From the AOBS Chairman - Why Does ACGME Accreditation Matter to the AOBS and Your Future Board Certification?

Under the Memorandum of Understanding (MOU), the American Osteopathic Association (AOA) will cease accrediting Graduate Medical Education (GME) programs in 2020. This responsibility is being transferred exclusively to a single accrediting body known as the Accreditation Council for Graduate Medical Education (ACGME). All AOA residency programs have been instructed to apply to the ACGME using their very comprehensive application process to show that the AOA program meets the ACGME standards in GME. This critical transition process has been greatly aided by the foresight of the American College of Osteopathic Surgeons’ (ACOS) Resident Evaluation and Standards Committee (RESC), which for the past decade, ensured that all osteopathic surgery programs had adopted training standards that are viewed by both the AOA and ACGME as being identical or exceeding those required to achieve/maintain accreditation. Despite this preparation by ACOS leadership, not all residency training programs will make the transition from AOA to ACGME accreditation successfully. A failure of a program to achieve ACGME accreditation presents challenges for residents in training, the AOA, ACOS, and for the American Osteopathic Board of Surgery (AOBS).

Fortunately, most AOA accredited surgery programs have already completed or are near completing the ACGME application process. However, some programs, institutions, or GME leadership have chosen not to apply for ACGME accreditation, resulting in the loss of resident positions due to an inability to interview and match for future GME spots. In some circumstances, the program itself may be at risk for being closed. While some AOA accredited surgery programs have applied and earned the coveted “initial accreditation,” there are many AOA programs that have applied and achieved only a perfunctory “pre-accreditation status,” which means their application is on file but the GME program is not yet fully accredited as an ACGME program or is not yet in substantial compliance with ACGME standards.

For D.O. residents, they will continue to be eligible, and indeed required, to take the AOBS board certification examinations. However, once their program achieves “initial accreditation,” (not “pre-accreditation”) they will still have to wait three (3) years as an accredited ACGME program before they will be eligible to take the allopathic American Board of Medical Specialties (ABMS) e.g. American Board of Surgery (ABS) board exams. Of significant concern to the AOBS are those surgery residents who may be caught in middle of being in an AOA accredited residency that has not (or will not) achieve ACGME accreditation before the end of the MOU in 2020. In essence, these residents could be graduating from a program that is neither AOA nor ACGME accredited. Under current policy, these graduating chief residents would be ineligible to take either the AOBS or the ABMS board examinations. The AOBS and ACOS believe this is an untenable position for all concerned and are dedicating their efforts to ensure that “no resident is left behind.” The Osteopathic profession as a whole and the AOBS specifically remain committed to the board certification of all D.O. surgeons who satisfactorily meet GME requirements in either an AOA or ACGME accredited program now and in the future.  

The AOBS is charged with administering board certification examinations to graduates of AOA accredited residency programs. If a lesser number of D.O.’s graduate from AOA accredited programs, or there are a reduced number of D.O. programs in the future, there would be a similar reduction in the number of D.O.’s who sit for the AOBS board certification examinations. And since some of our member disciplines (Plastics & Reconstruction, Vascular, Cardiothoracic, Neurosurgery, and Critical Care) are already relatively small in number as compared to General or Urological Surgery, a lesser number of examinees and diplomates ultimately impacts the AOBS’s ability to maintain its high standards of providing a valid, defensible, psychometrically-sound high stakes certification examination with all the necessary updating, referencing, item writing, question review and exam administration e.g. oral examiner requirements. Your AOBS is dutifully monitoring the impact of single accreditation and is working to affect the decision-making process within the AOA and ACGME in order to ensure that our D.O. residents have the ability to graduate from an accredited GME program and achieve board certification in their specialty. 

Timothy M. Burandt, DO, FACOS
Chairman, American Osteopathic Board of Surgery