What is the difference between accredited versus non accredited residency?

[Frozen]

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From what I understand: a non-accredited program = you cannot sit for the specialty board certification exam (ACGME)?

How does this work for combined residencies (ie IM/PEDs, IM/EM)? From what I see most of them are non-accredited...

How does this work for fellowships?

Thank you for your help in advance.

Frozen

 

[Smurfette]

1. non accredited means non-ACGME, so you cannot sit for the boards (ABMS specialties)

2. I believe (others can correct me if I am wrong) that combined programs will enable you to sit for the respective boards, but you have to fulfill the specific requirements of the given board you are applying for (i.e. the correct number of weeks of the required rotations). Thus for med-peds, you'd have to fulfill the minimum peds and/or the minimum IM requirements to be eligible to sit for the boards. I would think that they automatically fulfill the criteria, especially as most people end up picking one over the other, but if not, this may mean that you need to use some elective time to get more time on one or the other specialty (?). This is a better question for those in a combined residency program as I am speculating on this detail....However, I've NEVER heard that combined programs are board ineligible. It would defeat the purpose of the training in the first place.

3. A non-ACGME accredited residency *could* severely affect your ability to get a fellowship. Many fellowships only want a board eligible person, and coming from a non-ACGME program, one would not meet this criteria. And fellowship PDs want you to sit for the specialty boards, which means you need to pass the initial (IM, peds, GS, etc.) boards as well. This is not as likely to be a problem with non-ACGME fellowships, but as I said, you still would not be board eligible....if you put in that much time and effort, get something in return. Patients are savvy and can look up your credentials. They know BC status is important.

4. The biggest problem with a nonACGME residency is that you can't be boarded....and most employers and hospitals are now requiring board eligibility and/or certification to maintain privileges. Some insurance payors also want BE/BC status to get you on their plans. No privileges or no insurance coverage means you are not employable.

 

[Ludicolo]

From what I understand: a non-accredited program = you cannot sit for the specialty board certification exam (ACGME)?

Correct.

How does this work for combined residencies (ie IM/PEDs, IM/EM)? From what I see most of them are non-accredited...

Each half of the combined program is accredited separately by their own respective specialty review committee. Upon completion of a combined residency program, you are eligible to sit for two certification exams, i.e. become dual boarded.

To address Smurfette's concern: the duration of a combined program is longer (usually by one year) than either individual specialty residency. This allows residents to complete the minimum requirements for each respective specialty, without burning elective time.

How does this work for fellowships?

In the eyes of the ACGME, fellowships are simply advanced residencies. Someone starting an IM subspecialty fellowship straight out of residency, for example, would simply be considered a PGY-4 "resident".

Some fellowships are accredited. Some aren't. Accreditation allows you to sit for the respective subspecialty board. Same rules apply.

 

[group_theory]

Just further clarification - All Med/Peds programs are accredited. It has its own RRC along with input from the Internal Medicine RRC and Pediatrics RRC. This seperate ACGME accreditation (for Med/Peds) was started in 2007.

Prior to 2007, the Med/Peds program needed specific approval from each specialty board (ABP, ABIM) in order to operate. Now the requirements from the ABP and ABIM is that the Med/Peds program must be ACGME accredited.

The other combined programs (FM/IM, IM/EM, EM/PD, Psych/Child Psych/PD, PD/PMR, etc) aren't yet accredited on their own (and so each program must receive permission from each specialty board as well as permission from the respective ACGME RRCs prior to operating. The ACGME has plans to accredit the rest of the Combined Residencies but with the lack of numbers, not sure what the final plan entails. Med-Peds was easy since it was such a large group and already firmly established.

 

[NotAProgDirector]

Group Therapy is correct.

Except for Med/Peds, no combined residency is officially "accredited" because there is no accrediation for combined residencies. Hence, as long as each half of the combined residency is accredited, you'll be able to sit for both boards.

Actually, most combined residencies are SHORTER than doing two tandem residencies. This is because the elective time built into the residencies can be "double counted", and because many of the skills learned overlap. Usually a combined program is one year shorter than both individual, but it depends. Med/Peds is 4 years, which is 2 years shorter than both individually.