I don't believe this is actually pressure from the ACGME. If anything its a move made by the AOA that puts all the work of protecting residents on the programs themselves. Otherwise, it would be the AOA's responsibility to find spots for all the residents that are caught without an accredited program in July of 2020.
I wouldn't be surprised if this forces a lot of those programs to make the decision one way or the other. And, I wouldn't be surprised if it nudged those on the fence to apply, but only time will tell.
They honestly should have already been poised to do that. They've known about the merger for over a year and they were just sitting by. What was their plan, to accept residents, who could never finish, without deciding whether or not to actually apply to stay accredited? According to Mad Jack, that's unthinkable, because all PDs are honest, ethical, and organized.
You give PDs a lot more credit than I think is warranted. I've seen PDs repeatedly lie to applicants just for the program to be ranked higher. I'm sure many are honest and ethical, but many also aren't, and are looking out for themselves above all. Then of course you've got a whole slew of ones that are just disorganized or lazy that will delay things until someone forces their hand.
PDs are people, they have the same flaws as others. Many have probably convinced themselves that giving residents even 1 year of training is doing a service to them, regardless of whether those residents will ever be eligible for board certification.
It varies depending on the specific specialty committee. 6mos-1yr minimum is what's being projected. Programs need to apply ASAP. The sooner they apply, the sooner they'll know what they need to do to be accredited. With that info, they can actually decide whether or not it's worth it.
People keep assuming every ACGME program is held to the same standard. They aren't. While there are "some" universal standards, there are always programs that get waivers or have rules bent for them. In addition, some rules on paper can be interpreted in many different ways (what does "devotion to research" mean, "x hrs devoted to program activities", etc. etc. - the wording is purposefully vague). It's the nature of the beast when you're dealing with thousands of programs in very different settings. The only way for AOA programs to really know what they need to do is to apply in the first place. If this policy makes them do it faster, I'm all for it.
I actually agree with YankeeCandle (which blows my mind in and of itself) on the idea that most programs will be willing to fork over the application fee just to see what's going to happen. $10-$15k is actually nothing for almost all of these hospitals. Now will they all spend the millions to be accredited for those that require it, probably not, but they probably want to know how much it'll actually cost. Some won't, but most will.
Also, I wouldn't be surprised if the programs willing to throw in a towel this early in the game, are hospitals that were already considering dropping their residency program. Residency programs are constantly in flux. Some are fragile and collapse pretty quickly at the first sign of trouble or change. One example is the LECOM ophtho program. When the PD passed away, they tried to briefly find a replacement, and then decided it wasn't worth it, sending all the current residents packing. This stuff unfortunately happens.
Its hard to tell. Residency programs on average increase spots by 1-2%/yr. In 5 years that will be close to 5-10%. We'll have to see just how many AOA spots close/open in that time to know what the net spots will be. Even if we assume 30% of AOA spots will disappear (I honestly think that's high), that's only about 900-1000 spots, which is only about 3-4% of the total residency spots.
From what my director of GME has said, all of my hospital's programs intend to apply for accreditation. I also know that 3 of them are already in the process of filling out the paperwork (I know because they're making a few residents do it - ridiculous).
I agree.
