Move to Single Accreditation System Looms

AAFP Tool Can Connect GME Programs, Save Family Medicine Slots

July 01, 2017 05:41 pm Sheri Porter

(Editor's Note: This story was modified after initial publication to clarify that the research conducted by the Robert Graham Center for Policy Studies in Family Medicine and Primary Care using statistics drawn from the American Osteopathic Association website as of April 11, 2017, focused solely on family medicine residency programs. Language also has been added to more clearly differentiate between pre-accreditation and full accreditation by the Accreditation Council for Graduate Medical Education. We regret any misunderstanding resulting from the omission of this information in the original version of this story.)

The AAFP has created a new tool, dubbed the Family Medicine Residency Explorer, that is designed to help family medicine residency programs accredited by the American Osteopathic Association (AOA) succeed in the move to a single graduate medical education (GME) accreditation system.  

[Illustration of United States map with human figures]

Why is this important?

Because the clock is ticking on the consolidation process: Programs currently accredited solely by the AOA have until June 30, 2020, to meet accreditation standards of the Accreditation Council for Graduate Medical Education (ACGME) and, thus, retain their status as accredited residency programs.

The urgency of the situation is outlined in statistics gathered by family physician Julie Petersen, D.O., a health policy fellow at the Washington-based Robert Graham Center for Policy Studies in Family Medicine and Primary Care.

The work done by Petersen and her fellow researchers at the Graham Center -- David Grolling, M.P.S.; Graham Center Medical Director Winston Liaw, M.D., M.P.H.; and Graham Center Director Andrew Bazemore, M.D., M.P.H. -- is titled "Osteopathic Family Medicine Medical Education Status During the Single Accreditation System Transition." 

Story Highlights
  • The AAFP has launched a new tool called the Family Medicine Residency Explorer to help smooth the transition to the single graduate medical education accreditation system coming in 2020.
  • Concern is growing about the potential for lost family medicine residency slots if osteopathic programs aren't accredited by the Accreditation Council for Graduate Medical Education in a timely manner.
  • Rural and community-based osteopathic residencies are particularly vulnerable to transition challenges because of a lack of resources within their communities.  

Although 98 of the 262 osteopathic family medicine programs were already dually accredited, data that Petersen gathered from an area of the AOA website that lists residency program opportunities( revealed that 91 percent of AOA-only accredited family medicine residency programs had not yet received full ACGME accreditation.

Put another way, based on numbers recorded as of April 11, as many as 623 family medicine residency slots per year are at risk of being lost because of the single accreditation system process at the very time when the primary care workforce pipeline needs to be brimming with recruits.

And the numbers put rural America at particular risk. Petersen found that 31 rural programs -- 91 percent of the total number of rural family medicine programs -- had not yet completed the transition to dual accreditation.

"The medical community overall has a lot to gain by expanding access to rural and community- based GME, an area in which AOA programs excel," said Petersen in an interview with AAFP News.

She pointed out that the AOA has had great success at creating the GME infrastructure the primary care world has been trying to establish for decades.

Petersen noted that according to an AOA report,( about 56 percent of osteopathic physicians work in a primary care specialty, and about 16 percent of osteopathic family medicine residency programs are located in rural areas.

Abundant evidence shows that many programs in the AOA community have begun the transition process, she said. However, because many of these programs have not yet achieved full ACGME accreditation, "we as a community need to be vigilant and aware of this transition as it happens," Petersen added.

"We want to make sure programs aren't slipping through the cracks, and we should pay special attention to those small and rural programs that are the most vulnerable and that have the fewest resources to ensure they are successful in this transition," she added.

Stan Kozakowski, M.D., director of the AAFP Division of Medical Education, said the immediate challenge facing the AOA-only accredited programs right now is that programs must achieve "pre-accreditation" status with the ACGME if they are to participate in the 2018 AOA residency matching program.

"In plain English, that means AOA programs must only have applied and sent in their application by Dec. 31, 2017," Kozakowski told AAFP News.

Once that step is accomplished, the bigger task is obtaining full ACGME accreditation.

"We know that some of the AOA-only accredited programs will experience challenges in receiving full ACGME accreditation because they must, as all programs do in the ACGME system, meet a set of institutional requirements, as well as program- or specialty-specific requirements," said Kozakowski.

He added that two of the most common requirements that have been problematic for the AOA programs was having family medicine faculty to role-model maternity care and inpatient pediatric care.

"Those are two big stumbling blocks for these programs," said Kozakowski.

And that's where the Family Medicine Residency Explorer tool comes in.

"I had this idea of the residency mapper about a year ago," he explained. "My thought was to find a way to create conversations between programs that are exploring or engaged in the accreditation process with currently accredited programs as a means of sparking creative thinking about how people could share resources."

For example, an ACGME program director could use the mapper to find nearby osteopathic programs and reach out to offer assistance. Perhaps the D.O. residents could travel to the ACGME-accredited host institution to fulfill the maternity care requirement or engage in inpatient pediatrics taught by family physicians.

"The tool is very simple in the sense that we're trying to provide programs with a means of connecting with their neighbors and potential partners to at least discuss ideas that might help programs to move forward or share resources," said Kozakowski.

Primary care is faced with an undeniable risk for losing GME positions, and the mapper is a free tool everyone can access, he noted.

"Look, workforce is everybody's business," Kozakowski said. "We all have to step up, because this affects our collective future.

"Wouldn't it be fantastic if every family medicine program director in the country went into the tool, searched by their location, put in a certain radius and said 'Who's around me, and who can I help, or who do I need help from?'" he asked. "That's my dream."

Related AAFP News Coverage
2017 Osteopathic Match Results
D.O. Physicians' Passion for Family Medicine Continues


Allopathic, Osteopathic Medical Communities Announce Transition to Unified GME Accreditation

Fresh Perspectives: Accreditation Merger Creates Unified Standard, Preserves D.O.s' Identity