MEDICAL STUDENT LIFE

2
1
1

2

3
1

CT

21
MA
2

15

CT

11
NJ

1

9

1

1
1

1

8

MD

9

1
2

1

15

3

3

2

DE
DC

1

5

1
2
1

11

4

7

2

1

1

1

2

1

4
1

1

5

4

1

1

12

8

1

2

5

1

2

3

Number of AOA Programs
Number of ACGME Programs

2
5

2

Puerto Rico

Number of AOA/ACGME Residencies by State

TWO ROADS, ONE DESTINATION
Zach Jarou, MSIV
EMRA MSGC Chair
Michigan State University
College of Human Medicine
Lansing, MI

Bradley Davis, OMS3
Michigan State University
College of Osteopathic
Medicine
Detroit, MI

20 EMRA | www.emra.org

The single accreditation system will ensure quality,
consistent training for all physicians-in-training,
and will provide increased access to fellowships for
osteopathic trainees.

I

n February 2014, after months of
discussion, the American Osteopathic
Association (AOA) and the Accreditation
Council for Graduate Medical Education
(ACGME), along with the American
Association of Colleges of Osteopathic
Medicine (AACOM), reached an
agreement for a single accreditation
system for the graduate medical education
(GME) system in the United States.

The road ahead
Beginning in 2015, AOA-accredited
year period to transition to ACGMEaccreditation. Programs with an
osteopathic focus will continue
under the new system and will be
Likewise, under the new agreement,
allopathic medical school graduates will
have access to the traditionally osteopathic
training programs.
The single accreditation system will
ensure quality, consistent training for all
physicians-in-training, and will provide
increased access to fellowships for
osteopathic trainees. It is not yet clear
whether there will be a single match
program, although this seems likely. At
this point, when it comes to licensure
for osteopathic physicians, it seems
that COMLEX-USA will not be going
anywhere. However, there will likely be
opportunities to help program directors
better interpret COMLEX scores when
considering osteopathic applicants.
While a framework has been created,
the impact for emergency medicine
training will continue to evolve as the
AOA and AACOM appoint osteopathic
representatives to serve on the ACGME
Board and Emergency Medicine Residency
Review Committee (RRC).

The changing landscape
While some variation from this plan is
to be expected, we hope to explain how
the transition to a single accreditation
system should unfold over the next
several years, as well as summarize the
options currently available to osteopathic
students applying for emergency medicine
residency training programs.
As of this month,
approved EM residency programs

(www.opportunities.osteopathic.org), and
167 ACGME-accredited programs
(https://www.ama-assn.org/go/freida).
Five programs are dually accredited,
bringing the combined number of training
programs to 217.

Traditional AOA and dually
accredited programs
For students seeking to match into AOAapproved or dually accredited programs,
the process is fairly straightforward via
the AOA Match. The advantage of
dually accredited programs is that

Allopathic and
osteopathic medical
school graduates will
have access to all training
programs, including MD
graduates wishing to
complete osteopathicfocused programs.

ACGME credit, and have the option

traditional AOA-approved intern year,
while others accept osteopathic graduates
directly from medical school.

Board of Medical Specialties
All AOA-approved EM
residencies require four years of training,

requirements, it is also important to keep
in mind that without completing a

internship year.
Rank lists for the AOA match must be
released at the beginning of February. On
the other hand, the National Residency
Matching Program requires rank lists to
be submitted by late February, and results
are released in late March. Students who
successfully match in an AOA program via
the National Matching Services (NMS) are
not eligible to apply for ACGME programs
via the NRMP.

ACGME programs +/- AOA
internship
Osteopathic students seeking ACGME
residency training have a number of
options available to them, including the
decision of whether or not to complete
a traditional AOA intern year prior to
applying for an ACGME program. It may
be wise for interested students to
of programs they are considering.
Programs in areas of the country without a
strong osteopathic representation, or that
have never before accepted osteopathic
residents, may not be worth aggressively
pursuing. The majority of ACGME
programs are three years in length with a
handful of programs offering four years
of postgraduate training. Some ACGME
programs will not take osteopathic
applicants who have not completed a

year, you will not be able to obtain
a permanent license to practice
– Michigan, Oklahoma,
Pennsylvania, Florida, and West Virginia.

AOA Resolutions 42 and 29
The AOA began approving ACGME
training in the 1980s, when the number
of osteopathic medical school graduates
outnumbered the number of osteopathic
GME positions. In 2000, AOA Resolution
42 provided a mechanism for approving
an ACGME PGY-1 year as equal to an
AOA-approved internship, with certain
stipulations.
The applicant must have an AOA
membership, complete an application
agreeing to the approval process and
release of information, must demonstrate
osteopathic educational activity (such
as AOA conference presentations or
attendance), and the PGY-1 rotations
have to be similar to the traditional AOA
internship. Between 2002 and 2010,
more than 2,000 Resolution 42
requests were approved, while only
11 were denied. More recently, in 2010,
AOA Resolution 29 allowed for approval
of an entire ACGME residency, not just
the intern year. By taking advantage
for ACGME training, trainees
are eligible for licensure in all
50 states.
April/May 2014 | EM Resident 21

Resident
EM
Official Publication of the Emergency Medicine Residents’ Association
April/May 2014
VOL 41 / ISSUE 2

In
the
Field
Pre-hospital medicine
EMS, backboards, hypothermia
and more