4 things to know about Osteopathic Recognition

One part of the transition to the single GME accreditation system was the inclusion of a new programmatic designation—Osteopathic Recognition—for ACGME-accredited residency and fellowship programs that provide education in osteopathic principles and practice. Currently, 233 programs have received Osteopathic Recognition in 24 specialties and subspecialties.

Below is a deeper dive into what it means for programs to have Osteopathic Recognition, which programs are obtaining it, and how program directors can receive assistance in getting it.

1. More residency programs—including historically ACGME-accredited programs—are obtaining Osteopathic Recognition.

15% of the 233 residency and fellowship programs that currently have Osteopathic Recognition are historically ACGME-accredited.

So far, residency programs in 24 specialties and subspecialties have obtained Osteopathic Recognition.

2. Residency programs with Osteopathic Recognition have a demonstrated commitment to osteopathic education.

Programs with Osteopathic Recognition integrate osteopathic education into nearly every aspect of training, notes Marita Powell, DO, the director of osteopathic education responsible for the osteopathic curriculum for the family medicine and internal medicine residency programs at United Health Services Wilson Regional Medical Center in Johnson City, New York.

Dr. Powell’s programs, which had been dually accredited by both AOA and ACGME since 1995, were among the first to obtain Osteopathic Recognition in 2015.

“Osteopathic Recognition is a way to make sure trainees can continue learning osteopathically at the GME level,” says Dr. Powell, who is also a consultant with the AOA’s Application Assistance Program. “When a DO has osteopathic training throughout both medical school and residency, there’s a through line to their training, and it helps cement a DO’s knowledge of both OMM and the osteopathic philosophy, so they’re more likely to maintain these skills throughout their career.”

The requirements for Osteopathic Recognition listed below illustrate some of the ways the osteopathic philosophy is integrated into training:

• Programs must integrate osteopathic principles and practice (OPP) into the six ACGME competency areas and formally evaluate residents’ performance in the application of OPP in each of the core competencies.
• Programs must create an osteopathic learning environment through longitudinal and focused educational experiences, which can include seeing patients in an osteopathic/OMT clinic and completing osteopathic didactics/labs.
• Programs must appoint a director of osteopathic education (DOE), who oversees and directs the Osteopathic Recognition curriculum and assessments.
• Programs must also have at least one additional qualified core osteopathic faculty member, in addition to the DOE, who is willing to lead and train the next generation of physicians in osteopathic principles.

Justin Stumph, DO, a third-year chief resident in the osteopathically recognized family medicine residency program at the Cleveland Clinic’s Center for Family Medicine, says he can see the ways Osteopathic Recognition has enhanced his GME training.

“The osteopathic philosophy is incorporated into much of what we do, from the admitting process to outpatient appointments to day-to-day office visits,” he says. “I love that we incorporate osteopathic manipulative treatment into our day-to-day office visits. That’s the way I want to practice after residency.”

3. Students want Osteopathic Recognition.

Roughly 71% of third-year DO students said they would prefer a residency program with Osteopathic Recognition, according to a 2015 AACOM survey.

“When you have Osteopathic Recognition, you’re showing potential residents that you have an extra specialty that you can teach them,” Dr. Powell says. “You can become a good doctor in almost any residency program, but not every program will give you in-depth osteopathic training.”

Sandra Snyder, DO, program director of the Cleveland Clinic’s family medicine residency program, has seen an exponential increase in applications from both DOs and MDs in the last decade, she says. The numbers began rising dramatically after 2009, when the historically ACGME program earned dual accreditation. They continued climbing after the program obtained Osteopathic Recognition in 2015.

Although Dr. Snyder attributes some of the jump in DO candidates to a new osteopathic medical school campus nearby that just graduated its first class of 40 students, she believes the majority of the increase in applicants is due to interest–from DO and MD candidates–in a program with a strong focus on osteopathic training.

“In 2009, we received about 30 applications from DOs,” she says. “Last year, we had almost 300 applications from DOs. On the MD side, we’ve gone from 65 applications in 2009 to almost 120 last year. We’re seeing these increases because we have this neat osteopathic environment that really embraces holistic family medicine.”

Dr. Stumph, a third-year resident in Dr. Snyder’s program, says he sought out programs with Osteopathic Recognition when he was applying to residency three years ago, even though there weren’t many programs with the designation at the time.

“It was something I was looking for in a program,” he says. “Because I knew I wanted to continue my osteopathic education in my GME.”

Kelly Raj, DO, the program’s director of osteopathic education, notes that all of the program’s DO and MD residents participate in the osteopathic aspect of the program. In fact, the option to learn osteopathic manipulative medicine and osteopathic concepts is a draw for many of the program’s MD residents, who take an onboarding course prior to starting residency to become more familiar with them, she says.

“We have an MD graduate who is now a geriatrician,” she says. “Many of her patients live in nursing homes. She said OMT is essential to her care of these patients because it allows her to treat their pain without prescribing drugs.”

4. Programs can get free assistance with applying for Osteopathic Recognition.

After a few unsuccessful attempts at applying for Osteopathic Recognition, Andrew Posey, DO, the director of osteopathic education of the Cahaba Family Medicine Residency Program in Birmingham, Alabama, contacted the AOA’s Application Assistance Program and began working with Marita Powell, DO, who obtained Osteopathic Recognition for her program in 2015.

“I’m new to academia,” he notes. “I was less familiar with the ACGME milestones and core competencies, and at the start of this process, I didn’t have a lot of admin time to work on the application.”

After working with Dr. Powell and Tiffany Moss, MBA, executive director of osteopathic accreditation at ACGME, Dr. Posey’s program earned Osteopathic Recognition this spring. Dr. Posey credits the success, in part, to their help.

“Dr. Powell provided me with some of the materials she used, and we were able to implement them in our own way,” he says. “It helped us not have to reinvent the wheel when we were creating evaluation materials, commitment letters and block rotation diagrams.”

Programs often don’t realize that they already have many of the elements in place that they need to obtain OR, Dr. Posey says.

“Part of getting OR was clearly explaining to the ACGME committee what we were already doing,” he says. “In previous applications, I hadn’t clearly described and explained those things. With the insight I got from Marita and Tiffany, I was able to describe our program in the language that the ACGME wanted me to use.”

Dr. Posey says he wishes he had reached out to the AOA’s Application Assistance Program sooner.

“It’s a great resource, and the AOA covered the cost of our consultant,” he says. “That was really helpful because we don’t have a big budget for that.”

Programs interested in working with the AOA’s Application Assistance Program can contact the AOA GME team at singlegme@osteopathic.org.