The osteopathic medical profession has gained a substantial number of CMS-capped training slots through the development of dual and parallel programs. Though the slots are flexible and can be either AOA- or ACGME-designated slots, AOA positions would have suffered a greater loss if they had not become available at all. Leaders in the profession agree the contribution of dually accredited training programs has been positive and should continue to be a strategy to increase the number of available slots to DOs. However, it should not be the only strategy.
Leadership in osteopathic postdoctoral training believe AOA training for osteopathic physicians is superior to ACGME training because they receive continued training and education in osteopathic principles and practice.
26 Dual and parallel programs are required to follow the same standards as all other AOA-approved programs without exception. The success of dual programs is a winning solution for the profession and a growing number of graduates who elect to train in dual and parallel programs.
Completion of a parallel program would ensure that trainees continue in the osteopathic medical profession throughout their career. Although there were a reduced number of parallel programs reported in 2008, that number has shown an increase, primarily due to the COPT's approval of consortium models.
Osteopathic board specialties depend on recruiting new graduates to maintain viability for the specialty. Physicians in each osteopathic specialty volunteer their time to create curricula for the specialty, teach students and trainees, participate in certification examination development, and hold leadership positions in the profession representing the specialty. There are many ACGME-trained osteopathic physicians who contribute to the profession in osteopathic leadership positions. Osteopathic physicians who trained in ACGME programs may apply through Resolution 29, 42, or 56 to become eligible for AOA board certification, which is required to participate in a number of leadership positions, as previously stated. Unless a trainee expects to need licensure in 1 of the 4 states requiring an AOA-approved first year of training (Florida, Michigan, Oklahoma, and Pennsylvania), application through Resolution 56 will meet the eligibility for AOA board certification and requirements for licensure in all other states.
An AOA/ACGME dual program can fill its AOA-approved slots and then attain additional DOs through the NRMP Match. Although the program is dually accredited, it does not necessarily mean the DOs are in approved AOA positions and eligible for AOA board certification at the end of training. Osteopathic physicians in ACGME slots who complete the same program as the DOs in approved AOA slots may find they need to use other pathways to be eligible for AOA board certification. Many dual programs have increased their number of approved training slots to match the number of actual DO trainees in their program to avoid the need for DOs to apply for ACGME program approval. To the benefit of these students, the AOA approved a policy (Resolution 39 [M/2006]—Resolution for Program Approval for Residents Training in a Dual Track Program at the Time of AOA Approval) that if an ACGME program becomes AOA approved, any DO currently in the program is eligible for full AOA approval of their training.
There are additional costs and responsibilities to programs that are dually accredited through the AOA and ACGME. They must pay required AOA and ACGME fees, become a partner in an Osteopathic Postdoctoral Training Institution (OPTI), and be subject to standards and requirements for maintaining approval by both regulatory bodies. They also have to provide registration data, submit reports, and go through site reviews for both the AOA and ACGME.
27 However, the payoff—the ability to maintain CMS-funded slots, meet hospital staffing needs, and fill slots with preferred US physicians
28—continues to be rewarding for these programs.
Accreditation by the AOA may also be an attractive element to MDs seeking residency programs because it provides MDs with diversity of curriculum—specifically, training experience with DO residents from which they may learn osteopathic approaches to clinical issues. Also, a program that must meet the accreditation requirements of 2 organizations could be perceived as inherently superior to one that must only meet the requirements of 1 body.