Citing concerns that a memorandum of understanding issued by the Accreditation Council for Graduate Medical Education (ACGME) did not sufficiently recognize the osteopathic medical profession’s core principles, AOA Trustee Boyd R. Buser, DO, announced yesterday that the AOA and the American Association of Colleges of Osteopathic Medicine (AACOM) face barriers to unifying GME accreditation and have been unsuccessful thus far in reaching an agreement with the ACGME.
Nevertheless, the AOA and AACOM will continue negotiating with the ACGME, he said.
To safeguard the profession during the continuing negotiations, the AOA House of Delegates today approved a policy stating that any unified GME accreditation system “protect and preserve the unique distinctiveness of osteopathic medicine, osteopathic medical education, COMLEX-USA, osteopathic board certification, osteopathic divisional societies, osteopathic specialty affiliates, the AOA and the osteopathic medical profession.”
The new policy also calls on the AOA to work toward developing AOA-approved subspecialty fellowships in case negotiations with the ACGME remain unsuccessful.
The resolution, one of several that address the ACGME issue, reflects perceptions that the AOA has not solicited sufficient feedback on the proposed unification, as well as concerns that negotiations with the ACGME have not been transparent.
The Florida Osteopathic Medical Association (FOMA), which submitted the resolution, broached several potential consequences of unification, including increased costs to osteopathic programs in instituting ACGME standards and loss of training opportunities for DOs if MDs are allowed into OGME programs.
“People in our state were asking questions that nobody seemed to be able to answer,” said FOMA President Gregory J. James, DO, MPH, before the House meeting began. “With the little bit of information we’ve been given, there has been a lot of concern that the proposed unification could potentially lead to a takeover of the DO profession by the MD profession.
“There has been almost no transparency in this process other than reports that the AOA, AACOM and the ACGME are moving forward with unification.”
During an AOA town hall meeting Thursday night, Dr. Buser and AOA Executive Director John B. Crosby, JD, explained that confidentiality agreements prevented them from disclosing the details of negotiations with the ACGME.
To keep the profession apprised of developments to the extent allowed, Crosby previously discussed the unification plan in The DO in videos posted in March and October 2012 and in his December 2012 column.
Dr. Buser, who represented the AOA in negotiations with the ACGME, explained the reasoning behind the move toward unification in the December 2012 issue of The Journal of the American Osteopathic Association.
If the AOA, AACOM and the ACGME do not agree on a unified accreditation system, the originally proposed change to the ACGME’s common program requirements could go into effect. Per this proposal, ACGME-accredited programs in all specialties will be barred from recognizing previously completed OGME.
The change would primarily affect DOs who pursue ACGME-accredited fellowships after completing AOA-approved residencies. The proposal would also have an impact on DOs in traditional rotating internships who plan to enter ACGME residencies that require a transitional year. DOs would still be able to match into ACGME residencies from their fourth year of medical school.
During an AOA Board of Trustees’ reference committee meeting before the House convened, Jeffrey S. Grove, DO, questioned whether the number of DOs that would be affected by the ACGME’s original proposal is large enough to justify a sweeping overhaul of GME accreditation.
“How many people do osteopathic residencies and then go on and do allopathic fellowships?” asked Dr. Grove, the president of the American College of Osteopathic Family Physicians (ACOFP), which submitted a resolution resembling FOMA’s. “We believe that number to be 250 people or less. So we are jeopardizing the profession for that segment of people.”
Speaking as a member of the Pennsylvania Osteopathic Medical Association, which submitted one of the resolutions on unified GME accreditation, Carol L. Henwood, DO, stressed that the osteopathic medical profession should identify the specific ACGME subspecialty fellowships that osteopathically trained residents are pursuing. “If we need more of these training programs, it is the responsibility of organized medicine to create them,” she said at the AOA Board reference committee meeting.
“What better place to invest capital than in programs that make future members?” agreed Joseph P. McNerney, DO, of Michigan.