Find answers to all your single GME questions, including how the transition will impact your training and what you can expect.
The osteopathic medical profession is currently transitioning to a single accreditation system for graduate medical training. By 2020, all residency programs in the U.S. will be accredited by the Accreditation Council for Graduate Medical Education (ACGME). Both DO and MD students will be able to match into residency programs of their choice.
The following questions have been submitted by osteopathic residents.
There are a number of reasons why we are moving to a single accreditation system. It provides for consistent methods of evaluation and accountability, it enhances opportunities for all residents, and it enhances transparency to outside entities, including the federal government, licensing boards, credentials committees and the public. All of these factors played a role in the AOA, Accreditation Council for Graduate Medical Education (ACGME) and AACOM agreeing to transition from separate AOA and ACGME GME accreditation systems to a single GME accreditation system.
The single GME accreditation system is limited to GME. Osteopathic entities including the accreditation of colleges of osteopathic medicine, AOA board certification, and osteopathic licensing examinations are preserved.
The single GME accreditation system also incorporates osteopathic medicine through the addition of Osteopathic Neuromusculoskeletal Medicine (ONMM) as a specialty accredited by ACGME and through the designation of Osteopathic Recognition. All ACGME accredited programs can receive Osteopathic Recognition by offering education in Osteopathic Principles and Practice (OPP).
Since July 1, 2015, AOA-accredited training programs have been eligible to apply for ACGME accreditation. The AOA will cease GME accreditation on June 30, 2020.
To ensure that all residents graduate from an accredited training program, AOA standards have established deadlines for programs to apply for ACGME accreditation. If a trainee cannot complete a program by June 30, 2020, that program must either 1) apply for ACGME accreditation, or 2) stop accepting trainees. If a program does not apply by the deadline, it will not be able to participate in the AOA Match the following February or accept new trainees to begin training the following July. Read more about this policy.
Should an AOA program not achieve ACGME accreditation by June 30, 2020, the AOA, ACGME, and AACOM recognize there may be unique circumstances whereby some programs make a good faith effort to achieve ACGME accreditation but still have not transitioned successfully to ACGME accreditation by that date. An agreement reached by the three organizations in March 2017 seeks to protect residents in such programs or situations by giving the AOA restricted authority to extend the AOA accreditation date to allow any remaining resident in such programs to complete training in an accredited program.
Pre-accreditation is a status that signifies that an AOA-approved program or institution has submitted an application for ACGME accreditation and is conferred automatically upon submission of an application for accreditation in the ACGME Accreditation Data System (ADS). Continued pre-accreditation is a status given to a program with pre-accreditation and does not achieve initial accreditation upon review by the Review Committee. ACGME initial and continued accreditation is conferred when it is determined by the appropriate ACGME Review Committee that the program or institution is in substantial compliance with the applicable Program Requirements and/or the Institutional Requirements. Learn more about the ACGME accreditation process for AOA programs and AOA institutions.
Programs or institutions with ACGME pre-accreditation or continued pre-accreditation must maintain their AOA approval.
The AOA Opportunities database displays all current AOA program’s current status within the single accreditation transition process. View a list of former AOA programs no longer listed in Opportunities that have transitioned to ACGME accreditation.
A list of sponsoring institutions and programs that applied for ACGME accreditation through the single GME accreditation system is also available on the ACGME website.
The AOA and AACOM have each nominated three representatives to sit on the ACGME Board of Directors, and will each nominate one more by 2020. These board members participate on the ACGME Monitoring Committee that oversees consistency of decision-making, standard-setting, and process implementation among the ACGME Review Committees.
Further, the AOA has nominated members to all 21 ACGME Review Committees (where there are corresponding AOA-approved programs) and the Osteopathic Principles Committee, and the Institutional Review Committee; thus, over 50 osteopathic physicians now sit on the ACGME’s Review and Recognition Committees that oversee both recognition, and program and institutional accreditation.
The single accreditation system is strictly limited to GME and does not include board certification or medical school accreditation. The AOA believes it is important to the public for DOs to demonstrate competency in osteopathic principles and practice through osteopathic board certification.
The ACGME Board of Directors recently approved changes which incorporate AOA board certification throughout the ACGME Common Program Requirements. AOA board certification is codified as a valid and appropriate credential for ACGME program directors and faculty. The Common Program Requirements, recognizing that osteopathic graduates may take osteopathic certifying boards, also incorporate AOA board pass rates, along with ABMS pass rates, for program assessment. In addition, program directors are also required to inform applicants of their eligibility for relevant specialty board examinations, including AOA board certification.
The AOA has approved Section X of the AOA Basic Documents for Postdoctoral Training, specifically outlining the policies for AOA program accreditation during the transition to the single GME accreditation system. In addition, the AOA Council on Postdoctoral Training and Program and Trainee Review Council have approved additional policies and processes regarding single GME, which can be found here.
The AOA, ACGME and AACOM are committed to protecting residents during the transition to the single graduate medical education (GME) accreditation system. The terms of the new system require that the AOA no longer accredit GME programs after June 30, 2020.
The three organizations recognize there may be unique circumstances whereby some programs make a good faith effort to achieve ACGME accreditation but still have not transitioned successfully to ACGME accreditation by that date. An agreement reached by the three organizations seeks to protect residents in such programs or situations so they have the ability to complete AOA-accredited training and advance to AOA board eligibility.
The agreement will give the AOA restricted authority to extend the AOA accreditation date to allow any remaining resident in such programs to complete training in an accredited program. The AOA Council on Postdoctoral Training (COPT) and AOA Program and Trainee Review Council (PTRC) are currently developing a structure for AOA accreditation of GME programs after 2020.
The councils for will look at each program/resident on a case-by-case basis to determine the appropriate route to complete training. Please direct questions related to this agreement to firstname.lastname@example.org.
The AOA has a mechanism for DOs to have their ACGME PGY 1 training recognized as AOA approved, which is sometimes referred to as Resolution 42. This will remain available for the foreseeable future for DOs completing, or who have already completed, ACGME training seeking licensure in in states that require an AOA approved first year of training.
Yes, student and resident representatives have served on the AOA Board of Trustees and House of Delegates, providing critical input throughout the transition process.
Osteopathic residents currently serve on the ACGME’s Osteopathic Principles Committee, ONMM Review Committee, Council of Review Committee Residents, and Milestones working group.
The AOA provides a pathway for osteopathic physicians (AOA or ACGME trained) to sit for AOA board examinations in the areas for which it certifies. For AOA programs that achieve ACGME accreditation during the transition, all current osteopathic residents will receive AOA approval following completion of training, which will satisfy the AOA board training eligibility requirements. During the transition, the ABMS boards will offer certification to osteopathic physicians under specific circumstances (summarized in this chart). Individuals seeking ABMS certification should monitor relevant ABMS board websites for any changes in policy. Note that the rules for entering advanced ACGME training are established by the ACGME. Those rules may allow a trainee to enter advanced ACGME training, but do not guarantee the trainee would be eligible to sit for the ABMS board examination.
The ACGME Board of Directors recently approved changes which incorporate AOA board certification throughout the ACGME Common Program Requirements. Starting July 1, 2019, trainees who trained in an AOA or ACGME accredited program are eligible to enter ACGME accredited residencies and fellowships.
At the time of the MOU, approximately 50% of osteopathic graduates were training in ACGME residencies. Neither the AOA nor ACGME controls which applicants are chosen for specific programs. However, program directors are looking for residents who will complement and be an asset to their program. Competitive ACGME programs have sought and accepted osteopathic medical graduates for many years. We have every confidence that DO graduates are well qualified and will continue to have opportunities in competitive residency training positions.
AACOM provides reports on osteopathic medical GME placements, which reports that the osteopathic medical match rate remains over 99%. You can review the AACOM’s reports by graduation year here.
NRMP also has published Charting Outcomes in the Match for U.S. Osteopathic Seniors, which reports how applicant qualifications – including the number of ranks, COMLEX scores, research experience and work/volunteer experience – affect match success. You can view the NRMP’s report for 2018. This year, for the first time NRMP also has prepared interactive versions of Charting Outcomes that allow applicants to compare their own characteristics with those of applicants who previously matched to their preferred specialty. You can view the interactive version for DO applicants, as well as the home page for all Charting Outcomes reports.