The Value of Osteopathic Recognition
After a 5-year transition, as of June 30, 2020, Single Accreditation is now complete. Under the single accreditation system, the Accreditation Council for Graduate Medical Education (ACGME) serves as the nation’s sole accreditor for both osteopathic (DO) and allopathic (MD) residencies and fellowships. Now there are new opportunities for expansion of osteopathic principles and practices (OPP) through the distinction of Osteopathic Recognition (OR). OR is a designation conferred by the ACGME’s Osteopathic Principles Committee upon ACGME-accredited programs that demonstrate, through a formal application process, the commitment to teaching and assessing OPP at the graduate medical education (GME) level.
Undergraduate osteopathic medical education emphasizes holistic patient care and accentuates the mind, body, and spirit. This parallels the role and value of family medicine, including that family physicians help patients prevent, understand, and manage illness, navigate the health system and set health goals.
OR is an important distinction for residency programs. It allows programs to strengthen their applicant pool in accordance with their missions. Each year there are an increasing number of DO family medicine applicants. From 2018 to 2019 there were 410 more DO seniors (1,399 vs 989) in the National Resident Matching Program (NRMP) match. Many of these seniors wish to continue OPP training during their GME years.
More family medicine residencies have embraced OR than other specialties. Of the 240 programs that have achieved OR (approximately 2% of the 12,104 currently accredited programs), 152 of those are Family Medicine (63%). That represents 22% of the nation’s family medicine programs.
Programs have pursued OR to preserve existing American Osteopathic Association (AOA) and dually accredited programs, increase osteopathic education in the region, embrace value-added OR benefits, and attract a larger applicant pool. The osteopathic approach reduces medical care costs, improves outcomes and patient satisfaction. Teaching the principles of osteopathy also provides an excellent opportunity for allopathic residents to enhance their knowledge and skill in OPP, including osteopathic manipulation.
Programs interested in obtaining OR use the online application within the Accreditation Data System (ADS). OR requirements and FAQs can be found on the ACGME website. There is no initial ACGME site visit required or fee to apply. Programs need to have at least 2 DO faculty, with one of those being the Director of Osteopathic Education. This role can be shared between programs. Many regional consortiums and Colleges of Osteopathic Medicine have staff expertise in the application process. There are national experts within the Assembly of Osteopathic Graduate Medical Educators or American College of Osteopathic Family Physicians who can guide programs through the process. Information on how to promote an osteopathic learning environment is also available, even if osteopathic recognition is not manageable at this time.
Programs interested in gaining OR may want to find a mentor, assure institutional support, and recognize the strength of curricula, didactics and training already happening in the program. Some challenges can be meeting and maintaining the additional accreditation requirements and recruiting enough DO faculty. This latter will likely improve as the number of DO residents increases.
Pursuit of the ACGME distinction of OR may not be the right step for every program but having osteopathic residents and allowing them to continue their osteopathic pursuits will benefit all residents, both allopathic and osteopathic, as well as their patients.
-Katina Rue, DO, FAAFP, FACOFP Central Washington Family Medicine Residency/AFMRD Board; Kim Stutzman, MD, FAAFP Family Medicine Residency of Idaho Nampa; Michelle Chadek, MS, CPMSM, CPCS, MPEC Director of Graduate Medical Education | Pacific Northwest University and WWAMI Family Medicine Residency Network
