33rd ANNUAL SPRING FLING MAY 10, 2019 GARY L. SLICK, D.O. ACGME UPDATE 33rd ANNUAL SPRING FLING MAY 10, 2019 GARY L. SLICK, D.O.

Disclosure I have no relevant financial relationships or affiliations with commercial interests to disclose.

TIME LINE OF THE SINGLE ACCREDITATION SYSTEM APPLICATIONS FOR PROGRAMS BEGAN JULY 2015 AOA ACCREDITATION CEASES JUNE 30, 2020* *Residents in AOA non-accredited ACGME programs will be able to “Train Out” under AOA approved training

WHAT THE SAS IS (AND WHAT IT IS NOT) CHANGED GME ACCREDITATION UNCHANGED BOARD CERTIFICATION CME PREDOCTORAL EDUCATION LICENSURE EXAMS (COMLEX, USMLE)

SINGLE ACCREDITATION ACTIVITY 79% OF AOA PROGRAMS HAVE EITHER SUBMITTED APPLICATION OR ARE ALREADY ACGME ACCREDITED* 20% OF PROGRAMS HAVE APPLIED FOR OSTEOPATHIC RECOGNITION <14% OF AOA PROGRAMS PREVIOUSLY NOT DUALLY ACCREDITED SUBMITTING APPLICATIONS FOR ACGME ACCREDITATION HAVE APPLIED FOR OSTEOPATHIC RECOGNITION* * SOME OF THE 1200 AOA PROGRAMS WILL NOT APPLY FOR ACGME ACCREDITATION AND SOME HAVE NOT HAD RESIDENTS OR FELLOWS IN THEIR PROGRAMS FOR A FEW YEARS OR MORE  

ACGME ACCREDITATION TERMINOLOGY   PRE-ACCREDITATION – GRANTED TO ALL OSTEOPATHIC SPONSORING INSTITUTIONS OR PROGRAMS SUBMITTING A COMPLETED APPLICATION FOR ACCREDITATION CONTINUED PRE-ACCREDITATION – GRANTED TO APPLICANTS THAT ARE NOT SUBSTANTIALLY COMPLIANT WITH ALL ACGME REQUIREMENTS INITIAL ACCREDITATION – GRANTED TO APPLICANTS THAT ARE SUBSTANTIALLY COMPLIANT WITH ALL ACGME REQUIREMENTS

ACGME ACCREDITATION TERMINOLOGY CONTINUED ACCREDITATION – GRANTED TO PROGRAMS THAT HAVE UNDERGONE A FULL SITE VISIT TWO YEARS AFTER INITIAL ACCREDITATION AND DEEMED TO BE IN SUBSTANTIAL COMPLIANCE WITH THE COMMON AND SPECIALTY PROGRAM REQUIREMENTS

CURRENT STATUS OF INSTITUTIONAL APPLICATION SUBMISSION AND ACCREDITATION COMPLETED APPLICATIONS – 107* INITIAL ACCREDITATION – 48 INITIAL ACCREDITATION WITH WARNING – 11 PRE-ACCREDITATION – 0 CONTINUED PRE-ACCREDITATION – 3 CONTINUED ACCREDITATION – 34 PROBATION - 1 WITHDRAWAL OF APPLICATION – 10** *106 ONE YEAR AGO **5 ONE YEAR AGO

PROGRAM APPLICATIONS IN SAS TOTAL SAS PROGRAM POOL – 1072 APPLICATION NOT YET INITIATED – 16% APPLICATION INITIATED – 84% SUBMITTED – 76% NOT YET SUBMITTED – 6%

APPLICATIONS SUBMITTED (722) PRE-ACCREDITATION – 5% INITIAL ACCREDITATION – 68% CONTINUED PRE-ACCREDITATION – 12% CONTINUED ACCREDITATION – 13% WITHDRAWALS – 2%

CURRENT STATUS OF PROGRAM APPLICATION SUBMISSION AND ACCREDITATION COMPLETED APPLICATIONS – 722 INITIAL/CONTINUED ACCREDITATION (RESIDENCY)– 483 (81%) 8 ANESTHESIOLOGY (83%) 23 DERMATOLOGY (77%) 45 EMERGENCY MEDICINE (83%) 104 FAMILY MEDICINE (67%) 95 INTERNAL MEDICINE (86%) 4 NEUROLOGICAL SURGERY (50%) 9 NEUROLOGY (75%) 25 OB/GYN (81%) 5 OPHTHALMOLOGY (56%) 22 ORTHOPEDIC SURGERY (52%) 15 ONMM (38%) 11 OTOLARYNGOLOGY (65%) 7 PEDIATRICS (88%)

CURRENT STATUS OF PROGRAM APPLICATION SUBMISSION AND ACCREDITATION INITIAL/CONTINUED ACCREDITATION (RESIDENCY-CONTINUED) 3 PHYSICAL MEDICINE AND REHAB (75%) 3 PLASTIC SURGERY (50%) 15 PSYCHIATRY (71%) 8 RADIOLOGY (66%) 41 SURGERY (73%) 31 TRANSITIONAL YEAR (38%) 9 UROLOGY (82%) INITIAL/CONTINUED ACCREDITATION (FELLOWSHIP) – 127 (80%) 26 CARDIOLOGY (87%) 5 CRITICAL CARE (71%) 1 ENDOCRINOLOGY (17%) 21 GASTROENTEROLOGY (91%) 2 HEMATOLOGY/ONCOLOGY (75%) 1 INFECTIOUS DISEASE (25%) 9 INTERVENTIONAL CARDIOLOGY (70%)

CURRENT STATUS OF PROGRAM APPLICATION SUBMISSION AND ACCREDITATION INITIAL/CONTINUED ACCREDITATION (FELLOWSHIP-CONT.) 2 NEPHROLOGY (40%) 4 PULMONARY/CRITICAL CARE (93%) 2 RHEUMATOLOGY (50%) 3 HEMATOLOGY/ONCOLOGY (60%) 3 GYNECOLOGICAL ONCOLOGY (75%) 2 MATERNAL & FETAL MEDICINE (50%) 2 CRITICAL CARE SURGERY (66%) 1 GENERAL VASCULAR SURGERY (20%) 2 HOSPICE AND PALLIATIVE CARE (18%) 2 MOHS (66%) 0 GERIATRIC MEDICINE-FM (0%) 3 SPORTS MEDICINE (23%) 0 CHILD & ADOLESCENT PSYCHIATRY (0%) 17 OTHERS (6%)

CURRENT STATUS OF PROGRAM APPLICATION SUBMISSION AND ACCREDITATION (CONT.) PRE-ACCREDITATION – 32 1 ALLERGY 0 DERMATOLOGY 1 EMERGENCY MEDICINE 1 FAMILY MEDICINE 0 INTERNAL MEDICINE 0 NEUROLOGY 0 OB/GYN 5 ONMM 0 OTOLARYNGOLOGY 0 PEDIATRICS 0 PSYCHIATRY 0 GENERAL SURGERY 6 TRANSITIONAL YEAR 18 FELLOWSHIPS

CURRENT STATUS OF PROGRAM APPLICATION SUBMISSION AND ACCREDITATION CONTINUED PRE-ACCREDITATION – 86 1 ANESTHESIOLOGY 0 CARDIOLOGY 3 DERMATOLOGY 1 MOHS 3 EMERGENCY MEDICINE 1 ENDOCRINOLOGY 23 FAMILY MEDICINE 4 GASTROENTEROLOGY 1 HEMATOLOGY/ONCOLOGY 3 HOSPICE AND PALLIATIVE MEDICINE 2 INTERNAL MEDICINE 3 NEUROLOGICAL SURGERY 0 NEUROLOGY

CURRENT STATUS OF PROGRAM APPLICATION SUBMISSION AND ACCREDITATION CONTINUED PRE-ACCREDITATION (CONT.) 2 OBSTETRICS/GYNECOLOGY 3 OB/GYN FELLOWSHIPS 3 OPTHALMOLOGY 19 ORTHOPEDIC SURGERY 3 ONMM 3 OTOLARYNGOLOGY 1 PHYSICAL MEDICINE AND REHAB 0 PLASTIC SURGERY 3 PSYCHIATRY 1 RADIOLOGY 1 RHEUMATOLOGY 10 GENERAL SURGERY 2 UROLOGY

PRIMARY CARE 11% SURGICAL PROGRAMS 25% PERCENTAGE OF REVIEWED APPLICATIONS RECEIVING CONTINUED-PREACCREDITATION PRIMARY CARE 11% FAMILY MEDICINE 18% INTERNAL MEDICINE 2% PEDIATRICS 0% SURGICAL PROGRAMS 25% ENT 27% ORTHOPEDIC SURGERY 46% GENERAL SURGERY 20%

OSTEOPATHIC RECOGNITION – 210 CURRENT STATUS OF PROGRAM APPLICATION SUBMISSION AND ACCREDITATION (CONT.) OSTEOPATHIC RECOGNITION – 210 INITIAL ACCREDITATION – 142 CONTINUED ACCREDITATION – 50 APPLICATION PENDING – 15 RECOGNITION WITHHELD – 10 PENDING REVIEW – 15

PROGRAM DIRECTOR CREDENTIALS FOR SAS PROGRAMS PROGRAM DIRECTOR DEGREES D.O. – 69% M.D. – 31% PROGRAM DIRECTOR CERTIFICATION AOA – 55% ABMS – 40% AOA AND ABMS – 5%

OSU-CHS APPLICATION STATUS FOR OSUMC CONTINUED ACCREDITATION INTERNAL MEDICINE PEDIATRICS INITIAL ACCREDITATION ANESTHESIOLOGY CARDIOLOGY GASTROENTEROLOGY EMERGENCY MEDICINE FAMILY MEDICINE (OSUMC) INTERVENTIONAL CARDIOLOGY OB/GYN OMM PSYCHIATRY RADIOLOGY SURGERY

OSU-CHS APPLICATION STATUS FOR OSUMC (Cont.) CONTINUED PREACCREDITATION ORTHOPEDIC SURGERY OTOLARYNGOLOGY

OSU-CHS APPLICATION STATUS FOR NON-OSUMC PROGRAMS INITIAL ACCREDITATION EMERGENCY MEDICINE – LAWTON EMERGENCY MEDICINE – NORMAN FAMILY MEDICINE – ADA FAMILY MEDICINE – DURANT FAMILY MEDICINE – LAWTON FAMILY MEDICINE – McALESTER FAMILY MEDICINE – TAHLEQUAH ONCOLOGY – CTCA

STATUS OF TEACHING HEALTH CENTER PROGRAMS INITIAL ACCREDITATION FAMILY MEDICINE – TALIHINA FAMILY MEDICINE – TULSA INTERNAL MEDICINE – TAHLEQUAH OB/GYN – TULSA CONTINUED ACCREDITATION PEDIATRICS – TULSA

STATUS OF OSTEOPATHIC RECOGNITION APPLICATIONS INITIAL RECOGNITION ANESTHESIOLOGY CARDIOLOGY EMERGENCY MEDICINE – OSUMC AND LAWTON FAMILY MEDICINE – OSUMC AND TULSA THC FAMILY MEDICINE – LAWTON, McALESTER, TALIHINA INTERNAL MEDICINE –OSUMC AND TAHLEQUAH OB/GYN – OSUMC AND TULSA THC PEDIATRICS – OSUMC AND TULSA THC PSYCHIATRY RADIOLOGY SURGERY

2020 MATCH IMPLICATIONS ALL AOA TRAINING PROGRAMS NOT ACHIEVING ACGME INITIAL ACCREDITATION BY SEPTEMBER OF 2019 WILL NOT BE ABLE TO PARTICIPATE IN THE MATCH FOR 2020 AND WILL NOT BE ABLE TO MATRICULATE NEW APPLICANTS.

UNANSWERED QUESTIONS WILL THE SAS ADD MORE SLOTS FOR DOs WILL THE SAS OPEN MORE SURGICAL SLOTS FOR DOs WILL OSTEOPATHIC IDENTITY BE MAINTAINED WILL THE NEXT STEP BE SINGLE UNDERGRADUATE ACCREDITATION AND SINGLE PATHWAY TO LICENSURE WILL AOA CERTIFIED DOs CONTINUE TO BE PROGRAM DIRECTORS WILL INITIAL CERTIFICATION BY THE AOA CONTINUE

ACGME REQUIREMENT CHANGES NEW “LEARNING AND WORKING ENVIRONMENT” (FORMERLY “DUTY HOURS”) REQUIREMENTS WERE IMPLEMENTED JULY 1, 2018 (REQUIREMENT VI) REQUIREMENTS I-V WILL BE IMPLEMENTED ON JULY 1, 2019 NEW REQUIREMENTS FOR I-V ARE FAVORABLE FOR OSTEOPATHIC AND RURAL PROGRAMS WITH MORE OPTIONS FOR CURRICULUM DESIGN, SCHOLARLY ACTIVITY AND ACCEPTANCE OF AOA RESIDENCY TRAINING FOR ENTRY INTO FELLOWSHIP PROGRAMS

QUESTIONS?