Criteria for Excellence | Chapter 8F: Osteopathic principles and practice
Explore how osteopathic principles and recognition can strengthen residency education.
Preserve osteopathic principles and practice in residency education
The creation of a single accreditation system for graduate medical education (GME) for both allopathic and osteopathic programs under the Accreditation Council for Graduate Medical Education (ACGME) was intended to do the following:
Create a uniform system for evaluation and accountability for resident physicians’ competency across all accredited GME programs
Eliminate duplication in GME accreditation
Achieve efficiencies and cost savings for institutions currently sponsoring “dually” or “parallel” accredited allopathic and osteopathic programs
Ensure that all residency and fellowship applicants are eligible to enter all accredited programs in the United States
One of the challenges inherent in that process was the risk of losing the richness of Osteopathic Principles and Practice (OPP). Special attention continues to be necessary to ensure the identity of osteopathic medical school graduates by preserving osteopathic principles and to create opportunities for allopathic physicians to gain exposure to osteopathic medicine. To facilitate the achievement of these goals, the ACGME created an optional pathway for ACGME-accredited residency programs to seek and obtain Osteopathic Recognition.
ACGME Osteopathic Recognition for residency programs
Osteopathic Recognition is “a designation conferred by the ACGME’s Osteopathic Recognition Committee upon ACGME-accredited programs that demonstrate, through a formal application process, the commitment to teaching and assessing Osteopathic Principles and Practice (OPP) at the graduate medical education level.”2
Understand the tenets of osteopathic medicine
The American Osteopathic Association (AOA) defines the tenets of osteopathic medicine as the following:3
The body is a unit; the person is a unit of body, mind and spirit.
The body is capable of self-regulation, self-healing and health maintenance.
Structure and function are reciprocally interrelated.
Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation, and the interrelationship of structure and function.
In many ways, the holistic tenets of OPP are closely aligned with the principles of patient-centered care embraced by family medicine. A Program of Excellence should carefully consider the option to seek Osteopathic Recognition as part of its strategic planning process. (See the Strategic Planning chapter for additional information.) Program leadership should carefully consider the pros and cons and the opportunities and challenges associated with Osteopathic Recognition since it is an option, not an accreditation requirement.
ACGME requirements for Osteopathic Recognition
The requirements for Osteopathic Recognition, a robust set of related frequently asked questions, and other resources can be found on the ACGME website.
Program requirements for Osteopathic Recognition include the following:4
Have at least one resident per program year, averaged over a period of three years, in the osteopathic track
Teach OPP and integrate it into the six ACGME Core Competencies
Have a director of osteopathic education and at least one additional faculty member who is qualified to teach OPP (although external resources may be shared)
Have enough resources to teach osteopathic manipulative treatment (OMT) (e.g., suitable exam/treatment tables)
Require osteopathic-focused scholarly activities for residents and faculty participating in the osteopathic track
Participate in a community of learning that promotes the continuum of osteopathic medical education
Opportunities and challenges of Osteopathic Recognition
Osteopathic Recognition may present a program with potential opportunities that include, but are not limited to, the following:
Opportunities for family medicine residency programs
Facilitating the recruitment of osteopathic medical school graduates, especially those who wish to maintain their osteopathic identity and practice OMT during training and into practice
Providing training opportunities for allopathic medical school graduates who wish to gain a greater understanding of OPP and learn OMT skills
Improving all residents’ skills in musculoskeletal medicine
Challenges of implementing an osteopathic track
Potential challenges for some programs may include the following:
Lack of qualified faculty to teach OPP
Cost of equipment and/or affiliations needed to fulfill the teaching requirements
Lack of resident interest in participating in an osteopathic track
A careful read of the ACGME’s FAQs captures several potential solutions to overcome possible barriers and fulfill the requirements.
Determine whether Osteopathic Recognition supports your residency program
In summary, a Program of Excellence should carefully determine if Osteopathic Recognition can serve as a tactic to achieve its strategic plan, with a larger goal of incorporating the values and skills of OPP to enhance patient care.
References
- Accreditation Council for Graduate Medical Education. History of the transition to a single GME accreditation system. Accessed March 3, 2023.
- Accreditation Council for Graduate Medical Education. Osteopathic Recognition. Accessed January 10, 2023.
- American Osteopathic Association. Tenets of osteopathic medicine. Accessed November 20, 2022.
- Accreditation Council for Graduate Medical Education. Osteopathic Recognition requirements. July 2021. Accessed November 20, 2022.