The accreditation of osteopathic medical schools is overseen by the American Osteopathic Association (AOA) Commission on Osteopathic College Accreditation (COCA). Periodically, COCA proposes revisions of their accreditation standards to “ensure that academic quality and continuous quality improvement delivered by the colleges of osteopathic medicine (COMs) reflect the evolving practice of osteopathic medicine.”1
The AAO, our component societies and multiple individual members of our organization raised significant concerns with proposed revisions of the current standards that recommended a significant change in the leadership qualifications for Osteopathic Manipulative Medicine (OMM) Department chairpersons for our COMs.
The recommended change would not limit board certification by the American Board of Neuromusculoskeletal Medicine (AOBNMM) to serve as the department chair of OMM, but would allow an individual with board certification by the American Osteopathic Board of Family Practice (AOBFP) to assume this OMM leadership position.
COCA recently upheld the requirement that only an individual with AOBNMM certification can serve as the department chair of OMM in our COMs, but there was much background work by our organization to reaffirm this standard.
Laura E. Griffin, DO, FAAO, while AAO President, drafted a formal response from the AAO Board of Trustees and our membership urging COCA to reconsider and to remove this proposed change. Dr. Griffin acknowledged the level of training and clinical exposure to osteopathic principles and practices (OPP) in individuals completing a residency in neuromusculoskeletal medicine requires a significantly higher standard in every respect. The AAO’s position is that the OMM leadership in our COMs are responsible for all aspects of osteopathic education and must be held to the highest standards in our profession.
Our profession is in the midst of a transition to a single accreditation system where osteopathic education will be overseen by the Accreditation Council of Graduate Medical Education (ACGME). Dr. Griffin expressed an added concern that diluting OMM leadership would directly impact the first two years of osteopathic education, which may be the only substantial exposure to OPP for many DOs.
One reason cited for this proposed standard change was the lack of availability of NMM board-certified physicians to fill department chair positions. Dr. Griffin presented the current data of more than 800 NMM board-certified physicians in practice. In addition, there are 48 NMM residency programs at 37 institutions with an average of 45 residents graduating each year that are board-eligible. There will be 54 residents eligible to sit for NMM boards in 2017. Almost every current AOA NMM residency is anticipating transitioning to the ACGME to ensure a continued pool of qualified NMM trained physicians.
The recent COCA standard revision for department chair of OMM in our COMs is as follows:
Element 7.5: OMM/OPP Leadership:
A COM must employ a Doctor of Osteopathic Medicine with an active medical license and active board certification from the American Osteopathic Board of Neuromusculoskeletal Medicine (AOBNMM) or a Certificate of Special Proficiency in OMM (C-SPOMM) to serve as the Department Chair of OMM/OPP, or equivalent.2
The leadership of our OMM departments was not the only discipline with a proposed standard change that could diminish osteopathic physician presence. There was a recommendation to not require primary care leadership by an osteopathic physician at our COMs. The response to that COCA change also led to much concern. The recent COCA standards reaffirmed the need for an osteopathic physician to chair our primary care disciplines and reads as follows:
Element 7.4: Primary Care Leadership:
A COM must employ a Doctor of Osteopathic Medicine with an active medical license and active board certification from a primary care discipline to serve as the Department Chair of Primary Care (or equivalent). If the COM does not have an organized Department of Primary Care, the Department Chair of either Family Medicine or Internal Medicine or Pediatrics must be a Doctor of Osteopathic Medicine with active board certification.2
The AAO acknowledges that there are select individuals who are outstanding practitioners of OPP that do not have specialty certification, and many of them are valued members. Their individual contributions to the profession must not to be diminished, but there is a need to establish criteria to ensure that every COM OMM department chair has the highest level of credentials to be successful in that role.
The Academy is grateful to Dr. Griffin for her leadership in responding to these recent proposed COCA standard changes, as well as the response by our membership, component societies and other osteopathic organizations. This collective response was submitted in a positive and professional manner, which contributed to our profession maintaining the highest standards for our COMs.
- COM Accreditation. American Osteopathic Association website. http://www.osteopathic.org/inside-aoa/accreditation/COM-accreditation/Pages/default.aspx. Accessed May 4, 2017.
- American Osteopathic Association Commission on Osteopathic College Accreditation. Accreditation of colleges of osteopathic medicine: COM continuing accreditation standards. http://www.osteopathic.org/inside-aoa/accreditation/COM-accreditation/Documents/coca-standards-final-04-10-2017.pdf. Updated April 10, 2017. Effective July 1, 2017. Accessed May 4, 2017.