Video: Review of the proposed ‘historic’ new plan to unify GME accreditation

A new accreditation system for all DO and MD graduate training programs in the U.S. is now in the burgeoning stages after the AOA, the Accreditation Council for Graduate Medical Education (ACGME) and the American Association of Osteopathic Medical Colleges (AACOM) agreed this week to pursue a unified system. This agreement, announced Wednesday, follows negotiations that took place after the ACGME proposed new program requirements last year that would have limited access for DOs going into ACGME-accredited programs.

“This is a watershed moment for medical training in the U.S.,” the ACGME’s CEO Thomas Nasca, MD, said in the news release. AACOM President Stephen C. Shannon, DO, MPH, called the initiative “historic.”

“A unified accreditation system creates an opportunity to set universal standards for demonstrating competency with a focus on positive outcomes and the ability to share information on best practices,” said AOA President Ray E. Stowers, DO.

In this video, AOA Executive Director John B. Crosby, JD, reviews the plan and explains what will happen next and how it will affect DOs and osteopathic medical students.

thedo@osteopathic.org

1. Thomas W. Brown, DO on Oct. 26, 2012, 5:09 p.m.

   This is a great achievement for osteopathic medicine. When I wanted to apply for ACGME surgery residencies in 1973, I was denied, despite great recommendations, solely because I was a DO, and “could not take the American College of Surgeons certifying exam.” I went in to ob/gyn and was happy I did– and was certified by the ABOG.Most of my training was in the US Air Force, and was excellent. Also, I never felt that I missed anything in medical school compared to my allopathic colleagues. I have been the “first DO” in several institutions and have been warmly received very quickly (within a week) after the rest of the staff realized I knew what I was doing.

2. Kenneth E. Johnson, DO, FACOOG on Oct. 26, 2012, 6:46 p.m.

   Congratulations to the AOA and ACGME for all their hard work on this very critical issue for our patients, students, residents, faculty and fellows. This is a very exciting time to be a physician in America. KEJ

3. Adam Burch OMS-I on Oct. 26, 2012, 7:51 p.m.

   This is HUGE news for medical students attending osteopathic medical schools. It will take a lot of pressure off of the match process! I know that everyone here at Western U College of Osteopathic Medicine of the Pacific-Northwest is very excited and happy!

4. Matthew Schaefer, DO on Oct. 26, 2012, 11:16 p.m.

   Will this mean that for those of us who did an ACGME approved residency will not need to use the Resolution 42 workaround in order to get a license in FL, OK, PA, MI, and WV?

5. John Dery, DO on Oct. 27, 2012, 2:57 a.m.

   This is great news for osteopathy and the future of our medical education process. Thank you to all the individuals who have worked so hard to bring our profession to this point in history.

6. Peggy Wiedmann, MD on Oct. 27, 2012, 9:20 a.m.

   This is great news and an excellent first step. As program director of a dually accredited Family Medicine program, the amount of testing for osteopaths, which includes 2 intraining exams yearly and 2 board certification exams is excessive, expensive for the ostepathic resident and unnecessary. Hopefully this new GME accreditation process will result in unification of the board certication process as well.

7. Albert P Hirdt, DO on Oct. 27, 2012, 10:27 a.m.

   I graduated from NYCOM in 1984. Because of my age, I went directly to an allopathic Internal Medicine residency followed by an Allopathic fellowship in allergy, immunology and rheumatology fellowship. I am board certified in Internal Medicine by the ABIM and in allergy/immunology by the ABAI. I am fully licensed in NYS. If i apply for a license in FLA,PA,CA i need an osteopathic internship which I did not do. Does this agreement affect licensing boards.
   Sincerely,
   Albert P Hirdt DO

8. Justin Amaro, DO on Oct. 27, 2012, 10:31 a.m.

   While this is fantastic news for current and future osteopathic medical students seeking specialty residencies and fellowships, I have concerns for the future of osteopathic residency programs. I chose a DO-only residency, 1300 miles from my home, because of their unique training and philosophy — just as I went to an osteopathic medical for its distinct style of training. The rest of the residencies I applied to were all dual accredited and excellent programs, but all lacked the distinctive feel of my current program. I am in my final year of family medicine training, and my osteopathic training and skills in OMT are what set me apart from my ACGME peers. Also, I am taking only one set of boards which are gladly accepted by all of my prospective employers. We must be cautious not to lose our identity as osteopathic physicians. I pray this is not the death of residencies who strive not only to produce exceptional physicians, but exceptional Osteopathic physicians.

9. JB on Oct. 27, 2012, 5:34 p.m.

   Except for few grumpy and narrow-minded people I know, everyone is very satisfied with this decision, including myself. Talking to some FM/NMM residents, it is apparent that OMT unfortunately is becoming a dying profession. Providing an opportunity for MDs to learn and practice OMT will be the best way to preserve our tradition and legacy. I have always been bothered by the osteopathic system that only offers this gift of healing (OMT) exclusively to DOs, and at last this problem is solved. Currently, 6% of licensed physicians is DO and 94% MD. Imagine even 10% of MD dedicating to the practice of OMT. That will mean even bigger scale of OMT use in patient care in the history of osteopathic medicine.

   I can’t wait for the unified accreditation to take affect.

10. John H. Finley jr. D.O., FACOS, FACOFP(hon) on Oct. 29, 2012, 11:14 a.m.

    The entire Osteopathic profession cheers this remarkable achievement accomplished by leaders in our profession and those in ACGME. Congradulations to all involved.

11. Mitch Hiserote, D.O. on Oct. 29, 2012, 1:02 p.m.

    Being a California DO and having been educated and continue to practice in the state, the long shadow of the 1962 merger still persists today. Many of the same sentiments that are being expressed concerning this move as benefits to our profession echo those cited then. Certainly, having a single match and other very obvious logistical aspects are a positive move, but as stated in the press release, “the devil is in the details”. As anyone who has participated in the negotiation process, a mutually acceptable deal requires compromise from both parties. With the considerable talk about what we will gain and “no questions asked” in this move… I would like to hear more clearly what we as a profession are compromising and what is the perceived benefits to the allopathic profession. Until those details are released and the not so obvious aspects of this deal are revealed, I will reserve my cheering for later.

12. Vanessa M., DO, PGY-1 on Oct. 29, 2012, 9:57 p.m.

    I just entered an allopathic program for Pathology and I do not regularly use my OMT skills, but I do have to agree that I worry that this move looks very similar to what happened in California in the 1960′s. Even though I am being trained in an allopathic program, I am very proud of my Osteopathic medical school training. A very strong part of me worries that we are just shooting ourselves in the foot, and are just setting the Osteopathic profession back. We’ve come so far and yet I still have people come up to me at my hospital and ask what a DO is, and aren’t we less than the MD’s, or not really a doctor. I agree that this move could help with the future residency spot shortage, but at what cost will this be to our future DO’s?

13. Randy A. Shuck, DO,FACOFP on Nov. 1, 2012, 3:28 p.m.

    If you look back in history, you will notice several attemps to assimilate Osteopathic Medicine into Allopathic Medicine. From the Flexner Report, to California, to opening the residencies to Osteopathic students, it has been the undertone of absorbtion. Our weakness has been the rapid expansion of the schools without concern for appropriate training sites. There was not a correlation between class size and post-gradute postions. (until just recently, and obviously too little too late). A unified pathway to accreditation means getting rid of redundancies. The most obvious redundancy is two separate degrees. Yes it will be easier for students to get into training sites, but not Osteopathic sites. Over 50% already train in ACGME programs, get ready for the other 50% to welcomed in as well. Then, what’s next? the ratio of Osteopathic to Allopathic is roughly 100:1…how does TWO votes equal equality in GME?(AOA and AACOM on ACGME board)

14. Classof2014 on Nov. 2, 2012, 5:31 p.m.

    This is great news!! Out of the 100% students going into DO schools, only 10% initially choose a DO school because they have passion or want to learn about the osteopathic principles. The true reason is them not getting accepted into an allopathic school. However, studying in the school creates passion and teaches them the principles of osteopathic medicine. Once they finish it, their aim will be to get a residency and many will never practice OMM sadly. So, it is the true passionate ones are getting the chance through this unified program to teach their fellow MDs about the philosophies and maybe take it out of country as I’m assuming they won’t have issues practicing out of country because they are a DO. So, I don’t think this will eliminate the roots of osteopathic profession!

15. Emidio Novembre DO on Nov. 2, 2012, 6:56 p.m.

    It is clear to all of us that this is another attempt to absorb us. I notice there has not been a clause in this new agreement concerning AOA board certification. Now that all DO residencies will be ACGME approved even retroactively what happens to our certifications? It seems they are going to “volunterally” require us to sit for their boards otherwise our boards will be obselete.
    We need this question answered. This is the death nail to our profession. Whats next giving us an MD for $65.
    Being a DO is an honor. This above comment that most of us became DOs because we coudnt get in MD schools is a lie. This individual is projecting his own attitude on to us. Most DOs are proud to be DOs. Most patients and medical ancillary staff will openly testify that DOs are better physicians.OMT is only a small part of it. We listen and learn from our patients. We shake hands and put our hands on the patients shoulders, patients prefer us. OMT teaches us to touch our patients and form appropriate Doctor -Patient relationships. Osteopathic schools make better physicians!

16. Gail Dudley, DO, MHA, fACOFP on Nov. 2, 2012, 7:42 p.m.

    AS I said on the health policy fellows website(I did the AOA Health Policy Fellowsip 2003-2004) that I feel this is the beginning of the end for DO’s. I have to wonder if we as a profession have forgotten what happened in California in the 60′s. I wonder what Viola Fryman thinks. I am sure there are good reasons for this merger, and I know that there are many MDs who want to learn OMT. I just re-certified in NMM/OMM in March having taken it first in 2002. What’s next after this merger? Combining the schools so there are just MD/DO (witout the DO eventually) schools? Along with that will come discontinuation of the OMT training. There are allopathic schools out there (one in Florida) that say they have come up with the idea of mind/body/spirit training and viewpoint, and therefore ignore/efuse to admit that the Osteopathic profession had this from the beginning. I know that the majority of DOs never use their manipulation skills after taking their boards. I have always used OMT everywhere and always will, but I guess I am a dying breed just as our profession will be (I am very proud of my profession and training).I guess this became inevitable when the number of Osteopathic Hospitals began to decline and the number of Osteopathic schools multiplied (and there are many reasons for the school-cloning issue). I don’t know how long this project has been in the works or all the reasons why–need to know basis, i guess–but I hope this isn’t being done because its easier than fighting for our own training programs since we already too easily gave up our own hospitals. There are too few REAL DOs out there and now the MDs have put the last nail in the Osteopathic coffin.

17. Stacey OMS III on Nov. 3, 2012, 12:07 a.m.

    I agree with the few who have posted their concerns with conserving the osteopathic philosophy and practice. No, not everyone is excited for this chance and believes in it. Where I am most are concerned that 20 years down the road this will lead to the loss of DOs in the profession. I am a third year student and WANT the letters behind my name to always be DO and be able to live up to them with my practice. This may be okay for now, and maybe a good thing… But just think about the future and what this COULD mean.

18. E.S.vonHolten D.O.FACOI on Nov. 3, 2012, 12:52 p.m.

    The loud moan you heard on Oct.31 would’ve been A. T.rolling over in his grave! What poor students of history, we Osteopaths are. Ask and D.O. who was around during the California incident if they are comfortable with this.

19. William Kirmes , D.O. on Nov. 3, 2012, 4:58 p.m.

    Distinctiveness…loss of identity..inability to ever gain us full credibility with the public…What will happen to the real 10 fingered DO’s? Roll over A.T. and tell Tchaikovsky the news. Were gonna be one big happy family….Right…..

20. Student on Nov. 4, 2012, 11:02 a.m.

    osteopathic medicine does not own the rights to treating patients holistically or to the mind/body/spirit approach. this is just good medicine in general. and if the techniques of OMM prove to be effective, then this should be considered good medicine as well, and not held within the confines of the DO world. good medicine is good medicine. if it works, then why not just add it to the arsenal of tools used to help our patients? if this is the case, the rest of your concerns become one of politics and this apparent need for distinction that has only driven a wedge between the small minority that wish to keep the old ways alive and that of vast majority who see no need for such distinction.

    “survival of the fittest” refers to that which can adapt best to one’s environment. “be water my friend.”

21. Student on Nov. 4, 2012, 11:16 a.m.

    lots of fear here. change is inevitable. the goal should be to provide good medicine and do what is best for our patients. concerns of keeping a profession alive should truly take a back seat. the techniques of OMM that prove to be effective will not go away. there will be folks who continue to utilize them. and there will be those who push forward with research so that we can learn about it.

    the result (and one that makes sense): osteopathic techniques become a part of medicine in general, in the hands of those who wish to use it that is. it that regards, i guess one can say that osteopathic medicine will be absorbed by the greater world of modern medicine in general. as i said earlier, if it works, it does not need to be separated with political walls and the insecure need for distinctions.

    all of this said, i happen to be someone who feels that OMM can very effective. it is based on the profound understanding of anatomy and physiology (which includes biochemistry, histology, etc). we need to keep digging deeper for truth. political distinction will not stop this from happening. those few (and there are very few) who have an interest in doing so, will keep digging.

    as someone mentioned earlier, most DO students would have taken an MD seat if offered one. as an MS1, i do not know ONE student whose first choice was DO. do not be in denial of this. whether you loathe this fact or not, this is certainly the case for a vast majority of students. yes, some do realize the benefits of OMM, and jump on board afterward… but most will become 5-finger DOs in practice.

    tl;dr version: there is nothing to fear. today’s DO student (for the most part) have no desire to preserve distinction. they just want to become competent physicians who practice solid evidence based medicine. the politics of the game or the letters behind their name are of little concern.

22. Lauren on March 18, 6:46 p.m.

    Loss of distinction, says it all. I find this to be very sad news for our profession.