Because so many COMs have been established in recent years, some in the osteopathic medical profession may be under the misimpression that it is relatively “easy” to start one.
2,4 Nothing could be further from the truth.
When an educational institution seeks accreditation from the American Osteopathic Association's Commission on Osteopathic College Accreditation (AOA COCA), the first step required is to submit a request to the Association for applicant status. Prospective COMs with applicant status do not have the rights and privileges of accreditation. In addition, this status does not guarantee recognition by AOA COCA at any time in the future.
Applicant status is established when a formal request for evaluation is submitted to COCA by the chief executive officer of the prospective COM. When such a request is received, COCA's assistant secretary sends an application packet to the applicant institution. This packet includes forms, instructions, a schedule of application fees, and a checklist for reference when preparing the official application. To minimize confusion for the general public and the osteopathic medical community, the Commission does not publicly announce entities that have sought applicant status.
The estimated start-up costs for a new COM will vary. Based on recent experiences, typical start-up costs are outlined in
Figure 1. Start-up costs are dependent on the number of students expected to enroll and the facilities used, including any necessary modifications or new equipment purchases. Other factors that will have an impact on start-up costs include location (urban vs rural), size of faculty and staff, and any legal and consulting fees.
The next step in the accreditation process is
preaccreditation status. At this point, the applicant COM requests evaluation for preaccreditation from COCA. To obtain preaccreditation status, the institution's chief executive must submit a feasibility study to COCA. This report must include a variety of supporting materials. The feasibility study is reviewed by COCA's chairman, vice-chair, secretary, and assistant secretary.
7 After this formal review, a team of COCA evaluators conducts an on-site visit to verify the accuracy of the feasibility study. In addition, the applicant COM must be in compliance with requirements and procedures for preaccreditation status during this site visit. In addition to the feasibility study elements, the following standards must be met:
With regard to the fifth standard, students, on-site evaluators are especially concerned with the new institution's adherence to standard 5.7:
This standard is intended to assist institutions in developing their ongoing performance-improvement processes.
After the site visit, the on-site evaluation team produces a report that is then included with the institution's application for preaccreditation status. The complete application is composed of the following three documents:
Once the application is complete and forwarded to COCA for review, the Commission makes a decision whether to grant or deny preaccreditation status to the applicant COM. Preaccreditation status is valid for up to 5 years but an annual assessment is prescribed and reviewed by the Commission. During this time, allowable COM activities are circumscribed.
7 For example, student recruitment and admission is prohibited. Also, applications for admission cannot be accepted from potential students when a COM has preaccreditation status. Activities that are specifically forbidden include:
At this time, the COM begins to pursue provisional accreditation status. An institution with preaccreditation status has 5 years to attain provisional accreditation status. After 5 years, COCA will terminate the institution's preaccreditation status. Should an institution lose preaccreditation status, it will be permitted to reapply.
Provisional accreditation status is granted by COCA when the applicant COM demonstrates that it meets—or will meet at the time it is scheduled to begin its educational program—all COM accreditation standards that have been established by the Commission.
7 After provisional accreditation status is granted, the new COM has the full right and privilege of announcing that it has achieved provisional accreditation status, recruiting students, soliciting and accepting student admissions applications, matriculating new students, and offering a program of medical instruction with an approved osteopathic curriculum—while also taking care to note during all these steps that the institution is not yet fully accredited.
To continue provisional accreditation status, the new COM must demonstrate continued compliance with
Accreditation of Colleges of Osteopathic Medicine: COM Accreditation Standards and Procedures.
7 In addition, the institution must submit an updated feasibility study no later than 14 months before its intended opening date (
Figure 2). The updated feasibility study should provide COCA with information concerning the administration and operation of the COM's intended educational program through the graduation of its first matriculating class. In addition, future development plans, written agreements with clinical sites verifying a sufficient number of clinical positions to accommodate the new COM's entire first class of graduates, and formal affiliation agreements substantiating an adequate number of training positions required by the COM curriculum must be included.
After COCA receives the updated feasibility study and supporting documentation from the new COM, the first provisional on-site visit is scheduled. The team of evaluators then conducts its second visit to this new COM. Their report is presented at a regularly scheduled COCA meeting at least 7 months prior to the school's opening.
A new COM's provisional accreditation status is reviewed annually by COCA through on-site visits that are scheduled to parallel the matriculation and academic progress of the COM's first three graduating classes. The report of the on-site evaluation team is submitted to COCA for review, at which time the Commission determines whether to continue the COM's provisional accreditation status.
During the inaugural class' graduation year, an on-site visit is conducted by COCA evaluators to determine whether
accreditation status can be granted to the new COM. If a COM fails to achieve full accreditation status at this point, COCA will terminate the COM's provisional accreditation status and this information will be published online at
http://www.osteopathic.org within 30 days of final action.
Accreditation status—also known as “full” accreditation—is the highest level of accreditation awarded by COCA. Accreditation status grants the institution all of the rights and privileges of accreditation, including establishing an additional location or branch campus.
7
Once granted, accreditation status is reviewed and renewed on a 7-year survey cycle.
7 After the results of each on-site visit are reported to the Commission by the COCA evaluation team, the Commission determines if the educational institution has continued to meet all of the standards of accreditation status. After full accreditation status is achieved, the COM's status remains (ie, does not expire)—unless it is withdrawn by COCA for lack of compliance.