AOA, AACOM, and the ACGME agree to unified accreditation system

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I am curious to see how many MD's apply to D.O. post-grad spots, and what their success rates will be for competitive spots like Ortho.
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wjs010 said:
I've also seen people say the exact opposite, like the majority of programs won't make it on time, and they will be slow to convert. I'm wondering if anyone actually knows lol.
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No one knows. It just happens that people are usually slow to change, so programs getting organized and applying for pre-accreditation might be delayed. That said, there will probably be a rush in the beginning, a trickle after that, and then another mad rush the last 2 years, but this is all speculation. A lot of it is program dependant.

People say that MDs have tons of research compared to DOs, and I'm sure on average they do, but the average DO is going into primary care (close to 50%) and the average MD is not (close to 25% go to primary care). I still think the people at the top of the DO side have crazy credentials. I know a lot of fellow classmates participating in research projects this summer, in spite of my school having essentially zero research opportunities. Even I have 5 abstracts/publications from before med school across 4 research experiences. I also noticed that the DOs who match ACGME (match stats/charting outcomes) have comparable or slightly lower (within 1-2 research experiences/publications) research, ECs, volunteering, etc. than their MD counterparts in the same field. I know they are usually the upper 50%, but they are still 55% of DOs. If they can get research experiences similar to MD students, in spite of a lack of opportunities at their COM then so can most DOs.

I think the disparity in this regard is a bit overstated, and I'd like to see what actually happens.
 
Law2Doc said:
Yes, that will change. Nobody wants to be the bottom of the barrel, and so programs will change their approaches when they get put in the same barrel. And to some extent you emphasize that which you can get, so research becomes more important when a bigger chunk if your applicants have some.

Yes more access to residencies opens more options in theory, but if you needed the benefit of an osteo only residency to limit competition and get a slot, you are hosed. So I'd bet (and the allo leadership is betting on this too or they wouldn't have made it a sticking point in the deal)there will be a net loss of competitive slots to osteo grads. But probably more noncompetitive allo slots that otherwise might have gone to foreign grads. This was understandably a tough issue for osteo leadership to stomach, and part of the reason they had to initially leave the negotiating table and ultimately cave on this issue.
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I've read your posts and I will tell you that you make a good argument. I completely agree with you that there will be sacrifices made both from DO competitive slots and mid-low competitive ACGME slots.

However, I don't believe the shift will occur instantly in 2015 which will allow a couple of more years for these DO students to grab some competitive slots while they can. However, there will be a stronger focus on the DO side to augment research opportunities when in 2020 (or close to it) the entire match is unified and there are no AOA-only spots in existence. Competitive DO students will demand it.

But in looking at the "big picture" I do believe the merger is the first step in revamping the DO GME which will help more DO integration into academic programs and positions, and in turn revamp the research and clinical affiliations of the osteopathic undergraduate schools themselves. There will be collateral damage throughout this whole process, it's an inevitable unfornutate reality, but the end net result will be beneficial years down the line.
 
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KGflyboy said:
I think they MDs will be eligible for the old AOA residencies as soon as they are granted ACGME accreditation in 2015. Unless the plan gets delayed, your class will not be the first with MD applicants eligible for osteopathic residencies. However, like you said, we can only guess about how many programs take MDs from the start. I too am curious.
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from my understanding they will be granted preliminary accreditation starting 2015, then must be in full compliance within 5 years. or am I wrong?
 
wjs010 said:
I've also seen people say the exact opposite, like the majority of programs won't make it on time, and they will be slow to convert. I'm wondering if anyone actually knows lol.
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That is not how the merger is set up. All AOA programs will be accredited in 2015... as of the plan now. There is nothing to make on time. It is happening by default. They don't have to meet ACGME standards right away, so none of the programs will be left out.
 
KGflyboy said:
That is not how the merger is set up. All AOA programs will be accredited in 2015... as of the plan now. There is nothing to make on time. It is happening by default. They don't have to meet ACGME standards right away, so none of the programs will be left out.
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Could someone back this up? The email from the AOA was a little confusing. It sounded like , in 2015, the "transitioning" period would happen and would last until 2020, "at which point" the ones who didn't meet the standards would be dropped. Am I wrong in thinking this?
 
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TexasDocGibby said:
Just FYI:
The AOA and the American Association of Colleges of Osteopathic Medicine (AACOM) will host a town hall for osteopathic medical students and interns/residents to provide more information and answer any questions on the single GME accreditation system. It's tonight 7:00 P.M. Central.

https://cc.readytalk.com/cc/s/registrations/new?cid=26hb0k6paykl
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I suspect it will be just like the last one. No real information, just spin from carefully preselected questions.
 
DrBowtie said:
I suspect it will be just like the last one. No real information, just spin from carefully preselected questions.
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Very true, but I also thought I would never see a merger anytime soon...
 
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Dear WJW010 and KGFlyboy,

http://www.aacom.org/news/latest/Old%20Docs%20Not%20Searchable/AACOMgmeFAQs-OLD.pdf
"What will happen to the osteopathic training programs? If negotiations are successful, as of July 2015, all osteopathic training programs will automatically be deemed accredited by ACGME. And as occurred in the osteopathic accreditation process, with the next inspection all programs will need to meet the same requirements. "
 
DrBowtie said:
I suspect it will be just like the last one. No real information, just spin from carefully preselected questions.
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Well I was on the last one sending in question after question that was screened out.

But then I had a good PM convo on here with the moderator. I severely doubt the AOA executive who is moderating this one will personally address me afterwards... but I also think that there is a *chance* for less double talk in this town hall meeting.

There will be double talk, dont get me wrong. But I can chalk a lot of the double talk last time to the AOA being in a position of weakness and unable to lean on anything except "we were defending osteopathic pride" as a take home point. +/- the fear that saying things that were considered semi-confidential might harm their ability to go back to the negotiating table... they had a good reason for the double talk. I hated it, because I feel like being honest about what you did and did not do; what goals you made and which you missed, is an admirable thing to state. But now they have things much more "settled" so maybe they can be more straight forward.

Expect spin. But also expect more concrete (rather than rhetoric) answers.
 
DocEspana said:
Well I was on the last one sending in question after question that was screened out.

But then I had a good PM convo on here with the moderator. I severely doubt the AOA executive who is moderating this one will personally address me afterwards... but I also think that there is a *chance* for less double talk in this town hall meeting.

There will be double talk, dont get me wrong. But I can chalk a lot of the double talk last time to the AOA being in a position of weakness and unable to lean on anything except "we were defending osteopathic pride" as a take home point. +/- the fear that saying things that were considered semi-confidential might harm their ability to go back to the negotiating table... they had a good reason for the double talk. I hated it, because I feel like being honest about what you did and did not do; what goals you made and which you missed, is an admirable thing to state. But now they have things much more "settled" so maybe they can be more straight forward.

Expect spin. But also expect more concrete (rather than rhetoric) answers.
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Agree but there are certain things that I'd like to know:

1. What is different about this agreement than the previously offered deal?

2. What are the exact requirements for MDs to enter the previous DO residencies? If the goal is for true GME equality, I hope the barrier to entry is low and the curriculum can run concurrent during residency.

As we saw with the previous talks the AOA version and the ACGME version can be quite different so I'm waiting for details to emerge from both sides.
 
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What I am interested in knowing is that now since it is merged, do we have to take usmle to apply at any acgme only residencies?
 
Just remember, the guy moderating this deal is the same person who when talking about unified accreditation said, "This is one step towards DOs taking over the world," at the last town hall meeting on this topic.

There will be spin. There always is. The truth will lie in the middle.
 
Pisiform said:
What I am interested in knowing is that now since it is merged, do we have to take usmle to apply at any acgme only residencies?
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This agreement does nothing to change how DOs will be viewed by traditionally MD programs. Nothing at all. Some of those programs will still require the USMLE just as they do now, or at least, strongly suggest it.
 
DO3 said:
This agreement does nothing to change how DOs will be viewed by traditionally MD programs. Nothing at all. Some of those programs will still require the USMLE just as they do now, or at least, strongly suggest it.
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Wow that's not fair in short-term since MD students I guess can apply to AOA residencies. So the only immediate benefit to us is that we can do acgme fellowship even if we had aoa residency which wasn't possible before?
 
I wonder how many of the AOA competitive residencies will just completely defect to the ACGME world. For example, I can imagine in fields like ENT or Neurosurgery the PD might not care too much about being an residency that meets the requirements for having "osteopathic principles" once ACGME accreditation comes through in 2015. This would immediately open up these residencies for MD applicants without additional OMM requirements.
 
Okay, it's ten till. Forget the cheesy music. Where are the drinks?
 
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Pisiform said:
Wow that's not fair in short-term since MD students I guess can apply to AOA residencies. So the only immediate benefit to us is that we can do acgme fellowship even if we had aoa residency which wasn't possible before?
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Bingo. The agreement does nothing but maintain the status quo for DOs. It was a response to the ACGME's new proposed common program requirements that would have prevented DOs who do a DO TRI or residency from applying to ACGME residencies and fellowships. With this agreement, things stay as they are for us.
 
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8:13 Original MOU rejected by the AOA for "lack of clarity," ultimately ACGME sent letter clarifying some aspects and AOA accepted the new MOU.
 
Being July 1st, 2015, AOA programs will receive "pre-accreditation" status from the ACGME and have until 2020 to apply and finish accreditation.

AOA certified DOs will not automatically qualify as program directors, but may do so on case to case basis (?). Some programs may require co-director certified by ABMS.
 
Just focusing on info we haven't heard yet.

AOA programs can reapply for ACGME accreditation as many time as needed without repaying application fee.

MD can enter DO programs after additional "education and training." He seemed to imply that certain fields will require more than others. If you're an MD who wants to do OMM residency, it may require more.

ACGME will NOT deny accreditation to programs based on hospital/program size.
 
Wolverines83 said:
so these programs that have "pre-accredidation" (all AOA programs I guess?) will be participating in which match?
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No word on that yet.

EDIT: "Highly likely" single match coming, but "not going to happen overnight." Will begin working on this now as we move towards transition. Not easy, but going to happen eventually.
 
8:26 COMLEX can't go away as a requirement because state medical boards require it as well as all the COMs for osteopathic physicians. The ACGME will drop the new requirement for residents to complete USMLE to do fellowships. Blah blah blah, lots of spin. "We anticipate that the merger will help increase acceptance of COMLEX among program directors."
 
8:34 Change is hard, but this is good for our profession. Question time.
 
"How will this merger effect DO students going into competitive specialties?"

A: Our access to competitive fields in the ACGME has been limited in the past...hopefully this merger is going to bring wider acceptance of osteopathic graduates among PDs.

Pre-accreditation question for current AOA residents:

A: All residents even from pre-accreditation programs will be able to do ACGME fellowships.

Students wondering about taking USMLE, single match, etc:

A: Nothing has changed as of today, still programs who will prefer to see USMLE, students who want to go to these programs should still take USMLE! However, PDs should be increasing their acceptance of COMLEX. Not overnight change, but sees signs already of moving in this direction already. There's no way to make a prediction about unified match at this time. There are contractual relationships, etc, tons of work to do, but we will be working towards that. (It doesn't sound like pre-accreditation in 2015 is going to mean an instant single match.)

Board certification question for current residents that I missed, sorry. He mentioned something about current residents still taking AOA board certification.

After transition, state licensing boards with the weird AOA TRI requirements for DOs will likely drop them since everyone will be under the same system.

In the immediate term, new/potential programs may be more likely to pursue ACGME since they will have to transition soon anyway. But osteopathic schools are reporting that the announcement is causing surge of interest since programs know they will soon be able to accept MDs and DOs.

Closing remarks.
 
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Wolverines83 said:
so these programs that have "pre-accredidation" (all AOA programs I guess?) will be participating in which match?
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But he also said that AOA programs will continue to be accredited by the AOA until 2020 or until they apply for ACGME accreditation. I brought this up in the other thread, to me it sounds like as AOA programs apply for ACGME accreditation and get approved, they will participate in the ACGME match, but programs that are still accredited by AOA will participate in AOA match. I think this will lead to fewer and fewer programs in the AOA match as they get ACGME approved, but two matches until all programs get accredited by ACGME.
 
To add the the AOA Board certification ... Dr. Buser said that ACGME pre-accreditation status will not allow DOs to take the ABMS Board. It will not be until the programs achieve full ACGME accreditation before its graduates can take the ABMS Board.
 
Does the new MOU need approval from the AOA House of Delegates?
 
costales said:
Does the new MOU need approval from the AOA House of Delegates?
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The AOA president said today at my school that putting the previous MOA last year before the House of delegates was not required but the Board of Trustees elected to put it before the House which affirmed the rejection of the MOA. This seemed to say that this does not need House approval if it is already approved by the Board of Trustees.
 
Thanks for the update. It'd be beyond embarrassing if the House shoots it down at its next meeting.
 
NMDO said:
But he also said that AOA programs will continue to be accredited by the AOA until 2020 or until they apply for ACGME accreditation. I brought this up in the other thread, to me it sounds like as AOA programs apply for ACGME accreditation and get approved, they will participate in the ACGME match, but programs that are still accredited by AOA will participate in AOA match. I think this will lead to fewer and fewer programs in the AOA match as they get ACGME approved, but two matches until all programs get accredited by ACGME.
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There was nothing to this effect in the town hall. They plan to accredit only until 2020. There won't be any loophole match that's for AOA only.
 
AlbinoHawk DO said:
There was nothing to this effect in the town hall. They plan to accredit only until 2020. There won't be any loophole match that's for AOA only.
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Sorry, I was referring to the matches from 2016 up until 2020. After 2020 there would be no reason for two matches since all programs will be ACGME accredited. From 2016-2020, there will be fewer and fewer programs in the AOA match, because as programs get ACGME accredited they will participate in the ACGME match, while programs that haven't applied for ACGME accreditation yet will participate in the AOA match (because they will still be AOA accredited until they apply or until 2020).
 
NMDO said:
Sorry, I was referring to the matches from 2016 up until 2020. After 2020 there would be no reason for two matches since all programs will be ACGME accredited. From 2016-2020, there will be fewer and fewer programs in the AOA match, because as programs get ACGME accredited they will participate in the ACGME match, while programs that haven't applied for ACGME accreditation yet will participate in the AOA match (because they will still be AOA accredited until they apply or until 2020).
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it will be interesting to see how quickly this happens
 
THH said:
I wonder how many of the AOA competitive residencies will just completely defect to the ACGME world. For example, I can imagine in fields like ENT or Neurosurgery the PD might not care too much about being an residency that meets the requirements for having "osteopathic principles" once ACGME accreditation comes through in 2015. This would immediately open up these residencies for MD applicants without additional OMM requirements.
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I think this is a really good point, and not just for competitive residencies but any AOA residency which doesn't really incorporate OMM. I guess we'll just have to wait and see what these "osteopathic principles" are and if AOA programs are willing to go the extra yard.
 
I keep hearing that IMGs will be getting boned in this deal, but I dont see why. Why would IMGs feel anything in this deal?
 
ChrisGriffen said:
I keep hearing that IMGs will be getting boned in this deal, but I dont see why. Why would IMGs feel anything in this deal?
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It hinges on the idea that offshores are already working at a singificant disadvantage (which they are, minus nepotism). So you open all residencies in existence to them. Awsome. They could always use more spots and there are hundreds of unfilled spots in the AOA.

Except by unifying their educational ranks, the USMDs and DOs have just made graduate education "theirs" in a group collaboration that offshore groups are not a part of. So they now have an actual roof that they can work together to reach as far as number of schools/students they want to have in all combined US medical schools of any flavor. If ACGME + AOA equals another 2,000 spots they dont fill yet... then they need to open ~18 more schools. When they control all the residencies, lord knows there will be HEAVY push to make sure they leave none of their own students behind. and the plans to open enough schools to fill every last residency spot are already in motion and the schools that will fill the last spots already have ground broken on their construction.

Even if you assume the school that will fill the last spot just broke ground today, it will be done being built in 2 years. So it will fill that last spot in 6.
 
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DocEspana said:
It hinges on the idea that offshores are already working at a singificant disadvantage (which they are, minus nepotism). So you open all residencies in existence to them. Awsome. They could always use more spots and there are hundreds of unfilled spots in the AOA.

Except by unifying their educational ranks, the USMDs and DOs have just made graduate education "theirs" in a group collaboration that offshore groups are not a part of. So they now have an actual roof that they can work together to reach as far as number of schools/students they want to have in all combined US medical schools of any flavor. If ACGME + AOA equals another 2,000 spots they dont fill yet... then they need to open ~18 more schools. When they control all the residencies, lord knows there will be HEAVY push to make sure they leave none of their own students behind. and the plans to open enough schools to fill every last residency spot are already in motion and the schools that will fill the last spots already have ground broken on their construction.

Even if you assume the school that will fill the last spot just broke ground today, it will be done being built in 2 years. So it will fill that last spot in 6.
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That's the thing. In the short term its good for IMGs, because it means more GME to fill, but in the long term its still a bad sign for them. Any IMGs in the system now were already feeling a pinch, but they'll still be OK (get some residency) until say 2025 (a guess) when almost all GMEs are filled with US MD and DO grads.

I wouldn't mind a residency expansion before that though.
 
I'm doing a bit of research on the history of the negotiations.

Do we know why the MOU failed the first time? There are suggestions that this is because the AOA didn't want MD students entering their residencies, but has this been proven? Are there any documents relating to this?

Thanks!
 
BurghStudent said:
I'm doing a bit of research on the history of the negotiations.

Do we know why the MOU failed the first time? There are suggestions that this is because the AOA didn't want MD students entering their residencies, but has this been proven? Are there any documents relating to this?

Thanks!
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The official response (and this has been confirmed to be true by people speaking in unofficial capacity who were at the meeting) was that the representatives of the AOA and AACOM had been given leeway to negotiate and they agreed to the deal. The they came back and brought it to the board of the AOA who had serious concerns that they may have given too much. So they brought it to the AOA house and the house felt that it represented something good but that the ambiguous language was actually an attempt to basically leave the AOA's backdoor wide open for [insert spooky primarily-MD organization here] to come in and dismantle the AOA's influence.

The official comment was there wasnt enough safeguards to assure osteopathic uniqueness. The problem was that everyone had agreed on a hard "absolutely must be done by now" deadline, and that deadline was about a week after the AOA meeting that rejected the policy due to their concerns.

It did not seem to be related to opening residencies. I think that was always assumed to be the asking price and people knew that was unavoidable. It seemed more tied to ambiguous language about how the AOA would continue to exist in the new arrangement. Ironically they *appear* to have had a more legitimate existence in the first MOU than in this more recent agreement.
 
NMDO said:
Sorry, I was referring to the matches from 2016 up until 2020. After 2020 there would be no reason for two matches since all programs will be ACGME accredited. From 2016-2020, there will be fewer and fewer programs in the AOA match, because as programs get ACGME accredited they will participate in the ACGME match, while programs that haven't applied for ACGME accreditation yet will participate in the AOA match (because they will still be AOA accredited until they apply or until 2020).
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I thought they will all be made pre-accredited and it's for then to lose in 2020.
 
DocEspana said:
The official response (and this has been confirmed to be true by people speaking in unofficial capacity who were at the meeting) was that the representatives of the AOA and AACOM had been given leeway to negotiate and they agreed to the deal. The they came back and brought it to the board of the AOA who had serious concerns that they may have given too much. So they brought it to the AOA house and the house felt that it represented something good but that the ambiguous language was actually an attempt to basically leave the AOA's backdoor wide open for [insert spooky primarily-MD organization here] to come in and dismantle the AOA's influence.

The official comment was there wasnt enough safeguards to assure osteopathic uniqueness. The problem was that everyone had agreed on a hard "absolutely must be done by now" deadline, and that deadline was about a week after the AOA meeting that rejected the policy due to their concerns.

It did not seem to be related to opening residencies. I think that was always assumed to be the asking price and people knew that was unavoidable. It seemed more tied to ambiguous language about how the AOA would continue to exist in the new arrangement. Ironically they *appear* to have had a more legitimate existence in the first MOU than in this more recent agreement.
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Thank you for the response.

The memorandum of understanding should really be made public, but I can see why they would hesitate to do that.
 
DocEspana said:
The official response (and this has been confirmed to be true by people speaking in unofficial capacity who were at the meeting) was that the representatives of the AOA and AACOM had been given leeway to negotiate and they agreed to the deal. The they came back and brought it to the board of the AOA who had serious concerns that they may have given too much. So they brought it to the AOA house and the house felt that it represented something good but that the ambiguous language was actually an attempt to basically leave the AOA's backdoor wide open for [insert spooky primarily-MD organization here] to come in and dismantle the AOA's influence.

The official comment was there wasnt enough safeguards to assure osteopathic uniqueness. The problem was that everyone had agreed on a hard "absolutely must be done by now" deadline, and that deadline was about a week after the AOA meeting that rejected the policy due to their concerns.

It did not seem to be related to opening residencies. I think that was always assumed to be the asking price and people knew that was unavoidable. It seemed more tied to ambiguous language about how the AOA would continue to exist in the new arrangement. Ironically they *appear* to have had a more legitimate existence in the first MOU than in this more recent agreement.
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Makes sense, considering the way in which things went down last time. I also agree that it looks like the new agreement cost the AOA more than the original one would have. For example, the old agreeement would have had no effect on board certification. Now, osteopathic residedents will be eligiable for ABMS board certification. Clearly a win for students/residents/attendings but I can see where the AOA and osteopathic specialty colleges could see it as a loss.

A couple of questions haver come to my mind.

First, what is AACOM's role in this? If they're not involved in residency accreditation what was in necessary to include them in the process?

Second, it has been emphasized that COCA is not/was not party to this process, obviously in an effort to make clear that there is no merger between MD and DO schools. But if COCA is part of the AOA, how are they not part of it?
 
NurWollen said:
Makes sense, considering the way in which things went down last time. I also agree that it looks like the new agreement cost the AOA more than the original one would have. For example, the old agreeement would have had no effect on board certification. Now, osteopathic residedents will be eligiable for ABMS board certification. Clearly a win for students/residents/attendings but I can see where the AOA and osteopathic specialty colleges could see it as a loss.

A couple of questions haver come to my mind.

First, what is AACOM's role in this? If they're not involved in residency accreditation what was in necessary to include them in the process?

Second, it has been emphasized that COCA is not/was not party to this process, obviously in an effort to make clear that there is no merger between MD and DO schools. But if COCA is part of the AOA, how are they not part of it?
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It is similar to how the LCME was not included. COCA (And the LCME) do not represent the schools, they simply make sure the schools meet standards. Despite COCA being under the AOA and LCME being a joint collaboration by the AAMC and the AMA (basically name an MD institution and the AMA is actually behind it. Its so maligned, but it is also the invisible hand driving everything in the MD world). The AACOM represents the various schools, so basically it allowed your deans (and the like) to be represented at the negotiation table. Without the AACOM it would just be the AOA which, it could be argued, is not in touch with the needs of the education system who would be most directly impacted by all of this.
 
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Dr Yiot said:
I thought so too
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It was my understanding that to become pre accredited they had to submit an application. That's it. Just the submission offers pre-accreditation status. I'm not even sure if the fee is required immediately at the time of accreditation. It also seems (according to the town hall meeting) that the ACGME will go out of their way to make sure programs don't shut down, and even if their app gets rejected initially by the ACGME, they can continue to reapply without paying additional fees through the 5yr deadline.
 
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