Cummings Mark
M. Cummings is associate dean (emeritus), Michigan State University College of Osteopathic Medicine, East Lansing, Michigan.
Acad Med. 2021 Aug 1;96(8):1108-1114. doi: 10.1097/ACM.0000000000004109. Epub 2021 Jul 27.
In August 2014, the American Osteopathic Association (AOA) and the American Association of Colleges of Osteopathic Medicine (AACOM) signed a memorandum of understanding with the Accreditation Council for Graduate Medical Education (ACGME) to create the Single Accreditation System (SAS) for graduate medical education (GME) in the United States. The AOA made the decision that it would close its GME accreditation system in response to dramatic growth in colleges of osteopathic medicine, a shortfall in osteopathic GME positions with increasing dependence on the ACGME system, ACGME policy decisions that adversely impacted osteopathic students, and declining osteopathic student interest in primary care. Osteopathic teaching institutions bore responsibility for meeting ACGME accreditation standards between 2015 and 2020, including determining institutional sponsorship, which program applications to submit, program size, educational leadership, and whether to pursue Osteopathic Recognition. Approximately 692 of 954 (72.5%) eligible osteopathic GME programs in 2014-2015 obtained ACGME accreditation by June 1, 2020. There were sharp reductions in surgical and subspecialty programs and a significant drop of DOs in educational leadership positions. A low percentage of ACGME-accredited programs applied for Osteopathic Recognition. In closing its GME accreditation system and joining the ACGME, the AOA gave up control of its direct relationship with osteopathic residents, fellows, and teaching institutions to gain critical GME opportunities. In this article, the author considers whether this gain will offset the risks taken by the AOA, including decreased DO leadership opportunities and role models, lower than expected interest in Osteopathic Recognition, and possible decreased DO interest in osteopathic organizations and osteopathic specialty board certification. Time and the choices of current and future DO trainees in ACGME programs will determine the future of the osteopathic profession-and whether these risks were worth taking.
2014年8月，美国骨疗法协会（AOA）和美国骨疗法医学院协会（AACOM）与毕业后医学教育认证委员会（ACGME）签署了一份谅解备忘录，以创建美国毕业后医学教育（GME）的单一认证系统（SAS）。鉴于骨疗法医学院的急剧增长、骨疗法GME职位的短缺以及对ACGME系统的依赖增加、ACGME的政策决定对骨疗法学生产生不利影响以及骨疗法学生对初级保健的兴趣下降，AOA决定关闭其GME认证系统。在2015年至2020年期间，骨疗法教学机构负责满足ACGME认证标准，包括确定机构赞助、提交哪些项目申请、项目规模、教育领导权以及是否寻求骨疗法认可。在2014 - 2015年的954个符合条件的骨疗法GME项目中，约692个（72.5%）在2020年6月1日前获得了ACGME认证。外科和亚专科项目急剧减少，担任教育领导职位的骨疗法医生数量大幅下降。获得ACGME认证的项目中申请骨疗法认可的比例较低。在关闭其GME认证系统并加入ACGME时，AOA放弃了对其与骨疗法住院医师、研究员和教学机构直接关系的控制，以获得关键的GME机会。在本文中，作者思考这种收获是否会抵消AOA所承担的风险，包括骨疗法医生领导机会和榜样的减少、对骨疗法认可的兴趣低于预期，以及骨疗法医生对骨疗法组织和骨疗法专科委员会认证的兴趣可能降低。时间以及当前和未来ACGME项目中骨疗法学员的选择将决定骨疗法专业的未来，以及这些风险是否值得冒。
