OGME Corner

Donald B. Kaveny and Susan L. Rall

Annual Resident Reports - Due June 30, 2015

Annual resident reports for the 2014-2015 training year must be submitted to the ACOS office no later than June 30, 2015.  More than 750 individual annual resident reports are expected to be submitted and reviewed by the Residency Evaluation and Standards Committee (RESC) in August.  ACOS staff members will do an initial review of the reports to ensure their completeness, clarity, compliance (See checklist below).  Residents and program directors will be notified if reports are incomplete.  Late fees may be assessed if a report deferred, and the training year might be if the annual resident report does not meet the criteria required by the RESC.

Residents

Residents are reminded that the Resident’s Evaluation of the Program must include a narrative of the scholarly activity and completion of attestation statements. Residents submitting forms after the June 30 deadline will be assessed a $250 late fee. Annual resident reports will not be reviewed if outstanding fees have not been paid. All outstanding late and/or non-member fees must be paid in order to receive approval of training and to be eligible to sit for the AOA/AOBS qualifying board examinations.

Residents are required to maintain a record of their surgical procedures using the Operative Log (OpLog) system. Logs for the 2014-2015 training year must be completed by June 30.  Program directors must review the procedural logs for accuracy and compliance with required scope, volume, and variety of procedures outlined in the AOA/ACOS Basic Standards for Residency Training in Surgery and the Surgical Subspecialties.

For instructions on how to complete Annual Resident Reports, including username and password information, click here .

Program Directors

Program directors annual report documents are to be completed by program directors before June 30 and a copy is to be maintained onsite by the program.  These documents on file will be reviewed during the program’s periodic review for continuing approval.  Documents to be completed and maintained in the program files at the institution are:

- Program Director’s Evaluation of the Resident signed by the resident and program director
- Resident Operative Report (OpLogs) signed by both the resident and the program director
- Scholarly Activity documentation

Program directors are required to submit the following annual report documents electronically via the ACOS Member Community no later than June 30:

- Annual Resident Report Checklist for Program Directors
- Program Director's Statement of Resident Completion (Graduating Residents ONLY)
- Program Directors Annual Evaluation of the Program

ACOS staff uses the following checklist to determine if an Annual Report is complete and ready to be reviewed by the RESC. Due to the over overwhelming amount of annual resident reports received the ACOS, staff will not be able to answer individual questions regarding annual resident reports. You can use this checklist to evaluate your report before submitting it to ACOS. By doing so, you should be able to discern if it is complete and ready for review by the RESC:

• Previous training years have been approved by the ACOS.
• The Resident’s Evaluation Form of the Program is complete and submitted to the ACOS by June 30.
• The resident indicated a YES on the Statements of Attestation
• Program Director’s description of the scholarly activity and the resident’s narrative of the scholarly activity are consistent
• The surgical role(s) indicated on the operative report is consistent with the resident’s OGME level.
• The operative report reflects scope, volume and variety of major surgical procedures.
• The operative report accurately reflects the amount of procedures performed by the resident during the training year and meets the specialty requirements as stated in the ACOS Training Standards. (Note: The average amount of procedures performed by a resident is 150)
• The Program Director recommends advancement to the next training year and the training year was successfully completed.

ACOS will notify residents and program directors if annual reports are missing items or need clarification.

Unified Accrediting System/Single Accreditation System (SAS)

Sponsoring institutions for AOA accredited residency programs are now able to apply for Accreditation Council for Graduate Medical Education (ACGME) approval as a sponsoring institution for an ACGME accredited program effective April 15, 2015. Osteopathic Postdoctoral Training Institutions (OPTIs) also can apply for this status. The ACGM reported at the 2015 Association for Hospital Medical Education Institute that as of May 14, 2015, it had received eight applications from osteopathic institutions for consideration for approval as an ACGME sponsoring institution.

Osteopathic training programs will be able to apply for ACGME accreditation beginning on July 1, 2015. Upon receipt of an application by the ACGME, the program will be awarded ACGME “pre-accreditation” status according to the terms of the memo of understanding (MOU) determined by the AOA, American Association of Colleges of Osteopathic Medicine, and ACGME for the creation of a unified accrediting system for graduate medical education.  Programs are encouraged to submit their applications, completed to the best of their ability understanding fully that all standards may not be in full compliance, for ACGME accreditation.  The pre-accreditation status will remain in effect until the program achieves initial accreditation, the program withdraws the application, or June 30, 2020. The program will remain an AOA accredited program while in ACGME pre-accreditation status and must continue to comply with all AOA requirements.

A misconception about the single accreditation system is that a resident completing an AOA program, pre-accredited by the ACGME, would have the same benefits as a resident completing an ACGME program.  This is not the case.  The following is an AOA policy statement that was released in January 2015:

Clarification on Eligibility of AOA-approved Programs to Apply for ACGME Accreditation under the Terms of the Memorandum of Understanding

Under the terms of the Memorandum of Understanding (MOU), AOA-accredited programs fall into the following three categories and include the following provisions:

1. AOA-accredited programs that have at least one matriculated resident as of July 1, 2015, will benefit from all the provisions of the MOU including:
a. The program will be assigned an automatic “pre-accreditation” status upon receipt of a completed application. The ACGME will publicly recognize programs with “pre-accreditation” status on its website.
b. Residents who complete these programs after having achieved pre-accreditation status will be eligible for ACGME advanced residency and fellowship positions. This is according to the eligibility requirements that were in place June 30, 2013, or the standards that will be in place on July 1, 2016, whichever is less restrictive.
c. ACGME program accreditation standards for faculty credentials will be modified to accept AOA-certified DO personnel as faculty.
d. For programs seeking osteopathic recognition, the Osteopathic Principles Committee (OPC) could require that such programs have a program director or co-program director that is AOA-board certified.
e. Although requirements for program directors will not be changed except through ACGME’s regular review process, it will be acceptable for ACGME-accredited programs to have co-program directors, and one could be certified by an AOA specialty board.
f. Any currently AOA-accredited applicants whose initial applications are unsuccessful may reapply for ACGME accreditation at any time between July 1, 2015, and June 30, 2020. For any such reapplications, ACGME accreditation reapplication fees will be waived.

2. AOA-accredited programs with zero matriculated residents as of July 1, 2015, may apply for ACGME accreditation, and can benefit from the following provisions of the MOU: a. The program will be assigned an automatic “pre-accreditation” status upon receipt of a completed application. The ACGME will publicly recognize programs with “pre-accreditation” status on its website.
b. Residents in these programs between July 1, 2015, and June 30, 2020, who apply for initial year or fellowship positions in ACGME-accredited programs will be deemed to meet the ACGME initial year and fellowship entry requirements, providing residents meet relevant specialty eligibility requirements.

Standards for faculty, program directors/co-directors are not automatically modified for these programs.

3. Programs that are accredited by AOA after July 1, 2015, will not be eligible to apply for ACGME accreditation under the MOU, but would apply instead through the normal process for ACGME initial accreditation. a. For all intents and purposes, such programs that seek to apply for ACGME accreditation will apply for ACGME initial accreditation, similar to any other residency program, and will not be assigned automatic “pre-accreditation” status upon receipt of a completed application.

The AOA can continue to accredit programs between July 1, 2015, and June 30, 2020. However, those programs that attain initial AOA approval in this time period will not benefit from the terms of the agreement under the MOU. Residents that complete these programs will be subject to the ACGME’s common program requirements that take effect in 2016.

Provision 1. b is of particular concern to osteopathic program directors and residents: “Residents who complete these programs after having achieved pre-accreditation status will be eligible for ACGME advanced residency and fellowship positions. This is according to the eligibility requirements that were in place June 30, 2013, or the standards that will be in place on July 1, 2016, whichever is less restrictive.”

According to the MOU and pre-accreditation status granted to a program by ACGME, until an AOA accredited program is granted “full” or “initial” ACGME accreditation, residents applying for ACGME fellowships are still subject to the same eligibility requirements to as graduates of an AOA accredited residency training program (with the caveat that those graduates of the ACGME pre-accredited programs can be evaluated on the “less restrictive” requirements of either the June 30, 2013 or July1, 2016 requirements).
Some of the ACGME Review Committees, RCs have modified some of their eligibility requirements to make them more accommodating for osteopathic residents.  Unfortunately, the surgery RCs have not done so. RCs are autonomous and operate as separate entities, independent from one another and the ACGME. Therefore, the standards and eligibility criteria from RC to RC may differ markedly.  It is anticipated though that as the transition period continues the surgical RCs might also modify their eligibility requirements, but that remains to be seen.

Eligibility criteria for each specialty and subspecialty can be found at: http://www.acgme.org/acgmeweb/tabid/461/GraduateMedicalEducation/SingleAccreditationSystemforAOA-ApprovedPrograms/EligibilityRequirements.aspx

OpLog Data Migration

AOA/ACOS accreditation standards require that “All residents must enter their operative experience concurrently during each year of residency in the ACGME/ACOS case log system. There are over 100 AOA/ACOS accredited programs using the case log system, OpLog.  These programs can apply for ACGME accreditation beginning on July 1, 2015.  When ACGME receives an application from an existing AOA/ACOS surgical residency training program, that program will be awarded ACGME pre-accreditation status.  Program coordinators/case log administrators will have to verify the names of residents in their program to ensure that all their residents are in the new ACGME ADS system.  Upon verification, the case log data will be migrated from the old OpLog system into the ACGME ADS system framework which utilizes an updated version of the case log system.  After the migration is complete, residents and program coordinators will no longer have access to the old OpLog system/data. Data for past residents (no longer in the program) will not be moved into the ACGME ADS. Programs will need to get necessary data from the old site before access to the OpLog system is terminated June 30, 2020.

Instructions and guidelines for program coordinators/case log administrators will be provided upon the awarding of ACGME pre-accreditation status.  ACGME ADS personnel will be available to during the migration process. Questions about the OpLog system should be directed to Susan Rall, Assistant Director of Postdoctoral Training Standards and Evaluation at ACOS (571) 551-2110.