Transcript DO’s in ACGME programs

Pros and Cons of Dual
Accreditation
John B. Bulger, DO, FACOI, FACP
Director, Osteopathic Medical Education
Geisinger Health System
AACOM Annual Meeting
June 25, 2004
Overview
• Is there a crisis? What do the numbers
show?
• What are the pragmatic challenges to
getting from here to there?
• Why would a hospital do this?
• Vision for the future – integrated
medical education system which
maintains osteopathic distinctiveness
Is there a crisis?
That depends on your
perspective…
Number of DOs in AOA & ACGME Residency Programs
Trend for the Years 1993-2001
5000
4000
3000
2000
AOA
1000
ACGME
AOA/ACGME Task Force
2001
2000
1999
1998
1997
1996
1995
1994
1993
0
DO’s in ACGME programs
1312
1400
1200
1000
800
624
6.0%
600
400
2.9%
200
0
Total
JAMA. 2003;290:1197-1202.
'96-'97
'02-'03
DO’s in ACGME programs
450
400
413
405
350
300
250
200
150
233
14%
5%
188
'96-'97
'02-'03
7%
111
2%
100
50
54
2%
0
FP
IM
JAMA. 2003;290:1197-1202.
5%
Peds
DO’s in ACGME programs
69
70
69
60
54
50
40
30
20
17
11
18
17
9
10
0
ER
Surg
JAMA. 2003;290:1197-1202.
OB
IM/Peds
'96-'97
'02-'03
Overview
• Is there a crisis? What do the numbers
show?
• What are the practical challenges to
getting from here to there?
• Why would a hospital do this?
• Vision for the future – integrated
medical education system which
maintains osteopathic distinctiveness
ACGME program fees
• 5 or fewer residents = $2000
• 6 or more residents = $2500
• this yearly fee includes institution, site
reviews, etc.
• extra charges except for new
application fees, appeal fees, etc.
AOA program fees
• $300 per program
• $120 per trainee
• PLUS…
OPTI fees
•
•
•
•
$5000 membership fee plus
$255 per intern
$255 per resident
PLUS…
Extras
•
•
•
•
•
AOA Dues = $60 per trainee
AOA Dues for DME = $655
AODME Dues for DME = $300
DME Travel to AODME
COH Dues = $2500 (optional)
Our Example
IM Program
Program Fee
AOA/resident
OPTI/resident
AOA Dues
Total
ACGME Cost
$2,500
$2,500
AOA Cost
$300
$1,440
$3,060
$720
$5,520
Item
Number of
Trainees/
Programs
Cost per
Trainee/
Program
Cost per Item
AOA Program Fees
3
$300.00
$900.00
AOA Trainee Fees
43
$120.00
$5,160.00
AOA Dues for Trainees
43
$60.00
$2,580.00
OPTI Fee
1
$5,000.00
$5,000.00
OPTI Trainee Fees
43
$255.00
$10,965.00
DOME AOA Dues
1
$655.00
$655.00
DOME AODME Dues
1
$600.00
$600.00
DOME Travel
AOA COH Dues
TOTAL
$2,500.00
1
$2,500.00
$2,500.00
$30,860.00
PD requirements
• Internship program directors and
residency program directors must be:
– AOA board certified
– AOA members
– Osteopathic specialty college members
Board certification
• 80% rule
• If you have enough DO’s – this can be a
challenge
– Year 1 – 1:2, 50%
– Year 2 – 1:1, 66%
– Year 3 – 6:6, 89%, but if 5:6, 78%
Overview
• Is there a crisis? What do the numbers
show?
• What are the practical challenges to
getting from here to there?
• Why would a hospital do this?
• Vision for the future – integrated
medical education system which
maintains osteopathic distinctiveness
Recruitment
What are residency programs looking for?
• Competent communication skills
• Possibility for staff recruitment
• Proven commodity
Recruitment
• $15,000 - $25,000 for primary care
• Up to $50,000 for certain specialists
Recruitment
AOA
Internship
Residency
AOA/ACGME
Dual Accredited
Internship/Residency
ACGME
Residency
Total
%
5%
10%
83%
98%
(Number)
(38)
(75)
(601)
714
%
10%
8%
81%
99%
(Number)
(174)
(155)
(1488)
1817
Responses
Students
Interns/Residents
AOA/ACGME Task Force
IMG’s in ACGME programs
5623
5700
5600
5500
5400
5300
5200
5100
5000
4900
4800
4700
5033
24%
Total
JAMA. 2003;290:1197-1202.
26%
'96-'97
'02-'03
IMG’s in ACGME programs
3000
2574 2593
2500
2000
14%
1500
1000
500
0
7%
46%
'96-'97
'02-'03
51%
897
633 540
316
16%
13%
6%
FP
IM
JAMA. 2003;290:1197-1202.
10%
Peds
Overview
• Is there a crisis? What do the numbers
show?
• What are the practical challenges to
getting from here to there?
• Why would a hospital do this?
• Vision for the future – integrated
medical education system which
maintains osteopathic distinctiveness