Single GME Accreditation System Update

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1 Single GME Accreditation System Update Lorenzo L. Pence, DO, FACOFP Senior VP Osteopathic Accreditation AACOM 2018 Annual Conference COSGP Meetings Renaissance Hotel, Washington DC April 20, 2018

2 Disclosures I have nothing to disclose or any financial conflicts

3 Objectives Provide an update on the Single GME Accreditation System Review Board Eligibility Review program application statistics Identify resources available

4 ACGME Mission We improve health care and population health by assessing and advancing the quality of resident physicians' education through accreditation.

5 Where Are We Today? 33 Months into the transition

6 Transition Achievements

7 Transition Achievements Dates Achievements February 2014 MOU (2/26/14) July 2014 House of delegates Full Approval (7/14/14) November 2014 January 2015 February 2015 April 2015 ONMM and OPC work groups, draft requirements 1. AOA and AACOM become member organizations 2. New DO members to the board (Clinton Adams, DO, David Forstein, DO, Karen Nichols, DO, Gary Slick, DO) 3. Joint Task Force overseeing transition 1. AOA and AACOM full participation ACGME Board 2. ACGME Board Approved ONMM specialty requirements and OPC requirements for Osteopathic Recognition 3. DO s to serve on review committees 4. SVP named 5. IM and FM first to except AOA certification for PD s AOA Institutions start to apply

8 Transition Achievements Dates May 2015 July 2015 September 2015 October 2015 November 2015 Achievements AACOM Student survey on Osteopathic Recognition (OR) 1. AOA Programs start to apply 2. ACGME Programs and pre-accredited programs start applying for Osteopathic Recognition 3. Drs. Nasca and Buser give update to HOD First AOA programs achieve Initial Accreditation (IM) Transitional year RC makes changes to requirements First ACGME programs achieve Initial Recognition (18 programs) Nov/Dec 2015 January 2016 Eligibility FAQs for Specialties with a Preliminary Year (9 Specialties will accept AOA Internships during transition) Fellowship Eligibility during transition

9 Transition Achievements Dates February 2016 Achievements ONMM RC Added a 2 nd entry point for completion of an ONMM program March Process for combined/integrated programs 2. ACGME Common Program Requirements Phase 1 Task Force starts reviewing Section VI May OPC Meeting (2 nd to review OR applications), 18 additional programs achieve Osteopathic Recognition 2. ACGME moves to new location (401 North Michigan Ave) June 2016 July ONMM RC 1 st to meet at new ACGME address 2. 1 st ONMM Residency Program achieved ACGME Initial Accreditation 3. Various Review Committee start proposing changes to specialty requirements to add Osteopathic Board Certification Pass Rates Drs. Nasca and Buser present update to HOD

10 Transition Achievements Dates August 2016 Achievements 1. Neurological Surgery RC announce acceptance of AOA Board Certification for program directors. 2. With Neurological Surgery, 24 RC s accept AOA Board Certification as a requirement to be an ACGME program director September 2016 October 2016 January RC s submit proposed changes to requirements to include Osteopathic Board Pass rates 2. OPC meets and grants Initial Recognition to 12 additional ACGME Programs 3. New CLER Field Staff, Jose Zayas, DO ONMM RC approves 2 ONMM programs (total 3 to date) 1. OPC meets/approves 21 additional programs for OR 2. ACGME Common Program Requirements Phase 2 Task Force reviewing sections I-V

11 Transition Achievements Dates February 2017 Achievements 1. ACGME Common Program Requirement Phase 1 Task Force completing review and update to Section VI 2. Family Medicine RC proposed changes to FM requirements for adding Osteopathic Board pass rate, other RCs will be submitting proposed changes (19 to date) 3. ACGME Board approved RC proposed changes to requirements in a variety of specialties to add Osteopathic Board pass rate (16 specialties) 4. AACOM Student survey (3 rd year students) on Osteopathic Recognition (OR) March ACGME Common Program Requirements Phase 1 Task Force releases updated changes to section VI, 24 hour rule reinstated (same as AOA) 2. ACGME and AODME Joint Pre-Conference, Orlando, FL (first for ACGME) 3. ACGME, AOA, and AACOM: Agreement to Protect Residents during the Transition to a Single GME Accreditation System

12 Transition Achievements Dates Achievements April OPC meets/approves 10 additional programs for OR (Total 79) 2. ONMM RC meets/approves ONMM program (Total 4) RC s (15 have been approved, 5 with proposed changes) submit changes to requirements to include Osteopathic Board Pass rates June additional RC s with proposed focused revisions approved by ACGME Board Proposed changes to include Osteopathic Board Pass rates (20 RC s have made changes to date) 2. 1 additional RC has submitted proposed revisions to be reviewed September Board meeting 3. First ACGME FM/ONMM Program 4. New Field Staff (Arne Hasselquist, DO, Laura Hempstead, DO July Drs. Nasca and Buser - present update on Single GME Accreditation System to AOA House of Delegates

13 Dates Transition Achievements Achievements September OPC meets and grants Initial Recognition to 32 additional ACGME Programs. Total of ACGME Programs achieving Osteopathic Recognition surpassed 100 programs (Total 111) to date. 2. ONMM Review Committee meets, 3 additional programs achieve Initial Accreditation (Total 7) 3. ACGME Board approved RC proposed changes to requirements in Preventive Medicine to add Osteopathic Board pass rate (22 specialties) January OPC meets and grants Initial Recognition to 19 additional ACGME programs (120 programs) and 10 programs that achieved Continued Recognition (130 programs with Recognition) 2. ONMM Review Committee meets, 2 additional programs achieve Initial Accreditation (Total 9)

14 Transition Achievements Dates Achievements February February ACGME Board Meeting, Two additional DO physicians added to ACGME Board of Directors (Robert Juhasz, DO and Richard Pascucci, DO), with 2 more to be added in Common Program Requirements Phase 2 Task Force posted proposed changes to Common Program Requirements Sections I-V for comment March ACGME Annual Conference with the 2 nd ACGME-AODME Pre- Conference for Osteopathic Programs and Institutions April ONMM Review Committee meets, 2 additional programs achieve Initial Accreditation and 1 program moves to Continued Accreditation (Total 11) 2. Over 100 +, AOA programs, have achieved ACGME Accreditation since January 2018 (Total 440)

15 Common Program Requirements Proposed Changes CPR s* CPR s to include both: o o Residency Common Requirements Fellowship Common Requirements Osteopathic Board Certification o Acceptable criteria Program Directors Faculty AOA residency training acceptable for fellowships training New requirement: Program Directors to provide applicants information on Board eligibility *Comment period ended on March 22, 2018

16 Where Are We Today? AOA and AACOM DO representatives participate on the ACGME Board Integration of DO s on ACGME Review Committees Institutions and programs applying and achieving ACGME Accreditation Programs applying and achieving Osteopathic Recognition Changes to CPR s: Section VI complete and Sections I-V coming soon Resources available on the ACGME website, etc.

17 Match

18 Match Fourth Year Students (2018 Match - AOA^, NRMP, SF, UM, and MM*) Third Year Students (2019 Match - AOA^, NRMP, SF, UM, and MM*) Second Year Students (2020 Match - NRMP, SF, UM, and MM*) First Year Students (2021 Match - NRMP, SF, UM, and MM*) *Applicants that are eligible for Military Match ^Check AOA Opportunities page for eligible programs 1. National Matching Service (AOA) 2. National Residency Matching Program (NRMP) 3. Military Match (MM) 4. Urology Match (UM) 5. San Francisco Match (SF)

19 Students and the Match Students need to familiar with the Single GME Accreditation System and the match process (AOA, NRMP, etc.) Students Need to take and active role in researching programs Students must be realistic on their competitiveness for particular specialties Do not forget the DO match for those eligible for 2019 Match Always have a back up plan

20 Questions for Programs Transitioning to ACGME Accreditation

21 Questions: Transitioning Programs What questions should student be asking? Does the program have ACGME accreditation? o If no, has the program applied? If no, does the program plan to apply? If yes, what is the timeline? Which match(s) will the program participate?

22 Questions: Transitioning Programs What questions should student be asking? Which certifying board(s) will a graduate of the program be eligible? Does the program have Osteopathic Recognition? o If no, has the program applied? If no, does the program plan to apply for Osteopathic Recognition? If yes, what is the timeline?

23 Board Eligibility

24 Pre-Accreditation Student matches into an AOA program in Pre-Accreditation but the program never achieves ACGME Accreditation Student has matched into an AOA Accredited program Eligible for AOA Board Certification when completes program (Not eligible for ABMS) Eligible to apply for some ACGME Fellowships (eligibility rules in place in 2013 or 2016, whichever is less restrictive) Exceptionally Qualified Applicant Provision - eligible for some fellowships (specialty dependent)

25 Pre-Accreditation Student matches into an AOA program in Pre-Accreditation that later achieves ACGME Accreditation Student has matched into an AOA Accredited program that now has achieved ACGME Accreditation Eligible for AOA Board Certification when completes program May be Eligible for ABMS Boards (Board certification eligibility is determined by the individual certifying boards) Eligible to apply for ACGME Fellowships

26 Continued Pre-Accreditation Student matches into an AOA program in Continued Pre- Accreditation but the program never achieves ACGME Accreditation Student has matched into an AOA Accredited program Eligible for AOA Board Certification when completes program (Not eligible for ABMS) Eligible to apply for some ACGME Fellowships (eligibility rules in place in 2013 or 2016, whichever is less restrictive) Exceptionally Qualified Applicant Provision - eligible for some fellowships (specialty dependent)

27 Continued Pre-Accreditation Student matches into an AOA program in Continued Pre- Accreditation that later achieves ACGME Accreditation Student has matched into an AOA Accredited program that now has achieved ACGME Accreditation Eligible for AOA Board Certification when completes program May be Eligible for ABMS Boards (Board certification eligibility is determined by the individual certifying boards) Eligible to apply for ACGME Fellowships

28 Initial or Continued Accreditation Student matches into a program that has achieved ACGME Initial or Continuing Accreditation Student has matched into an ACGME Accreditation Eligible for AOA Board Certification and/or ABMS Boards when completes program Eligible to apply for ACGME Fellowships

29 Initial Accreditation Contingent Student matches into an AOA program in Initial Accreditation Contingent but the Institution never achieves ACGME Accreditation Student has matched into an AOA Accredited program Eligible for AOA Board Certification when completes program (Not eligible for ABMS) Eligible to apply for some ACGME Fellowships (eligibility rules in place in 2013 or 2016, whichever is less restrictive) Exceptionally Qualified Applicant Provision - eligible for some fellowships (specialty dependent)

30 Initial Accreditation Contingent Student matches into an AOA program in Initial Accreditation Contingent and the Institution achieves ACGME Accreditation Student has matched into an AOA Accredited program that now has achieved ACGME Accreditation Eligible for AOA Board Certification when completes program May be Eligible for ABMS Boards (Board certification eligibility is determined by the individual certifying boards) Eligible to apply for ACGME Fellowships

31 Single GME Webpages

32 ACGME Website

33 ACGME Website Scroll Down Link to Single GME Accreditation Webpage

34 Single Accreditation Website Links to resident and student information

35 AOA Residents And Students Links to Osteopathic Recognition Links to Fellowship eligibility

36 Fellowship Eligibility Links to fellowship Eligibility

37 Fellowship Eligibility

38 Fellowship Eligibility

39 Fellowship Eligibility FAQ s: SAS Question Eligibility for Fellowship Will individuals who are currently enrolled in AOAapproved residency programs be eligible for entry into ACGME-accredited fellowships? Answer Effective July 1, 2016, eligibility requirements for all fellowship positions require completion of prerequisite training in a program accredited by the ACGME, the RCPSC, or the College of Family Physicians of Canada (CFPC). Between July 1, 2015 and June 30, 2020, a resident who completes prerequisite training in an AOA-approved program with pre-accreditation status will be subject to the ACGME fellowship eligibility standards (per subspecialty) that were in effect June 30, 2013 or July 1, 2016, whichever is less restrictive. A number of Review Committees (see here for a list) allow programs to grant an exception to the eligibility requirements for prior training. If an individual graduated from a program with pre-accreditation status, is appointed to a fellowship program based on the exceptionally qualified applicant provision detailed in the ACGME Common Program Requirements, and has successfully completed Levels I, 2, and 3 of COMLEX USA, then that individual will not be required to take USMLE. NOTE: Some subspecialties did not in 2013, and will not in 2016, accept as prerequisite training anything other than completion of an ACGME-accredited program. *The eligibility requirements for every ACGME-accredited subspecialty that were in effect as of June 30, 2013, that were/are in effect between June 30, 2013 and July 1, 2016, and that will be in effect as of July 1, 2016, are posted on the Single GME Accreditation System section of the ACGME website.

40 AAMC Video Interview Standardized Video Interview (SVI) program 2019 NRMP Match for Emergency Medicine o Piloted NRMP Match Developed by the Association of American Medical Colleges (AAMC) Incorporated into Electronic Residency Application Service (ERAS) MyERAS applicants register for SVI if they plan to apply to EM Not an ACGME rule

41 AAMC Video Interview All applicants applying to ACGME Accredited EM programs to complete SVI (required yes/no) o o No Fees Must acknowledge that you have read and understand the rules when first launching SVI (legally binding contract) Allows applicants to share objective performance-based information about themselves o Add breadth and depth to applicants application o Provides program director with additional information to assess applicants o Scored by trained rater using a scale designed for the SVI (range 6-30)

42 AAMC Video Interview Key prerequisites for success in residency and practice Video interview designed to assess Interpersonal and Communication Skills Oral Communication Emotional Intelligence Teamwork and Leadership Professional Behaviors (Professionalism) Empathy and Altruism Ethics Cultural Competence Conscientiousness

43 Online interview 6 questions o AAMC Video Interview 30 seconds to read questions 3 minutes to respond to each question AAMC resources available today and will be updated in March 2018 (The AAMC Standardized Video Interview: Essentials for the ERAS 2019 Season) Applicant may only complete once Applicants can not retake to improve score

44 National Level 2018 AOA Match 582 programs 6,644 Current Osteopathic Students 479 Previous DO Graduates 7,123 Total for 2018 Match o 2,833 Participated (39.7%) 1,954 Matched (27.4%)* 879 Non-Match (12.3%) o 4,290 Non-Participation (60.2%) 2,473 Pre-match Positions 1,680 Post-Match Positions Filled 793 Post-Match Positions Unfilled *274 Military Included in Total Matched

45 2018 NRMP Match 43,909 Registered Applicants 37,103 Applicants submitted program choices (record high) 4,617 Active Osteopathic Applicants (student/graduates) o 3,771 Matched PGY-1 (81.7%) o 846 Unmatched 33,167 Positions (most ever offered) o o o 30,232 PGY-1 2,678 PGY Physician (R) Positions ONMM (first time offered) o FM/ONMM (first time offered) 31,899 Positions Filled o o 29,040 PGY-1 Filled 2,650 PGY-2 Filled 1,268 Unfilled positions

46 Match Results 2018* 5,984 Graduates 5,937 Seeking GME 2,525 Matched AOA 3,072 Matched NRMP 5,898 Matched/Placed (99.34%) 39 Not Matched 6,350 Graduates 6,303 Seeking GME 1,995 Matched AOA 3,878 Matched NRMP 6,224 Matched/Placed (98.75%) 121 Mot Matched *April 16, 2018

47 Agreement to Protect Residents What happens to residents in programs that do not achieve ACGME accreditation? Provides protection for residents in AOA-approved training programs, which do not achieve ACGME accreditation prior to June 30, 2020 o Unique circumstances that may limit a residents ability to complete program by June 20, 2020 ACGME, AOA, and AACOM agreement AOA will have restricted authority to extend AOA accreditation date Allows residents to complete training and be eligible for AOA Board Certification

48 ACGME Growth Over The Last Decade

49 ACGME-Accredited Programs 26% 33% 18% Courtesy of John Potts, MD

50 ACGME Today 11,040 Accredited GME programs*^ 198 Combined-Programs* 136,478 Residents* 78 Med/Peds (Accredited)* 831 Sponsoring institutions* Specialty and subspecialty areas 28 Review Committees 1 Institutional Review Committee 121 Other (Non-accredited)* 1 Family Medicine/ONMM* 2,237 Residents* 1 Recognition Committee Over 6,000 items/decisions per year *ACGME Data ( ) ^Total programs include Med/Peds but does not include other Combined programs

51 Status of Programs Applying For Accreditation and Osteopathic Recognition

52 Institution Applications Initial Accreditation 79 Initial With Warning 1 Continued Accreditation 8 Pre-Accreditation 3 Continued Pre- Accreditation 9 Withdrawn 6 Total Applications Total Applications Continued Pre- Accreditation Continued Accreditation Initial Accreditation Withdrawn Pre-Accreditation Initial With Warning *April 19, 2018

53 Program Applications Total Accedited Programs 440 Initial Accreditation Initial With Warning Continued Accreditation Continued Without Outcomes 2 Initial Accreditation Contingent Pre-Accreditation 1 71 Continued Pre- Accreditation 134 Withdrawn 6 Total Applications Total Applications Withdrawn Continued Pre- Accreditation Pre-Accreditation Initial Accreditation Contingent Continued Without Outcomes Continued Accreditation Initial With Warning Initial Accreditation Total Accedited Programs *April 19, 2018, Total program and Fellowship applications

54 Program Applications Allergy and Immunology Anesthesiology Dermatology Emergency Medicine Family Medicine Internal Medicine Neurological Surgery Neurology OB/GYN Ophthalmology Orthopedic Surgery ONMM Otolaryngology Pediatrics PM&R Plastic Surgery Psychiatry Radiology Surgery Urology Transitional Year Pre-Accreditation Continued Pre-Accreditation Initial Accreditation Initial With Warning Continued Accreditation Continued Without Outcomes Withdrawn *April 19, 2018, Total Program and Fellowship applications

55 Fellowship Applications Total Accedited Programs 69 Initial Accreditation Initial With Warning Continued Accreditation Continued Without Outcomes 0 Initial Accreditation Contingent Pre-Accreditation Continued Pre- Accreditation Withdrawn Total Applications Total Applications Withdrawn Continued Pre- Accreditation Pre-Accreditation Initial Accreditation Contingent Continued Without Outcomes Continued Accreditation Initial With Warning Initial Accreditation Total Accedited Programs *April 19, 2018, Total Fellowship Applications

56 Fellowship Applications Total Fellowship Applications Micrographic Surgery & Dermatologic Oncology Hospice & Palliative Medicine Cardiovascular Disease Critical Care Medicine Endocrinology, Diabetes, and Metabolism Gastroenterology Hematology & Medical Oncology Geriatric Medicine (Internal Medicine) Infectious Disease Interventional Cardiology Nephrology Pulmonary Disease Pulmonary Disease & Critical Care Medicine Rheumatology Maternal-Fetal Medicine Gynecologic Oncology Surgical Critical Care Pre-Accreditation Continued Pre-Accreditation Initial Accreditation Initial With Warning Continued Accreditation Continued Without Outcomes Withdrawn * April 19, 2018, Total Fellowship applications

57 Osteopathic Recognition Osteopathic Recognition to 130 Programs in 2 ½ Years * Initial Recognition *March 25, 2018

58 Osteopathic Recognition

59 Osteopathic Recognition

60 NRMP Match: Osteopathic Recognition* *NRMP Search Programs Screenshot

61 Osteopathic Recognition Specialty Application Pending* Initial Recognition* Continued Recognition* Allergy & Immunology 1 Anesthesiology 2 Cardiovascular Disease 2 Dermatology 2 Emergency Medicine 3 Family Medicine Geriatrics 1 Hospice & Palliative Medicine 1 Internal Medicine Internal Medicine/Pediatrics 1 Obstetrics & Gynecology 4 2 Osteopathic Neuromusculoskeletal Medicine 1 Pediatrics 3 Physical Medicine & Rehabilitation 1 Psychiatry 1 Radiology 1 Sports Medicine 3 Surgery 1 Transitional Year 2 3 Total *April 19, 2018

62 Resources Multiple resources on ACGME website Contact Executive Director ACGME Annual Conference and Pre-Conferences ACGME Workshops ACGME Presentations, Webinars, etc.

63 Thank You

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