Stephen C. Shannon, DO, MPH
Explaining the Planned Unified GME Accreditation System
As many readers know by now, the American Association of Colleges of Osteopathic Medicine (AACOM) recently joined with the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA) in a historic agreement to pursue a single accreditation system for graduate medical education programs in the United States beginning in July 2015. I believe this is a positive development for U.S. medical education and the health care system, and I want to take this opportunity to address concerns our readers (particularly students) may have about the proposed merger.
Discussions about a proposed merger were initiated by the ACGME move to change the Common Program Requirements for all ACGME residency and fellowship training programs. Their proposed changes would separate ACGME training from AOA training and require students to decide fully on one of the two systems for all of their graduate medical education, disrupting the existing pathway for DO specialty training. There was concern within the osteopathic community about whether these changes would limit osteopathic medical school graduates’ access to ACGME residency and fellowship opportunities. These issues were addressed during several months of dialogue, and concluded last month with the boards of each organization agreeing to pursue an agreement whereby ACGME would accredit all osteopathic graduate medical education programs currently accredited by the AOA.
Over the coming months, AACOM, AOA and ACGME will work toward defining a process, format and timetable for ACGME to accredit all osteopathic graduate medical education programs currently accredited by AOA, and also will work to reconcile the training standards of current AOA and ACGME specialty training programs. A unified system would ensure that physicians who complete osteopathic medical education would continue to enjoy access to ACGME residencies and fellowships, regardless of changes in accreditation policies and practice. Currently, ACGME accredits more than 9,000 programs in graduate medical education, with about 116,000 resident physicians, including over 8,900 osteopathic physicians. The AOA accredits more than 1,000 osteopathic graduate medical education programs, with about 6,900 resident physicians, all DOs. The success of these negotiations would result in a seamless transition to a unified system. Residents in or entering current AOA-accredited residency programs would be eligible to complete residency and/or fellowship training in ACGME-accredited residency and fellowship programs.
An additional and necessary aspect of successful unification will address the governance of a unified system. A successful outcome will result in the AOA and AACOM joining the ACGME’s other five sponsoring organizations (the American Hospital Association, American Medical Association, Association of American Medical Colleges, American Board of Medical Specialties and the Council of Medical Specialty Societies) as equal participants in the membership, governance, nomination and/or appointment structure of ACGME.
I believe the unified system would improve the quality and efficiency of the pathway to practice for all physicians--DOs and MDs alike. And it may very well drive coordination and collaboration in other graduate medical education areas, such as research, faculty development and innovation. I view the creation of a streamlined, solid graduate medical education system as essential to the continued growth and success of our profession, and I invite readers to learn more at AACOM’s GME web page, and by exploring our FAQs page on the issue.