c and D.4 D.3.b above, as may be determined; and be it further
RESOLVED, that the administrative staff of the Department of Education shall review applications under this program and act on approval, or other status if deficiencies are identified. All staff recommendations for denial of an internship OF AN OGME-1 application will be referred to the Executive Committee of the COPT PROGRAM AND TRAINEE REVIEW COUNCIL (ECPTRC) for decision. Regular reports will be prepared for review by the Executive Committee of COPT PTRC. ALL ECPTRC RECOMMENDATIONS FOR DENIAL OF AN OGME-1 APPLICATION WILL BE REFERRED TO THE PROGRAM AND TRAINEE REVIEW COUNCIL (PTRC) FOR DECISION; and be it further
RESOLVED, that the following administrative guidelines be approved:
A. The applicant must comply with the provisions of this resolution.
B. All DOs participating in ACGME training, who have not completed an AOA approved internship OGME-1, and who meet the Eligibility Criteria provisions of Substitute Resolution 19, are eligible to apply under the provisions of this program.
C. The applicant must complete a one-page AOA form, and place this on file in the AOA Department of Education, with a copy to the relevant specialty college.
D. The AOA Division of Postdoctoral Training EDUCATION DEPARTMENT/TRAINEE SERVICES will assess each application within 30

days of receipt to determine that the application is in order and complete. If the application is determined not to be complete, the AOA staff will notify the applicant within 7 working days.
E. IF THE APPLICATION IS COMPLETE, THE APPLICANT WILL BE NOTIFIED OF SUCH WITHIN 7 WORKING DAYS.
F. APPROVAL OF TRAINING UNDER THIS RESOLUTION WILL BE GRANTED ONLY AFTER THE APPLICANT COMPLETES THEIR FIRST YEAR OF POST-GRADUATE TRAINING.
G. THE PTRC MAY WAIVE THE CURRICULAR REQUIREMENTS IN D. 1. c. AND D. 3. b. IF IT IS DETERMINED THAT THERE ARE NOT SUFFICIENT AOA APPROVED TRAINING OPPORTUNITIES IN A PARTICULAR SPECIALTY.
H.
THE APPLICANT MUST COMPLETE ALL TRAINING WITHIN TWO CALENDAR YEARS OF THE APPLICATION DATE. IF THIS DOES NOT OCCUR, THE APPLICATION WILL BE CONSIDERED CLOSED.
I.
THIS PROCESS MAY NOT SUPPLANT THE ADVANCED STANDING REQUIREMENTS OF ANY SPECIALTY COLLEGE.
J.
PROOF OF ALL MISSING REQUIREMENTS MUST BE SUBMITTED TO THE AOA NO LATER THAN 90 DAYS AFTER THE COMPLETION OF A TRAINEE’S POSTDOCTORAL EDUCATION.

 
Hmm can someone summarize for people with no time? 😀
 
here is the important point
3. THOSE WHO MATRICULATED INTO AN ACGME-APPROVED FIRST YEAR OF POSTGRADUATE TRAINING AFTER JULY 1, 2008 AND DID NOT COMPLETE THE FOLLOWING REQUIREMENTS FROM
D.1.b. (APPLY TO THE AOA FOR SPECIAL CONSIDERATION DURING HIS OR HER ACGME RESIDENCY TRAINING, WITH NOTICE TO THE APPROPRIATE AOA-RECOGNIZED SPECIALTY COLLEGE);
D.1.d. (PARTICIPATE IN AN AOA-APPROVED OSTEOPATHIC TRAINING PROGRAM OFFERED BY A REGIONAL OPTI OR AOA-ACCREDITED HOSPITAL, TO INCLUDE OPP/OMT TRAINING VIA CLINICAL ELECTIVE ROTATIONS, OR CLINICAL/OMM-OPP TRAINING MODULES);
D.1.e. (ATTEND A REGIONAL OR NATIONAL MEETING OF THE AOA, AN AOA-AFFILIATED SPECIALTY SOCIETY OR AND AOA-AFFILIATED STATE SOCIETY); AND


D.1.f. (DEVELOP AND PRESENT A LECTURE ON OSTEOPATHIC MEDICINE OR OSTEOPATHIC PRINCIPLES AND PRACTICE IN THEIR HOME TRAINING PROGRAM);
MUST COMPLETE THE FOLLOWING REQUIREMENTS:

a. THE APPLICANT MAINTAINS TRAINEE MEMBERSHIP STATUS IN THE AOA.
b. THE APPLICANT MUST APPLY TO THE AOA FOR SPECIAL CONSIDERATION DURING HIS OR HER ACGME RESIDENCY TRAINING, WITH NOTICE TO THE APPROPRIATE AOA-RECOGNIZED SPECIALTY COLLEGE.
c. COMPLETE ALL THE ROTATIONAL CURRICULAR REQUIREMENTS OF AOA-APPROVED OGME-1 YEAR WITHIN THE ACGME PROGRAM. THIS MAY BE THE REQUIREMENTS OF A TRADITIONAL INTERNSHIP (OPTION 3), A PRELIMINARY INTERNSHIP (OPTION 2) OR OTHER OGME-1 YEAR (OPTION 1).
d. PARTICIPATE IN AN AOA-APPROVED OSTEOPATHIC TRAINING PROGRAM OFFERED BY A REGIONAL OPTI OR AOA-ACCREDITED HOSPITAL, TO INCLUDE OPP/OMT TRAINING VIA CLINICAL ELECTIVE ROTATIONS, OR CLINICAL/OMM-OPP TRAINING MODULES.

e. ATTEND A REGIONAL OR NATIONAL MEETING OF THE AOA, AN AOA-AFFILIATED SPECIALTY SOCIETY OR AND AOA-AFFILIATED STATE SOCIETY.
f. DEVELOP AND PRESENT A LECTURE ON OSTEOPATHIC MEDICINE OR OSTEOPATHIC PRINCIPLES AND PRACTICE IN THEIR HOME TRAINING PROGRAM.​

You no longer will need to beg if this passes, but they are now placing Osteopathic curricula requirements to the ACGME programs. So it may in fact be a little more difficult to obtain AOA approval for a ACGME program. However, I have no problems with this approach and think this is a well thought out and appropriate standardization.
 
Hmm can someone summarize for people with no time? 😀

Current Resolution 42 requirements require that a Letter of Exceptional Circumstances be written (with supporting document) to explain why the applicant went to an ACGME internship/residency instead of an AOA-residency. In this re-drafted resolution, it mentioned the high pass rate associated with this requirement so it opted to leave the letter of exceptional circumstances out of the new requirement.

Current Resolution 42 requirements require that the person seeking approval complete a curriculum that is loosely based on the Traditional Osteopathic Rotating Internship. This curricular requirement is the main reason for disapproval of Resolution 42 for applicants (according to a JAOA article). The re-drafted resolution will set the requirement to be one of three types of curriculums to mirror the three types of internship available in the osteopathic community.

Another change i see is in the wording (and IMHO will have the biggest impact). Current requirement states that an applicant do one of the following:
1. Attend AOA Annual Convention
2. Attend annual meeting of AOA specialty college or AOA divisional society meeting
3. Participate in an osteopathic training program run by an OPTI, or to do an OMM rotation, or do a rotation that incorporates OMM
4. Give an osteopathic clinical presentation to either your ACGME program OR specialty college (a copy of which goes to the AOA for approval)

with the re-drafted resolution, the wording is such that it now requires the applicant to do all of the above

Those are the 3 major differences I see.
 
All this crap really is, is an "attempt" to retain the best DO students in DO residencies. They figure if they can create enough crap the students will just give in or not work in 5 states.
 
On the flip side of things.... why don't we solve the AOA GME problem by pushing for more states requiring Traditional Internship for Licensure?! This way all DOs will stay in DO residencies.
 
Thanks, Jayne and Group

I guess I will worry about this more 4th year 😎.
 
I got my Resolution 42 approved this week 😀

(and yes, I am an intern currently)
 
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