AOA Bureau of Education meets...

The AOA’s Bureau of Osteopathic Education (BOE) met over the weekend.  Among other topics on the agenda, they considered the AODME’s resolution to repeal Resolution 29.  This resolution was approved by the BOE and will now be considered by the AOA’s Board of Trustees at their Annual Meeting in Chicago in July.  By all accounts there was a lively, collegial discussion on the issue of AOA approval of ACGME Training.

An important point to remember, that I cannot stress enough (apologies for the bolding):   Resolution 29 is germane ONLY to the FIRST YEAR of training and ONLY applicable after COMPLETION of ACGME residency training.  It appears that there is continued confusion on this topic.

Macy Foundation

I'm in Atlanta (with Bob Cain, DO) attending the Macy Foundation conference on Reforming Graduate Medical Education to Meet the Needs of the Public.  This meeting follows a Macy sponsored conference in October entitled:  Recommendations for an Accountable Graduate Medical Education System.

For those or you who are students of GME history and GME reform, you will know that the Macy Foundation has sponsored conferences on Medical Education many times in the past.  These can be found on their web site.  If you are interested in further historical perspective, consider reading the works of Kenneth Ludmerer, MD, one of the conference participants.

There are many significant issues facing GME and specifically OGME.  It is critical, now more than ever, that we keep our focus on our customers - the public - as we shape OGME policy.

JAOA Education Issue has Arrived!!!

An abbreviated re-post since a Blogger crash seems to have erased Wednesday's entry...


The annual JAOA Education Issue "arrived" in my in-basket this week.  As usual it is a treasure trove of information regarding OME and OGME in particular.  As many of you know, I have been compiling data from both the JAOA and the JAMA education issues for some time.  I will be sharing some of this data over the next several months.


In addition, Wednesday's Daily Report Blog contained a note about the AOA Executive Committee meeting and several AODME advocacy issues.

Fees and OGME

Follow-up from the Annual Meeting...

My read on the discussion was a concern more with the magnitude of the fee change than with the change to a flat rate fee structure based on FILLED positions.  The flat rate also includes inspections.  In addition, I think that it is critical that we have beyond anecdotal (show of hands) data the impact of changes to DMEs.

Some givens with opinion (my view - you may disagree that these are givens):

• The funding of OGME is convoluted at best.  It is a conglomeration of the AOA, Specialty Colleges, OPTIs, COMs, hospitals and BOS member board certified osteopathic physicians.
• Transparency is a concern in the current system.  It is difficult to "follow the money."  I am not suggesting that anyone is hiding anything.  The lack of transparency is primarily related to the first bullet.
• The multitude of stakeholders results in as many (and likely more) opinions on the topic.  A Specialty College may have one opinion based on their direct role in sponsoring an evaluating committee and another opinion based on their advocacy for their programs.
• The AOA "raised" fees two years ago (2009) as a result of the $25 per trainee fee that goes to specialty colleges to support the work of Specialty College evaluating committees (SPEC).
• The previous fee increase was in June in 2001 for AY 2002 ($300 per program, $120 per trainee).
• Comparing ACGME fees and AOA fees is comparing apples and oranges.
• It is more efficient in total to operate an AOA-accredited program than ACGME-accredited program.  We can argue the definition of efficiency.  I would argue that the total costs (accreditation fees, faculty, administration, etc.) are much lower for osteopathic programs if for no other reason than paid faculty/program directors are not mandated.  I would also argue that there are no data to suggest that outcomes are disparate for graduates of AOA and ACGME accredited programs.  But…
• In almost all cases, dually accredited programs originated from gaining AOA accreditation for established ACGME accredited programs.  Therefore, AOA accreditation fees and other added costs (dues, required courses and attendance) are additive.

At the EPPRC collaborative in October of 2010, there was general agreement from stakeholders in OGME that spending more money to promote quality training was appropriate.  While that seems laudable, this cannot be adjudicated until we have an accurate accounting of the current system – the entire system.  I believe that a simplified fee structure can help this happen.