Perspectives on the Single GME Accreditation System

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In his recent article, Dr. Cummings1 makes predictions based on inaccurate information. This serves no purpose but to alarm hospital leaders and program directors. On behalf of the American Osteopathic Association (AOA), I would like to set the record straight on several points.
First, osteopathic programs will not be required to expand their resident complement beyond their Medicare graduate medical education (GME) funding cap in order to meet a “minimum number of residents” requirement. The Accreditation Council for Graduate Medical Education (ACGME) has assured AOA and the American Association of Colleges of Osteopathic Medicine that program size would not be a sole determinant in the accreditation of a program, and no AOA program to date has been denied accreditation solely on that basis.
Second, compliance with ACGME companion requirements is unlikely to be an issue. AOA programs are successfully drawing on resources within larger affiliate systems to address such requirements.
Third, transitional-year programs are not required to be sponsored by two or more ACGME residency programs, as Dr. Cummings misstated. The standard requires that at least one ACGME-accredited program be designated as a sponsor, which mirrors current AOA standards.
Finally, growth in the number of new AOA programs between 2013 and 2015 was not “an unforeseen consequence of the [memorandum of understanding].”1 The AOA expected that some programs in development would accelerate their applications. The AOA has grown new training programs at a rate of 7.5% annually since 2008, with continued growth expected.
We take issue with Dr. Cummings’s suggestion that the number of approved AOA positions can “only be seen as inflated.”1 He has the information to understand there are a variety of reasons why programs and hospitals sought approvals for positions that ultimately were not fully funded or, in some cases, filled.
The transition to the single GME accreditation system is complex and challenging. All parties in the process are committed to perpetuating the distinctive elements of osteopathic GME and increasing opportunities for all physicians in training—MDs as well as DOs. We are pleased with the progress of the transition thus far. While Dr. Cummings is entitled to his own opinions about the transition, presenting them as facts does a disservice to your readers.
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