1 Reality of AOA Accreditation of ACGME Family Medicine Residency programs: Sustainable or Not? Richard R. Terry, DO, MBA, FACOFP Director, Osteopathic Medical Education Director, Wilson Family Medicine Residency
2 Data Collection: We electronically surveyed all 98 DO program directors from dual accredited programs with a 7 question Monkey survey ( 72 programs met survey criteria of having graduated at least one dual class) 56 completed the survey (response rate = 77%) We compared our results with hard data from both the ABOFP and ABFM We did a rough cost analysis approximating the cost of dual accreditation ( OPTI fees and other costs ) We obtained information from the ABOFP and the ABFM
3 Critical Questions? What is the driving force(s) behind this trend? What are the cost factors involved in dual accreditation? What are the tangible benefits of dual accreditation for allopathic programs? What is really happening with certification? Is dual accreditation a sustainable method of increasing osteopathic family medicine residency positions?
4 The Growth of Dual Programs Dual DO only Richard Terry: And growing by 5-10 programs per year
5 Dual programs: Solution or the problem?
6 DO Match 2010 FP results MD match just 42% spots filled by US MDS
7 Projected Numbers Number of COM Graduates COM Graduates COM Graduates
8 They just keep Multiplying
9 Why the Explosion? More schools - now up to 31 More graduates Larger class size and ever expanding DO graduates want FM More than 2 x as many DO grads ( 18.7%) want FM than MD grads.. (7.8%% of US MDs choose FM 2010)
10 Trends in Osteopathic Matching NRMP FM avail Unfilled Funded Slots Number Matched No. of Non-Participants Unfilled Slots Funded Slots No. of Non-Participants Number Matched Unfilled Slots Fm AOA 320 spots open! *Data drawn from AOA Office of Education and the AACOM Annual Report
11 Number of DOs in ACGME Residency Programs Year Fam. Med. Int. Med. Peds Anes. Emer. Med. OB/ GYN Psych. PM&R Path. Neuro % Change USMDs Comparison 320% 314% 651% 528% 721% 360% 257% 523% 339% 149% -36% -27% -2% -9% -6% -17% -8% -5% -6% -15%
12 DO GME: Where they are going? COM Grads DOS ACGME DOS AOA DO internship
13 Number of DOs in Family Medicine AOA and ACGME Programs: 1987 to OOO1 O2 O3 O4 O5 O6 O7 AOA ACGME AOA ACGME
14 Need for AOA-Approved Postdoctoral Positions Thousands 2005 to COM Grads Funded Slots Deficit COM Grads Funded Slots Deficit Richard Terry: Terry: AOA AOA Needs Needs spots spots already already at at a deficit. deficit.
15 % of all US medical school graduates will be DOs
16 PGY 1 spots 2008 vs 2020
17 But where is the incentive for allopathic programs to become dual accredited? TOP 3 reasons: US GRADS US GRADS US GRADS Improved reputation of program??????
19 Choice of Certification Board: Percent of Graduates Taking Both ABFM & ABOFP Certification Exams 100% 80% 50% <50% Richard Terry: Terry: Bottom Bottom line line One-half of of grads grads not not taking taking both both exams exams
20 ABFM certification. Why not????? Cost - of both AOA and ABFM exams and on going costs of maintaining certification. Lack of perceived value of ABFM ABFM exam not required by program and given after graduation ( MY RECENT 3 DOS NOT TAKING ABFM EXAM - Employer does not care!!)
23 Richard Terry: DOs have a higher failure rate on ABFM exam compared to the ABOFP exam
24 CERTIFICATION PERFORMANCE ABOFP VS ABFM? AOA AOA Dual Dual DO DO ABFM ABFM MD MD ABFM ABFM aobfp DO ABFM MD ABFM Conclusions: Richard Terry: Terry: Data Data From From ABFM-offical ABOFP-official DOs dual 98% pass ABOFP DOs dual 84.6% pass ABFM MDs dual 83.8% pass ABFM
25 Why the apparent performance variance? FP exam is given in March - results in May. Perhaps there is less incentive to prepare for ABFM exam? (Terry s theory) ( this is changing ) ABOFP exam easier for DOs because of Osteopathic component (Terry s hope) ABOFP exam easier exam then the ABFM exam (Terry s fear)
26 What about the costs of dual accreditation?
28 What are the additional cost factors? AOA- fees OPTI fees In service exam fees Additional faculty costs? Administrative support?
29 So where is the WIN in Dual accreditation? Increase US graduate applicant pool Increase US graduate applicant pool Increase US graduate applicant pool Integration of OMM in the residency program: benefits patients and MD residents Possible to enhance revenue from OMM outpatient and in-patient service Improved reputation of program?
30 What is the downside of dual accreditation? Additional costs: DO faculty,opti fees,aoa fees,certification fees,membership fees, etc, etc Two matches- makes no sense and forces our hand as PDs (Should rank best applicants DO/MD on same list-- side by side) The certification issues.. DO grads not choosing to take the ABFM exam or not performing as well?? Increased interest from US MDs in Family medicine: It is happening! The ever increasing numbers of DO graduates? Quality issues????
31 So should your program remain dual accredited? YES if: You can attract more quality graduates to your program It makes geographic sense ( new school opening up in your state or region ) Your program not attractive to High quality MDS You already have qualified DO faculty Your institution is willing to pay to play
32 Should your program remain dual accredited? NO if: You have remained competitive and attract quality applicants including top notch DOs You do not have qualified DO faculty You do not have funds to acquire qualified DO faculty Your program has no money..available to spend on additional fees..
33 Herb Stein s somewhat obvious law: If something can not continue, it won t! QuickTime and a decompressor are needed to see this picture.
34 Is dual accreditation a sustainable method of increasing osteopathic family medicine residency positions? ( My theory ) Doubtful IF: More US MDs want family medicine (less spots) Cost factors outweigh benefits (escalating OPTI fees) Continued trend of DOs not seeking ABFM certification - What is the point of being a dual program? Why would the allopathic programs want to pursue it.?????
35 What could work? Parallel programs - DOs and MDs train side by side, same faculty, similar curriculum but spots not dual accredited: DO spots just AOA accredited. WHY: Saves some money, avoids the certification duplicity and may enable program expansion to rural sites How: Designate a defined number of your approved spots purely osteopathic ( say if you have 8 make 3- JUST AOA accredited) OR Growth of new programs in virgin GME hospitals or new models of residency training (community health centers), ambulatory centers.
36 Why are parallel programs a better expansion option in allopathic institutions for now.. Spots protected from MD influx More curricular freedom Greater growth potential One master.. Cheaper-- do not need a FPC to train DO residents!!!
37 What in practical terms does a parallel program look like Can use shared faculty and FMC or alternate site(s) DO residents just adhere to ACOFP basic standards DO residents only sit for osteopathic in -training exam and ABOFP certification exam
38 Are either dual or parallel a sustainable expansion path for osteopathic family medicine? Most likely not! Limited capacity of GME spots Allopathic push back Overwhelming number of DO graduates OPTI fees are a disincentive
39 IMGS- no more doubtful.. US MD DO IMG? % 5% 75%
40 NEED MORE OSTEOPATHIC Family Medicine spots Develop alternative training models ( ie: VA sites, CHCs, rural hospitals, physician offices, online curriculums) Push the parallel track model in existing allopathic programs over the dual model Use political clout to selectively increase cap for primary care. Need 1000 more spots in osteopathic FM.. At least
41 Reference: Reality of AOA Accreditation of ACGME Family Medicine Residencies, Terry,RR and Hill,F (Feb issue of STFM)
Succession Planning and Career Development Emergency Medicine Association of Residency Coordinators This information was obtained from: International Association of Administrative Professionals http://community.iaap-hq.org/home
The Affordable Care Act and the Health Insurance Marketplace Are You Ready? The Affordable Care Act is here! In March 2010, President Obama signed into law the Affordable Care Act (ACA), putting comprehensive
The motivation and satisfaction of the students towards MBA at Karlstad University Business Administration Master s Thesis-One year program (FEAD01) 15 ECTS Academic Year Spring 2011 Thesis Advisors Inger
2014 4-2015 Train neee Information Veri fication and Regi istration Audi it TABLE OF CONTENTS SECTION PAGE I. TIVRA OVERVIEW... 2 WHAT IS TIVRA?... 2 WHY DO TIVRA?... 2 WHO DOES TIVRA INVOLVE?... 3 HOW
2014 Online College Students Comprehensive Data on Demands and Preferences Online College Students 2014: Comprehensive Data on Demands and Preferences A joint project of The Learning House, Inc. and Aslanian
The Surgical Workforce in the United States: Profile and Recent Trends April 2010 The Surgical Workforce in the United States: Profile and Recent Trends April 2010 Acknowledgments The Surgical Workforce
Administrative Residencies and Postgraduate Fellowships in Healthcare Administration SUMMARY REPORT 05/12/2010 Prepared by Strategic Communications for the American College of Healthcare Executives Residencies
OVERVIEW Evaluation of the Multi-Regional Model to Increase the Proportion of Baccalaureate Nurses Expansion in New York City and North Carolina (RIBN-E) Final Report October 31, 2014 The Center for Evaluation
Increasing Capacity and Efficiency in Programs Leading to Initial RN Licensure in Texas Texas Higher Education Coordinating Board Texas Higher Education Coordinating Board Jerry Farrington (Chairman) Robert
Total Rewards and Employee Well-Being research A report by WorldatWork February 2012 Contact: WorldatWork Customer Relations 14040 N. Northsight Blvd. Scottsdale, Arizona USA 85260-3601 Toll free: 877-951-9191
B R A N D M A N U N I V E R S I T Y GUIDE TO CHOOSING A UNIVERSITY 10 Questions you must ask before you enroll GUIDE TO CHOOSING A UNIVERSITY 10 Questions you must ask before you enroll B R A N D M A N
Committee on the Future of PhD Education Final Report September 2013 Executive Summary Vibrant, innovative PhD programs that attract top national and international students and develop them into world-class
Undergraduate students assist faculty members in a program of research What would I do as a research assistant? Administer research sessions with student participants Score /code the collected data and
A Consumer Guide to Understanding Health Plan Networks Table of Contents steps you can take to understand your health plan s provider network pg 4 What a provider network is pg 8 Many people are now shopping
Graduate School Options for Psychology Majors from http://www.psywww.com/careers/options.htm This section will help you learn about graduate programs in psychology, education, and social work that will
United States Government Accountability Office Report to Congressional Committees June 2013 COLLEGE TEXTBOOKS Students Have Greater Access to Textbook Information GAO-13-368 June 2013 COLLEGE TEXTBOOKS
Chapter Three Educating the Future Nursing Workforce for North Carolina * The critical issue confronting the Task Force with regard to nursing education programs was whether existing programs (and educational
Small Employers and Health Insurance Results of a survey of small employers in six rural California counties The Small Business Health Insurance Survey Project Why study small employers? Small businesses
Starbucks and ASU: Partners in educating leaders for the world. Starbucks Questions ASU Questions What is this new program? ASU is joining with Starbucks to offer an extraordinary new program to all of
PROGRAM REVITALIZATION: STRATEGIES for SURVIVAL Published by the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) 5600 N. River Road, Suite 720, Rosemont IL 60018 Phone: 773.714.8880
MEETING CALIFORNIA S NEED FOR THE EDUCATION DOCTORATE A Report Examining California s Needs for More Holders and Suppliers of Education Doctorates Prepared by The California State University March 2001