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Letters to the Editor  |   October 2005
Graduate Medical Education: Accuracy of AOA's Annual Data-Reporting Mechanisms Questioned
Mark Cummings, PHD
Author Affiliations
  • Mark Cummings, PHD
    Statewide Campus System Michigan State University College of Osteopathic Medicine East Lansing, Mich
    Associate Dean
Article Information
Medical Education / Graduate Medical Education
Letters to the Editor   |   October 2005
Graduate Medical Education: Accuracy of AOA's Annual Data-Reporting Mechanisms Questioned
The Journal of the American Osteopathic Association, October 2005, Vol. 105, 444-445. doi:https://doi.org/10.7556/jaoa.2005.105.10.444
The Journal of the American Osteopathic Association, October 2005, Vol. 105, 444-445. doi:https://doi.org/10.7556/jaoa.2005.105.10.444
To the Editor:
The American Osteopathic Association (AOA) needs to recognize and honestly address its failings in maintaining and reporting accurate data on osteopathic graduate medical education (GME). 
Unfortunately, this is not a new problem. It is an ongoing issue dating back several years. I and others in the profession have brought this issue to the direct attention of AOA leaders (written communication, December 1998). This concern has previously been commented upon in the Letters to the Editor section of JAOA—The Journal of the American Osteopathic Association,1 and it has led to a published correction.2 
Yet, problems of accuracy persist in the most recent report on osteopathic GME published in the JAOA.3 
The data in the two-page Table 7 of the November 2004 issue of the JAOA provide a good representation of the scope and pervasiveness of the errors regularly reported by the AOA. This table indicates that, across the osteopathic medical profession, there were 10 residents in training for urological surgery in the 2003–2004 academic year.3 
However, in October 2004, the Michigan State University College of Osteopathic Medicine (MSUCOM) in East Lansing reported 16 residents receiving training in urological surgery on the 2003 Trainee Information, Verification, and Registration Audit (TIVRA) report required by the AOA— and received and accepted by the AOA's Division of Postdoctoral Training. 
After receiving the November 2004 issue of the JAOA in which these erroneous data are reported,3 I personally called the other four AOA-approved programs to determine the total number of urological surgery residents for 2003. 
The Philadelphia College of Osteopathic Medicine reported nine residents to the AOA (R.A. Pascucci, DO, verbal communication, December 2004). The University of Medicine and Dentistry of New Jersey-School of Osteopathic Medicine (UMDNJ-SOM) in Stratford reported three residents (C. Mogil, DO, RPH, verbal communication, December 2004). Midwestern University's Chicago College of Osteopathic Medicine in Downers Grove, Ill, reported three residents, including positions at John H. Stroger, Jr, Hospital of Cook County in Chicago (D. Sefcik, DO, verbal communication, December 2004). When these data are added to those of MSUCOM, the correct number of residents is 31, not 10. 
Unfortunately, the errors reported by the AOA are not unique to the specialty of urological surgery. In that same table,3 four residents are listed in psychiatry at five specialty programs. The two MSUCOM Statewide Campus System programs at Henry Ford Bi-County Hospital in Warren, Mich, and MSUCOM in East Lansing, Mich, provided the names of 10 psychiatry residents in their 2003 TIVRA reports. Similarly, UMDNJ-SOM reported nine psychiatry residents during the 2003–2004 academic year (C. Mogil, DO, RPH, verbal communication, December 2004). With 19 residents in three of the five AOA-approved programs, additional calls to the other two institutions listed in the published AOA report were not necessary. 
Regarding the number of family practice residents and “combined” family practice residents (eg, family practice and osteopathic manipulative medicine; family practice and osteopathic manipulative treatment; family practice and emergency medicine; sports medicine; sports medicine and family practice; geriatrics; and internal medicine/family practice and geriatrics), the AOA reports in the same table3 that the number decreased from 725 in the 2002–2003 academic year to 605 in 2003–2004. 
The American College of Osteopathic Family Physicians, which independently (and carefully) tracks family medicine residents by name, has a count of 822 osteopathic GME second- and third-year residents for the 2004–2005 academic year (P. Turnipseed, verbal communication, December 2004). Clearly, the number of osteopathic family medicine residents did not increase by 217 in one year. 
In the specialty of pediatrics, the AOA reports that the resident number declined from 66 to 29 in one academic year.3 This number is implausible for what is calculated as a two-year residency with 15 programs. The three Michigan programs report 10 residents for 2003–2004 at Henry Ford Bi-County Hospital, MSUCOM, and the Kirksville College of Osteopathic Medicine (KCOM) of A.T. Still University of Health Sciences/St John Hospital in Detroit, Mich. 
Accurate reporting of such “census” data is extremely important—not only for researchers like me, but also for all individuals in the osteopathic medical profession and any agencies, governmental or otherwise, that may cite these data. The underreporting of participation in these programs distorts the health and status of osteopathic GME in particular and the profession as a whole. 
I am far less interested in pointing fingers of blame, however, than I am in seeing positive changes. 
If the AOA has the sole authority and responsibility for managing data on osteopathic interns and residents, it assumes certain obligations and functions. Among the prerequisites are the following: 
  • creating and using an effective infrastructure and instrument for collecting data;
  • employing knowledgeable personnel to manage and interpret the data gathered;
  • implementing fail-safe measures to ensure accuracy; and
  • providing financial resources sufficient to do the job properly.
All organizations occasionally encounter problems, and the AOA is no exception. The time has come, however, for the AOA to critically evaluate its internal systems for the collection and dissemination of postdoctoral data, inclusive of osteopathic GME. 
The strength and quality of an organization are not judged based solely on the presence of a problem. Instead, an organization's reputation is made on how it responds to criticisms and makes necessary adjustments and course corrections. 
It is my hope that the AOA will carefully assess its current systems, see this as an opportunity to address a longstanding problem, and react positively by implementing changes that will provide accurate and reliable data on osteopathic GME in the future. 

Editor's note: Dr Cummings served as the assistant director of the Department of Education at the American Osteopathic Association from 1979 to 1986.

 
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Baker HH. Re-examining the number of osteopathic residency programs [letter]. J Am Osteopath Assoc. 1998;98:77 .
Obradovic JL, Winslow-Falbo P. Osteopathic graduate medical education [published correction appears in: J Am Osteopath Assoc. 2004;104:147]. J Am Osteopath Assoc. 2003;103:513-522. Available at: http://www.jaoa.org/cgi/reprint/103/11/513. Accessed September 1, 2005.
Obradovic JL, Beaudry SW, Winslow-Falbo P. Osteopathic graduate medical education. J Am Osteopath Assoc. 2004;104:476-478. Available at: http://www.jaoa.org/cgi/content/full/104/11/468. Accessed September 1, 2005.