Ahmed Harris, Kortz Michael, Carmody J Bryan
Ophthalmology, Loma Linda University Medical Center, Loma Linda, USA.
Neurosurgery, University of Colorado, Denver, Colorado, USA.
Cureus. 2023 Feb 12;15(2):e34884. doi: 10.7759/cureus.34884. eCollection 2023 Feb.
In the United States, medical schools are accredited by either the Liaison on Committee Medical Education (LCME) or the Commission on Osteopathic College Accreditation (COCA), which assesses the quality and standards of Doctor of Medicine (MD)-granting and Doctor of Osteopathic Medicine (DO)-granting institutions, respectively. Thereafter, new MD and DO physicians complete graduate medical education (GME) training. Historically, the two physician licensure pathways have been predominantly separate, but in 2020, the Accreditation Council for Graduate Medical Education and American Osteopathic Association finalized a single accreditation GME system. Now, other elements of MD and DO physician training that have traditionally remained separate, such as undergraduate medical education (UME), are increasingly being scrutinized. Since 2010, when the accreditation of UME was last qualitatively criticized, the standards and competencies set forth by LCME and COCA have converged. COCA, in particular, has updated its requirements to emphasize scholarly activity, improve inpatient clinical rotation requirements, engage medical students, and enhance clinical faculty qualifications. Such convergence brings to question the continuing need for two independent accreditation pathways and barriers that may prevent a single accreditation. We argue that although MD and DO physicians are unique, the natural confluence of UME accreditation represents an opportunity to simplify and improve physician training in the United States. Our analysis suggests the major barriers to implementing a single accreditation system surround the requirement of Osteopathic Manipulative Medicine (OMM)-focused faculty by COCA and the two separate licensing exams (USMLE (United States Medical Licensing Examination) and COMLEX (Comprehensive Osteopathic Medical Licensing Examination)). However, with a continuing decline in osteopathic physicians practicing OMM and growing debate over a new single licensing exam, a single accreditation UME system may be practically achieved.
在美国，医学院校由医学教育联络委员会（LCME）或整骨医学院认证委员会（COCA）认证，这两个委员会分别评估授予医学博士（MD）学位和整骨医学博士（DO）学位机构的质量和标准。此后，新的MD和DO医生完成研究生医学教育（GME）培训。从历史上看，这两条医师执照获取途径主要是分开的，但在2020年，研究生医学教育认证委员会和美国整骨疗法协会最终确定了一个单一认证的GME系统。现在，MD和DO医师培训中其他传统上一直分开的要素，如本科医学教育（UME），正受到越来越多的审视。自2010年UME认证上次受到定性批评以来，LCME和COCA制定的标准和能力要求已经趋同。特别是COCA更新了其要求，以强调学术活动、改进住院临床轮转要求、让医学生参与进来并提高临床教师资质。这种趋同引发了对于两条独立认证途径以及可能阻碍单一认证的障碍是否仍有持续存在必要的质疑。我们认为，尽管MD和DO医师有所不同，但UME认证的自然融合代表了一个简化和改进美国医师培训的机会。我们的分析表明，实施单一认证系统的主要障碍围绕着COCA对专注于整骨手法医学（OMM）的教师的要求以及两项单独的执照考试（美国医师执照考试（USMLE）和综合整骨医学执照考试（COMLEX））。然而，随着从事OMM的整骨医师数量持续下降以及关于新的单一执照考试的争论不断增加，一个单一认证的UME系统可能在实际中得以实现。
