Potential COCA Accreditation Violation and Reporting

[concerned_student]

Current 3rd year student at a newer DO program with concerns regarding my and my peer's 3rd year core rotations. I'm seeking advice about the process of reporting violation of COCA Accreditation Standard 6.10:

A COM must ensure that each student participates in one or more required core rotation(s) prior to the fourth year clinical clerkship experience that is conducted in a health care setting in which the student works with resident physicians currently enrolled in an accredited program of graduate medical education. In addition to the above expectation, a minimum of one required third year clinical clerkship must be completed under the supervision of an osteopathic physician and more than one of the required third year clinical clerkship experiences must include an inpatient component.

It feels like our rotations have been haphazardly thrown together and many of us feel the school has strung us along with empty promises from the beginning. I believe the school will fail to meet compliance with Accreditation Standard Element 6.10 for my class. From my own personal experience as well as testimonials from my peers, a significant number of us will NOT complete a core rotation with resident physicians. Many of us are rotating in smaller, private community hospitals and/or outpatient clinics. We could possibly arrange a third year elective and find our own rotation with a residency program but as I understand the language of the requirement, this fails to meet the accreditation standard set forth by COCA.

I am concerned about potential retaliation by the school/admin regarding my future if I choose to move forward with a compliant. The COCA reporting policy does not allow for anonymous submissions and I do not want my chance at residency trashed due to retaliation remarks left in the dean's letter or a bogus professionalism claim for being the squeaky wheel.

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[SOOyC52H1Sof]

Some battles arent worth fighting. I was in a similar situation. Just find an away rotation with a residency program and just keep moving. You are almost there. Dont jeopardize it.

 

[BlueBleck]

I would make an anonymous email without any identifying information anyways and see if action is taken. If you were given a list of rotation tracks to select from in the beginning of the year, that might help. Make sure to scrub the file of your name.

SOOy is right though that it's up to you to determine if it's a fight worth having. If your school goes down before you leave, you'll be hurt. And imagine that COCA agrees and forces your school to shove a GME rotation into your schedule. Is it possible that they'll take away one of your electives? On the other hand, if they improve the situation, you'll be helping a lot of future students and possibly even yourself.

But I wonder how strict they are about the requirement though. For instance, one of my rotations was listed as a GME site with residents. And it is true that there were residents. But it was an ancillary site where I only really saw like 5 residents my entire time there, each time for maybe one day. If I had been unlucky, I might have never met a single resident. And also because it was an ancillary site, there was no PD or real teaching faculty to interact with. It was just working attendings who volunteered to take students and residents. My attendings were nice and were good teachers, so it didn't bother me, but if someone was hoping to understand the GME structure, this was a poor site even though it has GME.

 

[NurWollen]

Current 3rd year student at a newer DO program with concerns regarding my and my peer's 3rd year core rotations. I'm seeking advice about the process of reporting violation of COCA Accreditation Standard 6.10:

A COM must ensure that each student participates in one or more required core rotation(s) prior to the fourth year clinical clerkship experience that is conducted in a health care setting in which the student works with resident physicians currently enrolled in an accredited program of graduate medical education. In addition to the above expectation, a minimum of one required third year clinical clerkship must be completed under the supervision of an osteopathic physician and more than one of the required third year clinical clerkship experiences must include an inpatient component.

It feels like our rotations have been haphazardly thrown together and many of us feel the school has strung us along with empty promises from the beginning. I believe the school will fail to meet compliance with Accreditation Standard Element 6.10 for my class. From my own personal experience as well as testimonials from my peers, a significant number of us will NOT complete a core rotation with resident physicians. Many of us are rotating in smaller, private community hospitals and/or outpatient clinics. We could possibly arrange a third year elective and find our own rotation with a residency program but as I understand the language of the requirement, this fails to meet the accreditation standard set forth by COCA.

I am concerned about potential retaliation by the school/admin regarding my future if I choose to move forward with a compliant. The COCA reporting policy does not allow for anonymous submissions and I do not want my chance at residency trashed due to retaliation remarks left in the dean's letter or a bogus professionalism claim for being the squeaky wheel.

No anonymous complaints? That's pretty bad, COCA.

Sent from my SM-G930V using SDN mobile

 

[AnatomyGrey12]

The AOA is made up of criminals.

 

[Goro]

Current 3rd year student at a newer DO program with concerns regarding my and my peer's 3rd year core rotations. I'm seeking advice about the process of reporting violation of COCA Accreditation Standard 6.10:

A COM must ensure that each student participates in one or more required core rotation(s) prior to the fourth year clinical clerkship experience that is conducted in a health care setting in which the student works with resident physicians currently enrolled in an accredited program of graduate medical education. In addition to the above expectation, a minimum of one required third year clinical clerkship must be completed under the supervision of an osteopathic physician and more than one of the required third year clinical clerkship experiences must include an inpatient component.

It feels like our rotations have been haphazardly thrown together and many of us feel the school has strung us along with empty promises from the beginning. I believe the school will fail to meet compliance with Accreditation Standard Element 6.10 for my class. From my own personal experience as well as testimonials from my peers, a significant number of us will NOT complete a core rotation with resident physicians. Many of us are rotating in smaller, private community hospitals and/or outpatient clinics. We could possibly arrange a third year elective and find our own rotation with a residency program but as I understand the language of the requirement, this fails to meet the accreditation standard set forth by COCA.

I am concerned about potential retaliation by the school/admin regarding my future if I choose to move forward with a compliant. The COCA reporting policy does not allow for anonymous submissions and I do not want my chance at residency trashed due to retaliation remarks left in the dean's letter or a bogus professionalism claim for being the squeaky wheel.

The way it's worded seems to imply that having only one rotation in a residency program will suffice.

A COM must ensure that each student participates in one or more required core rotation(s) prior to the fourth year clinical clerkship experience

 

[alprazoslam]

Name the school please. Fame and Shame like a real man

 

[Cranjis McBasketball]

Have you reached out to your school about it?

 

[concerned_student]

No anonymous complaints? That's pretty bad, COCA.

"The complaint must be in writing and signed by the complainant. All signed complaints must be submitted to the Secretary, COCA; American Osteopathic Association; 142 E. Ontario St.; Chicago, IL 60611 or via email to [email protected]. Complaints that are received that are not signed by the complainant(s) or are submitted anonymously will not be processed."
Source: https://osteopathic.org/wp-content/uploads/2018/02/complaint-review-procedures.pdf

The way it's worded seems to imply that having only one rotation in a residency program will suffice.

A COM must ensure that each student participates in one or more required core rotation(s) prior to the fourth year clinical clerkship experience

A larger number of my class with complete third year without EVER rotating with a GME program, even for just a single rotation. I'd be content and consider the requirement satisfied if each student had at least ONE rotation with a residency program.

Have you reached out to your school about it?

We have basically been told to use an elective or do an away fourth year if we want to work with residents.

 

[concerned_student]

Name the school please. Fame and Shame like a real man

It is a newer school, that's enough to know.

 

[alprazoslam]

Complain after you graduate if you can’t do it anonymously. Lol coca is such a joke

 

[AnatomyGrey12]

The way it's worded seems to imply that having only one rotation in a residency program will suffice.

A COM must ensure that each student participates in one or more required core rotation(s) prior to the fourth year clinical clerkship experience

This is correct. But it must be during 3rd year clerkship to meet the requirement. This school is in clear violation.

This is why it’s such a joke that COCA doesn’t require actual clerkships agreements to be in place before they allow a school to take students.

The complaint must be in writing and signed by the complainant. All signed complaints must be submitted to the Secretary, COCA; American Osteopathic Association; 142 E. Ontario St.; Chicago, IL 60611 or via email to [email protected]. Complaints that are received that are not signed by the complainant(s) or are submitted anonymously will not be processed."
Source: https://osteopathic.org/wp-content/uploads/2018/02/complaint-review-procedures.pdf

This is some pretty cowardly **** right here.

 

[12jas]

Sounds very similar.....I bet I know the school but I agree with the above posters. Reporting them to COCA does nothing to help you. Protect your own interests at all costs. Don't be fooled the school administration doesn't care what rules they are breaking and they will retaliate. They hold a ton of power over you. Keep quite and name and shame as soon as you get your degree no sooner.

 

[DO2015CA]

It is a newer school, that's enough to know.

Lol nah fam. There have been so many that have started up

 

[DrStephenStrange]

When did the school's first class started?

 

[deleted936470]

It is a newer school, that's enough to know.

On a scale of 1 through 10, with '1' being the newest DO school opened and '10' being the 10th most recently opened school, how would you rate yours?

 

[Goro]

It is a newer school, that's enough to know.

A for profit school???

Unfortunately op, unless you complain, or get one of your faculty to complain, we cannot help you. Magic isn't real. This problem will not fix itself when it's on.

If the school does something to retaliate against you after your complaint, that is nice fat lawsuit material

 

[concerned_student]

A for profit school???

Unfortunately op, unless you complain, or get one of your faculty to complain, we cannot help you. Magic isn't real. This problem will not fix itself when it's on.

If the school does something to retaliate against you after your complaint, that is nice fat lawsuit material

I appreciate your suggestions and direction. I'll consider my options carefully moving forward.

 

[Giovanotto]

Hold up, it's 2019 and you're presumably born around the same time as me and you can't find a way to anonymously name and shame on a forum? Don't we have a confidential subforum on SDN now? This is ridiculous. As a third year, you don't quite have an idea how much your school is screwing you over yet. 4th year, when you start going to VSAS away rotations with the intentions of impressing programs, you're going to be in for a world of hurt. Help your future colleagues out and help yourself out by at least having one rotation with residents during third year. Your residency prospects literally depend on it.

 

[Whysoez]

Man things like this are really disheartening for current and future DO students.

 

[sharpstickie]

And this is why on almost every IM interview this year I've been specifically asked about the quality of my rotations and if I ever worked with residents. This makes us all look bad.

 

[AnatomyGrey12]

Pretty amazing that a school can blatantly ignore accreditation standards with no repercussions.

And it's clear COCA doesn't even WANT to know about it, let alone do anything about It. Making people sign their name to the complaint is a surefire way to never hear what's actually happening.

Even ACGME has anonymous reporting.

 

[sab3156]

Pretty amazing that a school can blatantly ignore accreditation standards with no repercussions.

These schools and AOA/COCA/NBOME are all part of the same osteopathic club in which standards don't really exist as long as they can keep making money.

The faster we see the end of this industry, the better.

 

[alprazoslam]

These schools and AOA/COCA/NBOME are all part of the same osteopathic club in which standards don't really exist as long as they can keep making money.

The faster we see the end of this industry, the better.

Yeah I hope LCME puts the hammer down like ACGME did. Osteopathy it’s old sense needs to die and be buried with the remnants of AT still and his femoral legacy

 

[Goro]

Yeah I hope LCME puts the hammer down like ACGME did. Osteopathy it’s old sense needs to die and be buried with the remnants of AT still and his femoral legacy

LCME has no jurisdiction over DO schools.

COCA won't do anything if they don't know about this.

Again, magic isn't real, kids.

OP, get your entire class to sign the complaint. The school can't retaliate against all of you.

 

[AnatomyGrey12]

COCA won't do anything.

FTFY. There is zero evidence COCA has ever taken meaningful action against a school.

 

[Goro]

FTFY. There is zero evidence COCA has ever taken meaningful action against a school.

This type of learned helplessness attitude ensures that nothing will be done.

I repeat, magic isn't real. You want change? MAKE it happen

 

[AnatomyGrey12]

This type of learned helplessness attitude ensures that nothing will be done.

I repeat, magic isn't real. You want change? MAKE it happen

Maybe faculty should start helping us instead of telling us to put our name on documents that could quite literally ruin our entire careers.

 

[sab3156]

LCME has no jurisdiction over DO schools.

I don't think you quite understood his post. Let me break it down for you.

ACGME put down the hammer on AOA and took over their residency programs, ensuring proper GME standards at those programs. They told AOA to get their act together and hand over all residency programs, or suffer the consequences (which was basically that no AOA residency graduates would be eligible for ACGME fellowships). This was a great move, and AOA could do nothing about it because they have no real power or any respect in the real medical world.

ACGME/LCME can, if they really wanted to, put down the hammer on AOA/COCA by telling them that by year 20xx, no graduates of COCA accredited schools will be eligible for residencies at ACGME programs. They can tell them that they must go through LCME accreditation standards to be eligible. This would overall be a good thing for medical education, because... let's be real - DO schools are trash when run by COCA standards. COCA doesn't even hold them accountable by the standards that are so bad to begin with.

That's what his post meant. He did not say that LCME controls DO schools.

 

[Goro]

Maybe faculty should start helping us instead of telling us to put our name on documents that could quite literally ruin our entire careers.

As I mentioned before, retaliation would lead to a lovely lawsuit.

OP can enlist Faculty from his/her own school.

I'm willing to help, but I'll needs lots of data to back up the complaint.

I'm seeing lots of excuses in this thread to support doing nothing. With that mindset, you get what you deserve.

 

[sab3156]

As I mentioned before, retaliation would lead to a lovely lawsuit.

OP can enlist Faculty from his/her own school.

I'm willing to help, but I'll needs lots of data to back up the complaint.

I'm seeing lots of excuses in this thread to support doing nothing.

You're telling someone to take a bullet for the rest of his classmates. No residency program wants to take a student that has an active lawsuit with their school, whether they are justified in that lawsuit or not. Why are you giving bad advice to people?

 

[alprazoslam]

I don't think you quite understood his post. Let me break it down for you.

ACGME put down the hammer on AOA and took over their residency programs, ensuring proper GME standards at those programs. They told AOA to get their act together and hand over all residency programs, or suffer the consequences (which was basically that no AOA residency graduates would be eligible for ACGME fellowships). This was a great move, and AOA could do nothing about it because they have no real power or any respect in the real medical world.

ACGME/LCME can, if they really wanted to, put down the hammer on AOA/COCA by telling them that by year 20xx, no graduates of COCA accredited schools will be eligible for residencies at ACGME programs. They can tell them that they must go through LCME accreditation standards to be eligible. This would overall be a good thing for medical education, because... let's be real - DO schools are trash when run by COCA standards. COCA doesn't even hold them accountable by the standards that are so bad to begin with.

That's what his post meant. He did not say that LCME controls DO schools.

Yeah this. They don’t have any power over DO schools but they can make do programs worthless

 

[Wjldenver]

My recommendation is that the OP should not pursue legal or formal action because they assume all of the graduation/financial risk. On a parallel note, I've seen residents formally complain about various residency programs and the ACGME also does not accept/investigate anonymous complaints either. See below:

Office of Complaints

www.acgme.org

Even if a law firm was to take this case on a contingent basis (which I doubt), the miscellaneous out-of-pocket costs passed on to the plaintiff can be substantial. For example, I've seen various law firms charge over a $1 per page for photocopying materials during the discovery phase which would be passed on to the student which is involved with the litigation. (...One of many out-of-pocket costs which would be passed on to the student/plaintiff.)

The path of least resistance is the best option here in my opinion. If the OP wants to rotate with residents, just arrange a portion of your 3rd and/or 4th year schedule accordingly. Then after you graduate, you can file a formal complaint against your school, and at least they won't be able to harass you as a student anymore (or delay your graduation).

PS) I don't know what school this is, but I'm amazed that they can't even schedule one in-patient rotation with residents. It's all about profit not student education in the AOA/COCA world.

 

[deleted936470]

My recommendation is that the OP should not pursue legal or formal action because they assume all of the graduation/financial risk. On a parallel note, I've seen residents formally complain about various residency programs and the ACGME also does not accept/investigate anonymous complaints either. See below:

Office of Complaints

www.acgme.org

Even if a law firm was to take this case on a contingent basis (which I doubt), the miscellaneous out-of-pocket costs passed on to the plaintiff can be substantial. For example, I've seen various law firms charge over a $1 per page for photocopying materials during the discovery phase which would be passed on to the student which is involved with the litigation. (...One of many out-of-pocket costs which would be passed on to the student/plaintiff.)

The path of least resistance is the best option here in my opinion. If the OP wants to rotate with residents, just arrange a portion of your 3rd and/or 4th year schedule accordingly. Then after you graduate, you can file a formal complaint against your school, and at least they won't be able to harass you as a student anymore (or delay your graduation).

PS) I don't know what school this is, but I'm amazed that they can't even schedule one in-patient rotation with residents. It's all about profit not student education in the AOA/COCA world.

Yeah, let's just wait until hundreds of other students are affected first and make posts like these to enable these kinds of problems and their persistence.

 

[DrStephenStrange]

FTFY. There is zero evidence COCA has ever taken meaningful action against a school.

COCA did put LMU on Heightened monitoring for once.

 

[alprazoslam]

COCA did put LMU on Heightened monitoring for once.

Proud LMUer right here


Lol

 

[Goro]

You're telling someone to take a bullet for the rest of his classmates. No residency program wants to take a student that has an active lawsuit with their school, whether they are justified in that lawsuit or not. Why are you giving bad advice to people?

My advice is that more than one person has to stand up and take action.

Otherwise, and I am using my words VERY carefully here, they are in the same position as the women who were assaulted by Harvey Weinstein, and did nothing because of the fear for their careers. What's more important here?

You are also ignoring the fact that a student who complains and gets they retaliation that you're afraid of will be at risk of not getting a residency anyway.

Because I guarantee you that the school will continue to do this until caught, and the students will have their careers jeopardized anyway, due to the substandard clinical training they'll be getting. And this bleeds out onto the profession as a whole. ALL DO grads will be damned on the reputation of this school.

Anyone who doesn't raise a voice in this forfeits their right to complain about COCA and the flaws of the profession.

 

[emergentmd]

Your a med student. Complain and risk being a 3rd yr med student forever.

Goro is right. Sometimes someone has to bite the bullet to complain or nothing will change. Problem is do you want to risk being Kaepernick.

There are adults all around the room, there are monitoring agencies looking at the new schools, its their job to monitor and investigate. You may want to be a martyr but I would keep my head down and finish. You learn very little real medicine in med school anyhow. Get into a good residency and that is when the learning begins.

 

[AnatomyGrey12]

As I mentioned earlier retaliation would result in a lovely lawsuit

Of course, which no medical student can afford and then no residency will touch them once they see they have an active lawsuit against their school.

OP can enlist Faculty from his/her own school.

I agree.

I'm seeing lots of excuses in this thread to support doing nothing. With that mindset, you get what you deserve.

Anyone who doesn't raise a voice in this forfeits their right to complain about COCA and the flaws of the profession.

Right, and anyone who didn’t raise their voice when Weinstein assaulted them forfeited their right to complain. What a bull**** argument, weak and cowardly.

COCA did put LMU on Heightened monitoring for once.

I said “meaningful action.” They put LMU on heightened monitoring but then allowed them to start a branch campus they 100% do not have rotation sites for.

Yeah, let's just wait until hundreds of other students are affected first and make posts like these to enable these kinds of problems and their persistence.

Hate to break it to you but there already are.

 

[CoomassieBlue57]

Hold up, it's 2019 and you're presumably born around the same time as me and you can't find a way to anonymously name and shame on a forum? Don't we have a confidential subforum on SDN now? This is ridiculous. As a third year, you don't quite have an idea how much your school is screwing you over yet. 4th year, when you start going to VSAS away rotations with the intentions of impressing programs, you're going to be in for a world of hurt. Help your future colleagues out and help yourself out by at least having one rotation with residents during third year. Your residency prospects literally depend on it.

I’ll add that in addition to VSAS away rotations, I have been on interviews where I’ve been asked questions about the quality of my rotations and to provide specific examples where I’ve worked with residents.

 

[sab3156]

My advice is that more than one person has to stand up and take action.

Otherwise, and I am using my words VERY carefully here, they are in the same position as the women who were assaulted by Harvey Weinstein, and did nothing because of the fear for their careers. What's more important here?

You are also ignoring the fact that a student who complains and gets they retaliation that you're afraid of will be at risk of not getting a residency anyway.

Because I guarantee you that the school will continue to do this until caught, and the students will have their careers jeopardized anyway, due to the substandard clinical training they'll be getting. And this bleeds out onto the profession as a whole. ALL DO grads will be damned on the reputation of this school.

Anyone who doesn't raise a voice in this forfeits their right to complain about COCA and the flaws of the profession.

Stop telling people to die as martyrs. You don't know what you're talking about. You aren't even an attorney and the OP isn't your client. Stop giving out half baked legal advice.

 

[Ho0v-man]

My advice is that more than one person has to stand up and take action.

Otherwise, and I am using my words VERY carefully here, they are in the same position as the women who were assaulted by Harvey Weinstein, and did nothing because of the fear for their careers. What's more important here?

You are also ignoring the fact that a student who complains and gets they retaliation that you're afraid of will be at risk of not getting a residency anyway.

Because I guarantee you that the school will continue to do this until caught, and the students will have their careers jeopardized anyway, due to the substandard clinical training they'll be getting. And this bleeds out onto the profession as a whole. ALL DO grads will be damned on the reputation of this school.

Anyone who doesn't raise a voice in this forfeits their right to complain about COCA and the flaws of the profession.

I think we need to have some campaign that we can launch calling out this nonsense after we’re done with school but I agree with above that you’re giving really bad advice. We don’t have any power until the day after we graduate. Until then they can literally ruin our futures on a whim and cute that it’s because we were unprofessional in some way.

 

[Sephirakra]

Stop telling people to die as martyrs. You don't know what you're talking about. You aren't even an attorney and the OP isn't your client. Stop giving out half baked legal advice.

At least Goro's taking a position here. All we've seen from you is complaining. Oh, and condescendingly explaining other people's half-baked ideas.

OP, put up or shut up. Take your stand or let it go.

 

[alprazoslam]

Still no name of school not like they gonna find out who you are on SDN

 

[Whysoez]

Still no name of school not like they gonna find out who you are on SDN

Second this

 

[alprazoslam]

Second this

Yeah if op doesn’t ball up this might just be as worthy as a troll post

“xyz sucks but I won’t tell you what xyz is”

 

[BorntobeDO?]

COCA did put LMU on Heightened monitoring for once.

And michican state after nassar

 

[BorntobeDO?]

Stop telling people to die as martyrs. You don't know what you're talking about. You aren't even an attorney and the OP isn't your client. Stop giving out half baked legal advice.

Whistleblowers almost always get fired, and it takes years to recover damages. I would not advise a student to martyr themselves over something like this.

This is not sexual assault or rape and to compare it to that is really doing a disservice. So what if you don't rotate with a resident automatically, put on the big boy/girl pants and set it up if its that important to you. Or fill out the surveys they are required to give at end of rotations and check no for the working with resident. Thats my advice.

Ironically enough if this situation was anything like harvey Weinstein the student would have a much better chance of success under title 9.

 

[Whysoez]

Yeah if op doesn’t ball up this might just be as worthy as a troll post

“xyz sucks but I won’t tell you what xyz is”

The least OP can do now is drop the name so DO applicants like myself can avoid the school.

 

[concerned_student]

This is not a "troll" post.

My hope was to seek advice about the process of reporting and to see if others have previously filed a compliant using the COCA reporting process. Retaliation is a very real and prominent threat as many have pointed out. I appreciate the thoughts and advice members have provided. It is (sadly) comforting to know that my classmates and I are not alone in having to deal with (what I feel are) non-compliant rotations.

In addition, this post should not be a witch hunt. I understand the want for a "name drop", but no further information will be shared. Doing so is not in the interest me and/or others should a compliant be filed and returned without finding. Any reporting will be conducted using the proper process.