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AOA Communication  |   April 2011
AOA Approval of ACGME Internship and Residency Training
Author Notes
  • From the Division of Postdoctoral Training (Mr Duffy) and the Division of Educational Resource Services (Mr Martinez) in the Department of Education at the American Osteopathic Association (AOA) in Chicago, Illinois. 
  • Address correspondence to Thomas Duffy, MPH, AOA Department of Education, 142 E Ontario St, Chicago, IL 60611-2864. E-mail: tduffy@osteopathic.org 
Article Information
AOA Communication   |   April 2011
AOA Approval of ACGME Internship and Residency Training
The Journal of the American Osteopathic Association, April 2011, Vol. 111, 244-246. doi:10.7556/jaoa.2011.111.4.244
The Journal of the American Osteopathic Association, April 2011, Vol. 111, 244-246. doi:10.7556/jaoa.2011.111.4.244
Web of Science® Times Cited: 4
Abstract

Since the 1970s, the American Osteopathic Association (AOA) has provided a means for osteopathic physicians to apply for approval of their postdoctoral training in programs accredited by the Accreditation Council for Graduate Medical Education (ACGME). Osteopathic physicians who trained in ACGME programs need this approval to meet AOA licensure and board certification requirements. The AOA approves ACGME residency training with several different approval processes. Approval of the first year of postdoctoral training occurs through Resolution 42, specialty approval (for specialties in which the first year of training is part of the residency), or federal or military training approval. For residency training, the AOA verifies successful completion of an ACGME training program before approving the training. The AOA is using customer surveys and online applications to improve the review process for applicants.

Osteopathic physicians who complete an internship or residency program accredited by the Accreditation Council for Graduate Medical Education (ACGME) may seek to have the training approved by the American Osteopathic Association. Approval of ACGME training began in the 1980s when graduates of colleges of osteopathic medicine (COMs) outnumbered osteopathic graduate medical education (OGME) positions. This problem lead to “a pilot project that granted COM graduates AOA approval of the first year of ACGME-accredited residency training.”1 Several changes regarding requirements and the application review process have been implemented since then. 
An osteopathic physician may choose to have his or her first year of ACGME training (ie, first year of postgraduate training [PGY-1]) approved by the AOA for licensure purposes if he or she practices in a state that requires an AOA-approved first year of training. Or, an osteopathic physician may have the entire ACGME residency approved by the AOA to become board eligible for AOA certification and be allowed to hold program director and director of medical education positions in AOA-accredited training programs. 
Approving ACGME training is dependent on the specialty. As noted by Freeman and Lischka,3 each specialty chose 1 of the following 3 options when the first year of OGME (ie, OGME-1 year) was restructured in 2007: 
  • OGME-1R (Option 1)—The first year of residency training is incorporated into the residency.2
  • OGME-1P (Option 2)—A preliminary tracked internship year is required before residency training.2
  • OGME-1T (Option 3)—A traditional internship is required for the first year of training preceding residency training; this option is also for trainees who have not yet decided on a specialty or who want the option of a traditional internship year.2
Specialties are listed by OGME-1 option in the article by Freeman and Lischka.3 
For OGME-1R specialties, approval of residency training includes the OGME-1 year. Prior to this process, applicants had to gain approval of an OGME-1 year before residency approval. This change affects only OGME-1R specialties; applicants in OGME-1P and OGME-1T specialties still must gain approval of the OGME-1 year before residency approval. 
ACGME Residency Training Approval
Approved applicants must meet 3 requirements before approval of ACGME residency training is granted. First, applicants must be AOA members in good standing. Second, applicants must complete an application agreeing to the approval requirements and release of training information. Lastly, the ACGME residency program must submit a letter that verifies that the applicant has successfully completed the program and includes dates of training. Staff at the AOA verifies the ACGME accreditation before granting approval. An applicant may seek multiple approvals if he or she successfully completed more than 1 ACGME program. 
A total of 3785 osteopathic physicians have had 4267 residencies approved by the AOA. The number of approved applications for ACGME residencies has increased since 2000 (Figure 1). Of the 3785 approved applicants, 2718 (71%) are current AOA members (Table 1). 
Figure 1.
Total number of residencies accredited by the Accreditation Council for Graduate Medical Education (ACGME) that were approved by the American Osteopathic Association (AOA) by year, 2000-2010. Since 2000, 3785 osteopathic physicians have had 4267 residencies approved by the AOA.
Figure 1.
Total number of residencies accredited by the Accreditation Council for Graduate Medical Education (ACGME) that were approved by the American Osteopathic Association (AOA) by year, 2000-2010. Since 2000, 3785 osteopathic physicians have had 4267 residencies approved by the AOA.
Table 1.
AOA Membership Status of Osteopathic Physicians Whose ACGME Training Was Approved, 2000-2010 *

Membership Status

No. (%)
Current AOA Members2718 (71)
Non-Members 1067 (29)
Total
3785
 Abbreviation: AOA, American Osteopathic Association.
 *Data current as of December 31, 2010.
Table 1.
AOA Membership Status of Osteopathic Physicians Whose ACGME Training Was Approved, 2000-2010 *

Membership Status

No. (%)
Current AOA Members2718 (71)
Non-Members 1067 (29)
Total
3785
 Abbreviation: AOA, American Osteopathic Association.
 *Data current as of December 31, 2010.
×
PGY-1 Year Approval
Resolution 42 (A/2000—Approval of ACGME Training as an AOA-Approved Internship) provides a means for approving a PGY-1 training year as an OGME-1 year. There are 4 requirements for Resolution 42, as follows: 
  • Applicants must have AOA membership.
  • Applicants must complete an application agreeing to the approval process and release of information.
  • A letter is needed from the ACGME program where the PGY-1 year was completed, including training dates and the completed rotations. The AOA compares the received rotations to a traditional osteopathic rotating internship curriculum (Figure 2).
  • Applicants must provide proof of an osteopathic educational activity. Applicants can complete this requirement through several different activities—attending an AOA-sponsored conference or convention for the equivalent of 8 Category 1-A continuing medical education hours, presenting an osteopathic clinical presentation to the current ACGME program (applicable if applicants are in training), or attending osteopathic training modules through a regional Osteopathic Postdoctoral Training Institution or AOA-approved residency training program.
Figure 2.
The traditional rotating internship curriculum at osteopathic graduate medical education programs accredited by the American Osteopathic Association (AOA). To receive AOA approval of the internship year, programs accredited by the Accreditation Council of Graduate Medical Education must be similar to osteopathic internship curricula.
Figure 2.
The traditional rotating internship curriculum at osteopathic graduate medical education programs accredited by the American Osteopathic Association (AOA). To receive AOA approval of the internship year, programs accredited by the Accreditation Council of Graduate Medical Education must be similar to osteopathic internship curricula.
Table 2 provides approval data for PGY-1 training through Resolution 42. Since January 1, 2002, the AOA has approved 2170 individuals and denied 11 for PGY-1 approval. Option 1 applicants can have their PGY-1 training approved by the AOA before applying for residency approval. This approval process follows the Resolution 42 approval process. 
Table 2.
AOA Approval of ACGME-Accredited First Year of Postgraduate Training *

Approval Status

Total, No.

Option 1 Specialty, No. (%)
Approved21702001 (92)
Denied 11 10 (90)
 Abbreviations: AOA, American Osteopathic Association; ACGME, Accreditation Council for Graduate Medical Education.
 *Data since January 1, 2002; data current as of December 31, 2010.
 Option 1 specialties represent those specialties that chose to incorporate the first year of postgraduate training into the residency when the traditional internship year was restructured.
Table 2.
AOA Approval of ACGME-Accredited First Year of Postgraduate Training *

Approval Status

Total, No.

Option 1 Specialty, No. (%)
Approved21702001 (92)
Denied 11 10 (90)
 Abbreviations: AOA, American Osteopathic Association; ACGME, Accreditation Council for Graduate Medical Education.
 *Data since January 1, 2002; data current as of December 31, 2010.
 Option 1 specialties represent those specialties that chose to incorporate the first year of postgraduate training into the residency when the traditional internship year was restructured.
×
At its July 2010 meeting, the BOT approved Resolution 29 (Approval of ACGME Residency) for applicants in OGME-1R specialties. Resolution 29 will likely reduce the number of Resolution 42 applications and approvals. As shown in Table 2, since January 1, 2002, OGME-1R specialties have comprised 2001 (92%) of the approved PGY-1 training; the rest are from OGME-1P and OGME-1T specialties. 
Federal and Military Approval
Osteopathic physicians training in federal or military internships are approved through a different review process. Applicants must be an AOA member in good standing and must complete an application and submit a copy of the military orders to gain approval. The military program submits a letter verifying successful completion of the PGY-1 year to the AOA. The military representative on the AOA Program and Trainee Review Council reviews forwarded applications. 
Continuing Evolution of ACGME Program Approval
The AOA continues to improve the approval process for ACGME-trained osteopathic physicians. The AOA e-mails surveys regarding the approval process to applicants once their training has been approved. The survey results and anecdotal evidence are collected by AOA staff to enhance the review process. For example, based on survey results, AOA approval applications were moved from a paper-based to an online format in January 2011. 
Conclusion
As the approval process continues to evolve, it is the goal of the AOA to ensure that the process is clear and understandable. This goal is being accomplished through process revisions and continued surveys of approved applicants. 
 Financial Disclosures: None reported.
 
Bulger JB. Approval of ACGME training as an AOA-approved internship: history and review of current data. J Am Osteopath Assoc. 2006;106(12):708-713.
American Osteopathic Association. The Basic Documents for Postdoctoral Training. Chicago, IL: American Osteopathic Association; 2010. http://www.osteopathic.org/inside-aoa/accreditation/postdoctoral-training-approval/postdoctoral-training-standards/Documents/aoa-basic-document-for-postdoctoral-training.pdf. Accessed April 13, 2011.
Freeman E, Lischka TA. Osteopathic graduate medical education 2010. J Am Osteopath Assoc. 2011;111(4):234-243.
Figure 1.
Total number of residencies accredited by the Accreditation Council for Graduate Medical Education (ACGME) that were approved by the American Osteopathic Association (AOA) by year, 2000-2010. Since 2000, 3785 osteopathic physicians have had 4267 residencies approved by the AOA.
Figure 1.
Total number of residencies accredited by the Accreditation Council for Graduate Medical Education (ACGME) that were approved by the American Osteopathic Association (AOA) by year, 2000-2010. Since 2000, 3785 osteopathic physicians have had 4267 residencies approved by the AOA.
Figure 2.
The traditional rotating internship curriculum at osteopathic graduate medical education programs accredited by the American Osteopathic Association (AOA). To receive AOA approval of the internship year, programs accredited by the Accreditation Council of Graduate Medical Education must be similar to osteopathic internship curricula.
Figure 2.
The traditional rotating internship curriculum at osteopathic graduate medical education programs accredited by the American Osteopathic Association (AOA). To receive AOA approval of the internship year, programs accredited by the Accreditation Council of Graduate Medical Education must be similar to osteopathic internship curricula.
Table 1.
AOA Membership Status of Osteopathic Physicians Whose ACGME Training Was Approved, 2000-2010 *

Membership Status

No. (%)
Current AOA Members2718 (71)
Non-Members 1067 (29)
Total
3785
 Abbreviation: AOA, American Osteopathic Association.
 *Data current as of December 31, 2010.
Table 1.
AOA Membership Status of Osteopathic Physicians Whose ACGME Training Was Approved, 2000-2010 *

Membership Status

No. (%)
Current AOA Members2718 (71)
Non-Members 1067 (29)
Total
3785
 Abbreviation: AOA, American Osteopathic Association.
 *Data current as of December 31, 2010.
×
Table 2.
AOA Approval of ACGME-Accredited First Year of Postgraduate Training *

Approval Status

Total, No.

Option 1 Specialty, No. (%)
Approved21702001 (92)
Denied 11 10 (90)
 Abbreviations: AOA, American Osteopathic Association; ACGME, Accreditation Council for Graduate Medical Education.
 *Data since January 1, 2002; data current as of December 31, 2010.
 Option 1 specialties represent those specialties that chose to incorporate the first year of postgraduate training into the residency when the traditional internship year was restructured.
Table 2.
AOA Approval of ACGME-Accredited First Year of Postgraduate Training *

Approval Status

Total, No.

Option 1 Specialty, No. (%)
Approved21702001 (92)
Denied 11 10 (90)
 Abbreviations: AOA, American Osteopathic Association; ACGME, Accreditation Council for Graduate Medical Education.
 *Data since January 1, 2002; data current as of December 31, 2010.
 Option 1 specialties represent those specialties that chose to incorporate the first year of postgraduate training into the residency when the traditional internship year was restructured.
×