Ryan Dyches, OMSIV, Arizona College of Osteopathic Medicine of Midwestern University
In July 2020, the five-year plan set forth by the Single Accreditation System (SAS) will be complete. As a result, all graduate medical education (GME) will be streamlined and overseen by one accrediting body – the Academic Council of Graduate Medical Education (ACGME). What does this mean to you as a medical student and applicant to GME?
If you’re an osteopathic medical student, this means two major changes. First, there are no longer two different matches for you to participate in. Gone are the days in which the agonizing decision had to be made whether to match into an AOA accredited program or roll your dice and go forward with the NRMP match. Second, there is no longer a worry about entering an AOA accredited program and being denied pursuing a fellowship in an ACGME program due to GME requirements.
If you’re an allopathic medical student, this means that now all programs are open to you, particularly those that were previously only available to osteopathic students.
Prior to the SAS, GME programs were accredited by two separate governing bodies. The majority of residencies pursued ACGME accreditation. Osteopathic programs, on the other hand, were accredited by the American Osteopathic Association. In addition, some programs chose to undergo accreditation by both the ACGME and the AOA. In 2014, the ACGME, AOA, and American Association of Colleges of Osteopathic Medicine (AACOM) approved an agreement to transition to the SAS by July 2020. The ACGME was selected to be the sole accrediting body and all programs would have to pass accreditation by July 2020.
Results of the SAS Implementation
All previously osteopathic accredited programs that successfully passed accreditation through the ACGME are now available to MD applicants. 946 out of 1244 (76%) DO programs have been accredited by the ACGME as of 15 September 2019. This number includes residencies and fellowships. If broken down, 84% of residencies successfully transitioned. Between 2015 and 2019, 191 programs closed; however, 42% of the programs closing cited that they had no trainees. In that same time period, AOA program residency positions increased by 1,655.
Osteopathic Recognition and Milestones
Osteopathic Recognition is a designation given by the ACGME to programs that “demonstrate the commitment to teaching and assessing Osteopathic Principles and Practice at a GME level.” Currently, 215 programs have received osteopathic recognition, two of them in the field of anesthesiology. As a part of the osteopathic recognition designation, residents in these programs are assessed via Milestones, which are competency based developmental outcomes. While graduation requirements from residency are set by the program director, these milestones guide curriculum from programs and set transparent expectations for residents.
While there have been some challenges with the implementation of the SAS, the results have been a streamlined and improved process for GME. Students have increased access to programs and decreased barriers when seeking training. Collaboration has increased in the GME community and the associated costs have decreased.