THE SINGLE ACCREDITATION SYSTEM: MORE THAN A MERGER

In February 2014 the Accreditation Council for Graduate Medical Education (ACGME), American Osteopathic Association (AOA), and American Association of Colleges of Osteopathic Medicine (AACOM) announced an agreement outlining a single graduate medical education accreditation system in the United States (http://www.acgme.org/What-We-Do/Accreditation/Single-GME-Accreditation-System; http://www.acgme.org/Portals/0/PDFs/Nasca-Community/FAQs.pdf). This single accreditation system allows graduates of allopathic and osteopathic medical schools to complete their residency and/or fellowship education in ACGME-accredited programs and demonstrate achievement of common competencies and milestones. The single accreditation system is intended to achieve 4 significant benefits:

1. To maintain consistent evaluation and accountability for the competency of resident physicians across all accredited GME programs

2. To eliminate duplication in GME accreditation

3. To provide cost savings and efficiencies for institutions currently sponsoring dually accredited or parallel accredited allopathic and osteopathic programs

4. To ensure that allopathic and osteopathic residency and fellowship applicants are eligible to enter accredited programs in the United States and can transfer from 1 accredited program to another without repeating training and without causing sponsoring institutions to lose Medicare funding

There are 4 broad dimensions to the agreement:

1. The agreement outlines the process for ACGME accreditation of current AOA-accredited programs. After June 30, 2020, the AOA will no longer accredit residency programs, so these programs must receive initial ACGME accreditation by June 30, 2020.

   Upon receipt of a completed institutional application, the ACGME may assign pre-accreditation status to the sponsoring institution. When the institution receives the pre-accreditation designation, the institution’s AOA-accredited programs can begin the process for ACGME designation. AOA-approved programs with and without matriculated residents are eligible for ACGME “pre-accreditation status.” Pre-accreditation is not synonymous with initial accreditation but rather indicates that the program remains under AOA approval while in the process of attaining ACGME accreditation. Initial accreditation and ultimately continued accreditation are awarded by the ACGME Review Committee when the applicant is in substantial compliance with the applicable Program and/or Institutional requirements. Programs that are not AOA acredited by July 1, 2015, must apply for ACGME accreditation similar to any other new program (http://www.acgme.org/Portals/0/PDFs/Nasca-Community/PathwaystoACGMEAccreditationforAOA-ApprovedPrograms.pdf).

2. The agreement clarifies the eligibility of osteopathic graduates entering into advanced training in ACGME-accredited programs. Physicians who graduate from programs with pre-accreditation status will be eligible for entry into ACGME-accredited advanced standing residencies and fellowships.

3. The agreement endorses incorporation of osteopathic medical principals within ACGME-accredited programs. ACGME-approved residency programs may apply for Osteopathic Recognition. Osteopathic Recognition signifies that the program is committed to teach and assess Osteopathic Principles and Practice at the GME level. Osteopathic Principles and Practice recognize that the patient is a unit of mind, body, and spirit; that the body has the intrinsic ability to heal itself when provided with the right environmental conditions; and that structure and function are interrelated. Both students who have graduated from osteopathic- and LCME-accredited schools may enter into a program’s designated osteopathic-focused track.

   Osteopathic Recognition is designed to provide an organized approach to perpetuate osteopathy’s contributions to patient care and to create opportunities for all physicians to learn Osteopathic Principles and Practices while creating program distinctiveness. (http://www.acgme.org/Portals/0/PDFs/FAQ/Osteopathic%20Recognition%20FAQs.pdf; http://www.acgme.org/Portals/0/PFAssets/ProgramResources/Elements_of_an_Osteopathic_Learning_Environment.pdf)

4. The 4th dimension of the agreement is the incorporation of the AOA and AACOM into the governance structure of ACGME. This will include board of director seats and playing a role in nominating representatives to various residency committees.

In February 2014, after more than a decade of discussions and 2 years of in-depth planning, the AOA and ACGME announced their intent to create a single GME accreditation system. This historic change has profound implications for both AOA- and ACGME-accredited programs. As of June 2016, 21 family medicine programs have applied for and 5 family medicine programs have received initial accreditation status under the single accreditation system. It is anticipated that more family medicine programs will begin the process when their institution receives pre-accreditation status.

The AFMRD, in collaboration with the ACOFP, has developed the Accreditation Navigation program to assist AOA program directors in the transition to ACGME Family Medicine accreditation. The Accreditation Navigation program is based on the popular and very successful National Institute for Program Director Development (NIPDD) program. The AFMRD and the family of family medicine organizations are poised to assist and welcome our osteopathic colleagues. A single accreditation system will provide excellent benefits for osteopathic and allopathic students who are dedicated and interested in providing patient-centered and focused health care.

• © 2016 Annals of Family Medicine, Inc.