COMMENTARY from Doc Thoughts

The Future of Residencies: Single MD/DO Accreditation System

Nirmal R. Gosalia

Disclosures

June 23, 2017

Editor's Note: The Accreditation Council for Graduate Medical Education (ACGME) announced that by 2020, all MD and DO residency slots would be combined under a single accreditation system. DocThoughts' Host, Nirmal Gosalia, invited Dr. John Potts, Senior Vice President at the ACGME, to clarify the decision and its impact. For more conversations with thought-leaders in healthcare visit DocThoughtsMed.com.

The ACGME notes that all numbers of dually accredited programs mentioned in the video were correct as of the interview date (September 15, 2016). In addition, the correct terminology is AOA approval.

Mr Nirmal Gosalia: Residency is changing, and here is what you need to know about it. Recently, the Accreditation Council for Graduate Medical Education announced that all residency programs in the US will come together under 1 umbrella accreditation system. Meaning all allopathic and osteopathic students are now eligible to apply to any accredited program in the US. This is a huge departure from the 2 separate systems that we had in the past, and naturally, as students, or as program directors, we have questions for what this means for us. We sat down with the ACGME to try to get a clear picture of the decision. Today, we are talking to Dr. John Potts, Vice President of Surgical Accreditation at the ACGME. Dr. Potts had a leading role in implementing the new system. Let us find out what this new system is all about.

Thank you so much for joining us and talking about this Dr. Potts.

John R. Potts, MD, Senior Vice President of Surgical Accreditation at the ACGME: My pleasure.

Mr. Gosalia: What is meant by the single GME accreditation system?

Dr Potts: Single Accreditation System - by that we mean that all medical school graduates will enter 1 system of accreditation for their residency programs. Historically, we have had accreditation, of course by the ACGME, but also by the American Osteopathic Association. Those 2 are going to come together so that there will be 1 accreditation system for all those residency programs.

Mr Gosalia: Why was this decision made to move toward a Single GME Accreditation system?

Dr Potts: The advantages of a single accreditation system [unintelligible 00:01:27] that it provides consistent evaluation and accountability to the programs. It actually enhances the opportunities for the medical school graduates. It eliminates a lot of duplication of effort and expense for residency programs. When this effort was undertaken a couple of years ago, as of that time there were about 150 programs in the country. They were accredited by both AOA and ACGME. Those programs had to meet all the requirements of both accrediting organizations, and pay fees to both accrediting organizations. Going forward there will only be 1 accrediting organization, and we can eliminate that duplication. To me 1 of the most important aspects of it is that it is a much more transparent system for the federal government who pays for graduate medical education, and most importantly for the public.

Mr Gosalia: How will the Single GME Accreditation System enhance opportunities for trainees?

Dr Potts: The ACGME, actually since its inception in 1981, has allowed graduates of colleges of osteopathic medicine and allopathic graduates to enter its residency programs, but has limited the entry into fellowship programs, in many instances, to graduates of ACGME accredited residency programs. Through this system, all graduates will be eligible for entry into ACGME accredited fellowship programs. On the flip side, for the allopathic residents, they will have the opportunity, if they wish, to learn osteopathic principles and practices.

Mr Gosalia: Now looking at this from a student's perspective, what impact will this decision have on MD and DO students seeking residency slots in the coming years?

Dr Potts: As I said, it enhances opportunities for both. Particularly for the DO students it enhances the opportunities at the fellowship level. They will be eligible for all ACGME accredited fellowships. For the allopathic graduates, it will also increase the number of residency slots available to them because in the past, graduates of allopathic medical schools could not apply to those programs that were accredited only by the AOA. Once those programs are accredited by ACGME, allopathic residents, or graduates, can apply to those programs as well.

Mr Gosalia: Will the [single-accreditation system] SAS cause greater competitiveness for the residency slots?

Dr Potts: I think in fact it will, if anything, be helpful to the students in terms of that competitiveness for residency slots. I say that because, even before the SAS, those DO students and allopathic graduates could apply to the ACGME programs. Those will still all be open to both cohorts, but there are a number of historically AOA only accredited programs that don't fill every year. Those will be available to the graduating pool of students regardless of which of medical school they come from. If anything, I think it will be a benefit to the students who are graduating.

Mr Gosalia: Will residency programs have to change their selection process after this decision is made?

Dr Potts: I don't think there will be any change on the part of those programs that have historically been ACGME accredited. If there is any change in the criteria for the residency selection process, it would be in those programs that have, in the past, been only AOA approved because now they will have a much larger pool of graduates for them to choose which could include MD students. Of course, they won't have to take MD students if they don't want to, but any of these students would be eligible for those programs, whereas, in the past, they have not been.

Mr Gosalia: This agreement between the ACGME, the AOA, and the AACOM was made 2 years ago. What has been accomplished within those 2 years?

Dr Potts: We are really pleased with the progress that has occurred in those 2 years. The ACGME Board of Directors now has individuals who were nominated by the AOA, sitting on the Board of Directors. We have individuals who are nominated by AACOM, and we should say that AACOM stands for the American Association of Colleges of Osteopathic Medicine. There are nominees from that organization sitting on our Board of Directors. We have nominees from the AOA sitting all of the specialty review committees that are relevant to those graduates from colleges of osteopathic medicine. We now have had applications from well over 200 programs that were historically only AOA approved applying for ACGME accreditation. Over 50 of those have already been accredited by the various review committees of the ACGME. The progress has really been substantial. We are very pleased with it, and we look forward to continued work with AACOM and AOA as this single accreditation system unfolds. We think it is going to be a good thing for the students, and a good thing for the public, for the patients that we have the opportunity to treat.

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