ampbell University Jerry M. Wallace School of Osteopathic Medicine (CUSOM), located in Buies Creek, NC, received approval as an accredited sponsoring institution by the Accreditation Council for Graduate Medical Education (ACGME) on August 21, 2015.
The medical school’s 19 affiliated residency programs are accredited by the American Osteopathic Association (AOA), CUSOM is now equipped to transition their existing and future programs to ACGME accreditation.
Once the transition is fully implemented by July 1, 2020, graduates of osteopathic and allopathic medical schools (DO and MD respectively) will complete their residency education in ACGME-accredited programs and demonstrate achievement of common milestones.
Leadership in the Continuum of Osteopathic Medical Education
Led by Founding Dean John M. Kauffman, DO
, and Associate Dean for Postgraduate Affairs Robert T. Hasty, DO
, CUSOM applied for ACGME accreditation early in the transition process directly as a medical school.
“We knew that we wanted to be in a leadership position with the GME programs to ensure quality and to help serve their needs in ways that medical schools are well positioned to do,” says Dean Kauffman.
CUSOM’s achievement demonstrates the school’s commitment to building high-quality graduate medical education (GME) programs. Recently CUSOM received the Strategic Team Award and Recognition (STAR) at the American Osteopathic Association (AOA)’s annual business meeting in Chicago in July 2015, for creating 363 new residency positions in 19 programs at seven affiliate hospitals in North Carolina since the opening of the school in 2013.
A Local Strategy
CUSOM's strategy to advance GME stems from its mission to train physicians for rural North Carolina. The new GME is a result of the recognition of North Carolina’s health care and medical education needs. The state has a growing and aging population coupled with a rising shortage of primary care physicians. Residency slots in North Carolina have a fill rate of around 98 percent and gaps exist in primary care residency positions. Campbell University's
solution: to educate osteopathic medical students, provide residency positions for all its graduates, and deliver quality health care to the rural and underserved communities in North Carolina.
“We don’t want to depend on residency programs from out of state. We feel we need to be creating new programs locally,” says Dr. Hasty.
The school plans to continue building residency positions in family medicine, internal medicine, pediatrics, obstetrics and gynecology, general surgery, psychiatry, and emergency medicine, among other specialties. Their ultimate goal is to have a residency position available for every student that graduates from CUSOM, capturing students that would otherwise be forced to relocate out of state for a residency position. Many studies show that physicians are more likely to practice close to where they completed their GME training, while more than half of those who leave the area upon completion of their GME training are likely not to return—and for North Carolina, this means the loss of local Campbell graduates.
Responding to Future GME Needs
CUSOM’s approach is also fueled by national trends in medical education. Residency growth continues to lag behind the proliferation of new medical schools and the increasing enrollment in the United States. CUSOM aims to develop 500-600 residency positions by 2020.
“Given the growth in schools, students need to have options to continue to succeed,” says Dr. Hasty. “We feel that GME is central to the mission of the medical school and to serving the needs of our students … and this is money well spent.”
Investing in the Future
According to Dean Kauffman, medical colleges can develop high quality training programs, have control over student outcomes, and thus deliver students that are best equipped for their futures as physicians. But this doesn’t come easily; Dean Kauffman invests an enormous amount of time in GME development, and the school invests in staff and resources.
Dean Kauffman, the 2014 American Osteopathic Foundation (AOF) Educator of the Year, maintains that the rewards from creating and maintaining GME far outweigh the costs in the long-run. As an example, Dean Kauffman cited a recent study on hospital internal medicine services that shows that resident-led teams, when compared to those with mid-level practitioners, have shorter lengths of stay, lower per-patient direct cost from hospital charges, and higher scores for patient satisfaction. With such high returns on investment, Dean Kauffman states, hospitals should capitalize on the service provided by having GME as part of a health system.
Below is the full transcript from AACOM’s recent interview with Dean Kauffman and Dr. Hasty about CUSOM’s experience in the transition to ACGME accreditation.
Q: Why was it important for you [Campbell University] to pursue ACGME institutional sponsorship accreditation?
A: CUSOM is focused on developing a residency position for every graduate. Currently, we have 363 AOA-approved positions in 19 programs at 7 organizations. This accreditation allows us to transition our current and future residency programs to the single accreditation system, which will accredit all residency programs – DO and MD - in the United States after 2020.
Q: What (if any) challenges did you face in deciding to move forward with ACGME accreditation? Were there significant financial considerations? If so, how did you manage these?
A: The largest challenge we faced was to decide where we wanted to go with GME. After thoughtful consideration, we knew that we wanted to be in a leadership position with the GME programs to ensure quality and to help serve their needs in ways that a medical school is well positioned to do so. There are significant financial considerations, particularly in staffing our GME team to support the quality of programs that we are developing. However, we feel that GME is central to the mission of the medical school and serving the needs of our student and this is money well spent.
Q: What led you to apply early in the process? Who decided to apply for ACGME accreditation right away? Program(s)? Institution? Who was in charge of the process? Who was involved?
A: CUSOM is focused on advancing our mission, and we knew developing an ACGME sponsoring institution was central to this under the single accreditation system. Dean John Kauffman and the Associate Dean for Postgraduate Affairs led the decision, and Dr. Hasty was in charge of the process with the assistance of our Director of Graduate Medical Education (Dawn Stull at the time).
Q: How did you prepare for this process? Were there models or templates you looked at beforehand?
A: Our preparation included talking with ACGME staff members, attending the ACGME annual convention, and reviewing established policies nationally.
Q: What was the application process like? How different was the experience from going through AOA accreditation? Did it require you to completely alter/overhaul to your current medical education program?
A: The application process was straightforward - quite streamlined. We did have to make significant changes to our policies and add new ones.
Q: Did you hire a consultant? Was there a project manager?
A: No. Dr. Hasty managed the project
Q: Were there any surprises throughout the application process? Any surprise costs? Any surprises in meeting the requirements?
Q: What advice would you give to other institutions going through the process?
A: Apply immediately to help serve your programs. It is important to support your existing programs, to help maintain relationships, and is in the best interest of your medical students.
Q: Do the programs affiliated with Campbell University that are transitioning to ACGME plan to apply for osteopathic recognition? Why or why not?
A: We feel that it is important to develop osteopathic-focused programs and are encouraging all of our affiliated residency programs to seek osteopathic recognition. Some of the benefits for them will include OMM support from CUSOM, high-quality residents, increasing the number of osteopathic physicians at their organization, and preservation of the osteopathic philosophy and culture.
Q: What (if anything) kept you up at night in going through the process?
A: It was a new experience for us and we wanted to make sure that we were successful in the process.
Q: What resources were helpful to you through this process? In retrospect, what resource or information do you wish you had as you went through the process? What could have made the process smoother?
A: A template application with template supporting documents/policies would have been very helpful.