ACGME/AOA merger and how it affects future DO Ob/Gyn residents

[imasadpanda]

It is probably too soon for anyone to tell, but I have a few questions/concerns about the recent merger.

I am a third year medical student getting ready to set up my auditions and was planning on going the DO route for my residency. I am, for the most part, in agreement with the merger. However, with the merger and AOA accreditation ceasing to exist in 5 years, I have concerns about the accreditation of my future osteopathic residency program, wherever it may be.

Do any medical students, residents, physicians, or program directors have any input on this? Are many programs planning on applying for ACGME accreditation in the near future? Or do the majority not currently meet ACGME requirements? Is ACGME altering their requirements for osteopathic residencies since many of them are not located at huge city hospitals?

Any input would be appreciated. Thank you!

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[Biology101]

This is such a "in the air" topic.

My thoughts are that it is going to be a rough 5 years for DO programs. They have to invest alot of time and money into bring their "level" up to that of ACGME standards. I think that some programs are really going to be strained. I have been following the forum chats on ACOOG and they are not very happy on there.

I asked a few people why it was so difficult for DO residency trained OBGYNs to apply for and get fellowships, and the answer I got....? The DO programs did not match their MD counterparts. Yes they may make excellent "bread and butter" OBGYNs, but they do not have the volume of a research university. Ultimetly this is going to be a good thing, but I think that it comes at a really bad time for current DO students wanting to do OBGYN at AOA institutions.

Just my thoughts

 

[anonperson]

The majority of osteopathic OB GYN residencies do not adequately train their residents to the extent of an allopathic OB GYN residency. There are a few that make the grade but this is the exception not the rule.

My take is that a fair amount of these osteopathic residencies will struggle to meet the requirements and will probably shut down, which is good. No point in training sub par physicians. Anecdotally, there is an osteopathic OB GYN residency down the road has 1-2 residents a year. Their main "teaching" hospital does not handle deliveries before 36 weeks so they have to go to a surrounding hospital to get high risk OB experience. Their GYN experience is similarly limited yet this program continues to graduate residents each year. And this is coming from someone getting trained at a relatively unknown community program in a suburban/rural area. My program is run of the mill and the training we get is overall pretty good but that is because the program is held to strict guidelines by a larger organization.

 

[imasadpanda]

Yeah I have also been following the ACOOG forum and some don't seem so happy but some view it is an opportunity.

I have the same thoughts/concerns about the osteopathic programs struggling to meet ACGME requirements but ultimately I think the merger was a good thing for standardizing medical education and opening up possibilities for D.O.'s in the future. I also think that there are some really great, quality AOA OB/GYN programs that are underrated and my hope is that this merger will weed out the quality programs from the not-so-great ones.

I fall into that category of "DO students wanting to do OBGYN at AOA institutions". I didn't take the USMLE....sooooooooo....yep. I'm not really sure what to do at this point. It's kind of impossible to predict which programs are going to apply for and meet ACGME accreditation requirements, but also relatively unfeasible for me to schedule a step 1 exam at this point in my medical career. Additionally, I WANT to do an osteopathic residency, so taking the USMLE isn't going to benefit me anyways. Applying for an AOA residency at this point in the game is a leap of faith I suppose

 

[Kabe21]

I keep seeing people say they need to do an AOA residency because they didn't take the USMLE. This is just not true. There are a LOT of ACGME programs that interview and rank applicants with only COMLEX scores. It is program specific, but many Ob/Gyn programs are very DO-friendly. Having the USMLE (Specifically having decent scores) is an advantage and a boost to your application but it is absolutely not a deal breaker. Doing well on the COMLEX is sufficient for many programs. Additionally, if you didn't take Step 1 and think it would be advantageous to you, you can always just take Step 2 so that you can show a USMLE score that is even more easily comparable to other candidates. Talk to residents, talk to programs, check out program websites, and look at FRIEDA to get information about specific programs. FRIEDA specifically answers "Do you take the COMLEX" and "Minimum COMLEX score". Don't settle for subpar residency programs or ones that you don't prefer just because you think it is the best you can do.

 

[imasadpanda]

I don't necessarily think that AOA residencies are sub-par. Some of them, maybe, but certainly not all. More options with ACGME would be nice though.

Is that FRIEDA feature relatively new? I have never seen it before, but it is pretty helpful! Thanks for letting me know of such a handy feature.

I've been debating on taking USMLE Step 2. I'm on the fence about it because I wasn't really sure how much it will help my application for ACGME without Step 1. What do you consider doing well on the COMLEX? With the FRIEDA feature, I saw some programs say >500 while others >550.

Another issue when it comes to choosing whether to do an AOA match vs an ACGME match is that the AOA match is first. If you match AOA, then you're dropped from the ACGME match from what I understand. In order to match ACGME, you have to forego the AOA match. It's s scary thing to do when you don't have a USMLE score in your pocket. I'm not saying I'm not brave enough to do it, but I want to be practical. Plus there are several AOA residencies I have heard great things about. I had absolutely no issue in doing an AOA match until this merger and I realized that some programs would no longer be accredited or shut down. I'm in a tough spot.

I suppose this is more of a newb question, but if I chose to do an AOA match and only ranked my top choices and didn't match, I could still then match ACGME, correct?

 

[Biology101]

yup

 

[DermViser]

The majority of osteopathic OB GYN residencies do not adequately train their residents to the extent of an allopathic OB GYN residency. There are a few that make the grade but this is the exception not the rule.

My take is that a fair amount of these osteopathic residencies will struggle to meet the requirements and will probably shut down, which is good. No point in training sub par physicians. Anecdotally, there is an osteopathic OB GYN residency down the road has 1-2 residents a year. Their main "teaching" hospital does not handle deliveries before 36 weeks so they have to go to a surrounding hospital to get high risk OB experience. Their GYN experience is similarly limited yet this program continues to graduate residents each year. And this is coming from someone getting trained at a relatively unknown community program in a suburban/rural area. My program is run of the mill and the training we get is overall pretty good but that is because the program is held to strict guidelines by a larger organization.

You mean don't adequately train with regards to volume?

 

[anonperson]

You mean don't adequately train with regards to volume?

The volume at a fair amount of these programs is ridiculously low so residents are not only missing a fair amount of bread and butter stuff (routine deliveries, routine c sections) but then also more complex things that a generalist should be able to handle (classical C section on a preterm infant, post op complications, minimally invasive hysterectomy approaches etc)

 

[DermViser]

The volume at a fair amount of these programs is ridiculously low so residents are not only missing a fair amount of bread and butter stuff (routine deliveries, routine c sections) but then also more complex things that a generalist should be able to handle (classical C section on a preterm infant, post op complications, minimally invasive hysterectomy approaches etc)

So is the lifestyle much better at these programs then?

 

[anonperson]

So is the lifestyle much better at these programs then?

That I can't specifically comment to. It makes sense it would have a better lifestyle.

But if you ask anyone in an OB residency, they always claim their residency is very busy even if that's not the case.

 

[Miasolo84]

I really wish people would do their research before spewing "facts". ACGME is just going to be the umbrella under which all programs will fall. ALL programs will have to meet the new standards that are set forth and be put thru a certifying system to get accreditation by ACGME. The only programs that probably wont go thru the hassel are dually accredited programs. So whether MD or DO, if a program does not meet the new standards set forth by the new system under ACGME then they will not be accredited.

 

[Junkster]

I trained in an AOA program and just graduated. When I was on my job interviews, my number of deliveries and procedures were on par with any program, AOA or ACGME. Some were even impressed at how many gyn procedures I'd performed. If you ask me what my program's shortcoming was, I'd say research and academic teaching. And speaking with classmates who went to ACGME and military OBGYN training programs, my clinical training was on par.

I do think the merger is a good thing in terms of standardizing training received by all OBGYNs, DO or MD. I hope the standardization will improve many of the programs that are falling short of what should be the minimum. The program I was training at has already started to increase emphasize academic and research time starting last year and I believe it was a huge improvement in our learning experience.

In general, this could be a good "weeding out" process in the long run to either improve programs or liquidate programs that cannot improve sufficiently.

 

[Mad Jack]

I really wish people would do their research before spewing "facts". ACGME is just going to be the umbrella under which all programs will fall. ALL programs will have to meet the new standards that are set forth and be put thru a certifying system to get accreditation by ACGME. The only programs that probably wont go thru the hassel are dually accredited programs. So whether MD or DO, if a program does not meet the new standards set forth by the new system under ACGME then they will not be accredited.

The MD programs all already meet the standards, as such was required for them to be accredited in the first place. That is why this is mainly an issue for osteopathic programs, which have been held to a lower standard for basically ever, since the goals of many smaller AOA programs (train community physicians) are not the same as those of ACGME programs (train Swiss army knife physicians that can work in any environment their specialty offers competently).

 

[Junkster]

I was curious and looked up ACGME probations or withdrawn programs in the past few years.

https://www.acgme.org/ads/public

There was a few programs I wasn't surprised in failing to meet standards. One of the programs on probation in the past year in particular was known to be substandard since the last approval.