New ACGME Requirement Proposal

[fozzy40]

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Basically there is a new ACGME requirement that is being proposed that requires medical students to complete an ACGME accredited internship before entering a ACGME accredited fellowship (effective 2014) or fellowship (effective 2015.) This has huge implications for osteopathic residents and medical students going into PM&R residency or fellowship. This is a more global issue targeting all other specialties i.e. derm, rads, anesthesia. However, there is a disproportionately number of ACGME vs. AOA PM&R residency programs when compared to these other specialties.

I posted this in the osteopathic forum.

VERY SERIOUS AND TIME SENSITIVE ISSUE! Go to link above to see who you can talk with about this issue.

 

[oreosandsake]

Wow, thanks for bringing this up Fozzy.

here is the exact language used

http://www.acgme.org/acWebsite/reviewComment/Common_Impact.pdf

 

[kstarm]

Thanks for posting this information fozzy. I was very disappointed to see this. Hopefully this will not go through.

 

[melancholy]

Interesting language about the unknown levels of competence, education, monitoring, or evaluation according to ACGME standards in AOA internships. I'd guess there are cases of substandard internships with deficiencies out there in both parties.

Having gone through an AOA internship, then ACGME residency and fellowship, I look back and consider how this would have affected me. I would have had to up-rank categorical PM&R spots which I feel are already quite competitive. The other option would be to compete against the radiology/anesthesiology/ophtho folks for transitional year internships, some of which seemed extremely competitive for various reasons. (location, schedule, reputation, etc.) Given the few osteopathic PM&R residencies, from a statistical basis, this would have driven me from applying to those residencies unless I were extremely set on going to one of these programs and felt that I had a decent chance of matching with them.

Down the line, fellowship applicants will have already been "tracked" into ACGME programs from residency and will be eligible for fellowships. I would assume this doesn't affect osteopathic PM&R residents who graduate from a jointly-accredited program. That does leave the few osteopathic residents who would then have to look at non-accredited fellowships.

Unfortunately, this adds to the pile of considerations that osteopathic students have to gauge during the application process.

It would be interesting to see some statistics of those who have completed AOA internships and gone onto ACGME programs, in PM&R and in other fields. I suspect it is a somewhat higher % in PM&R, but not certain as to how much higher.

These disappointing changes have potential implications at many different levels. I wonder what finally brought this about.

 

[Prof Moriarty]

I'm currently in an osteopathic internship at a program with a dually-accredited internal medicine program and an ACGME-accredited prelim year. There are slight differences in curriculum but we rotate side-by-side.

I start my ACGME PM&R program next year, so I'll finish in 2015. If this proposal passes and goes into effect then, anyone in my position will not be able to apply for ACGME fellowships. Am I reading this right?

If the ACGME wants to make a new rule, I guess that's their prerogative. The AOA certainly has its fair share of idiosyncratic rules w/r/t post-graduate training/licensure. But what irks me about this proposal is that it leaves the current class of interns (me) in the lurch. Future upcoming PGY-1's can make an informed choice, but current PGY-1's already are where we are, and I don't see language grandfathering us in.

 

[melancholy]

I'm currently in an osteopathic internship at a program with a dually-accredited internal medicine program and an ACGME-accredited prelim year. There are slight differences in curriculum but we rotate side-by-side.

I start my ACGME PM&R program next year, so I'll finish in 2015. If this proposal passes and goes into effect then, anyone in my position will not be able to apply for ACGME fellowships. Am I reading this right?

If the ACGME wants to make a new rule, I guess that's their prerogative. The AOA certainly has its fair share of idiosyncratic rules w/r/t post-graduate training/licensure. But what irks me about this proposal is that it leaves the current class of interns (me) in the lurch. Future upcoming PGY-1's can make an informed choice, but current PGY-1's already are where we are, and I don't see language grandfathering us in.

In your case, I think you would be fine. The proposed requirement for entry into an ACGME fellowship as of July 1, 2015 would stipulate you had completed an ACGME-accredited residency as your pre-requisite. You will have completed your ACGME residency. It would affects others in the future if they could not receive entry into an ACGME residency due to an AOA internship.

At least that's how I am reading it...

 

[sammybear]

That is correct; it will not affect you for your residency or fellowship training (if you prefer to pursue it).

 

[sblau001]

My heart bleeds red ketchup. If there is no reciprocity and allopaths are not allowed to take the osteopathic boards or perform an osteopathic residency, I say to hell with them (not all osteopaths- just the jerks who make the rules). If you can't play nice in the sandbox, eventually no one will want to be your friend.

 

[PhillDOc]

Agree with above. As written, if this does pass it will allow anyone in an ACGME residency to complete an ACGME fellowship regardless of internship type/program.

For osteopathic students applying now: does this affect us as applicants this year? The proposal would start July 1, 2014 right as we are starting our PGY-2 years. I cannot tell from the wording whether I can do an AOA TRI next year followed by an ACGME PM&R program in July 2014....don't want to show up first day of pgy-2 and be told to go home because my intern year isn't recognized....thoughts???

 

[Spartyon]

Agree with above. As written, if this does pass it will allow anyone in an ACGME residency to complete an ACGME fellowship regardless of internship type/program.

For osteopathic students applying now: does this affect us as applicants this year? The proposal would start July 1, 2014 right as we are starting our PGY-2 years. I cannot tell from the wording whether I can do an AOA TRI next year followed by an ACGME PM&R program in July 2014....don't want to show up first day of pgy-2 and be told to go home because my intern year isn't recognized....thoughts???

Bump...Should I apply for AOA traditional intership year or acgme transitional? Since this is pending is it safe to say we can do aoa route and still get approval for PGY-2 entry?

 

[theserbatron]

Bump...Should I apply for AOA traditional intership year or acgme transitional? Since this is pending is it safe to say we can do aoa route and still get approval for PGY-2 entry?

As far as I have read, this proposal is still up in the air... I would keep a close eye on the future developments. I don't think anyone has a crystal ball and knows exactly when this will go into effect, if at all, and unfortunately we aren't privy to any of the insider info.

If you must decide now, the safest thing might be to apply to both -- a difficult and costly proposition, but ultimately the safest.

You could also try speaking with the deans of your school and see if they have any insight/guidance. This was a hot topic last year among DO applicants to PM&R and many of us were unsure of how to go...

 

[theserbatron]

"May 25, 2012 – AOA leadership met with ACGME leadership at ACGME headquarters to continue our advocacy to withdraw or amend the proposed Common Program Requirements. A robust discussion focused on various scenarios of interaction between the two GME accreditation organizations. Both sides agreed that the meeting was productive and agreed to continue the discussion in early July. To allow the discussions between the AOA and ACGME to progress, the ACGME decided to delay its scheduled June vote on the proposed Common Program Requirements until September."

http://www.osteopathic.org/inside-aoa/Pages/acgme-policy-timeline.aspx