The AOA/ACGME Single Accreditation System and Its Immediate and Future Impact on Family Medicine.

BACKGROUND AND OBJECTIVES: The American Osteopathic Association (AOA) agreed to combine its graduate medical education programs with the Accreditation Council for Graduate Medical Education (ACGME) between July 1, 2015 and June 30, 2020 in an initiative called the Single Accreditation System (SAS). The objective of our study was to identify the impact the SAS had on the ACGME, family medicine (FM), and implications for the future of FM. METHODS: We collected and compiled data from the AOA, ACGME, and the National Residency Matching Program (NRMP). Analysis reveals the effects that the addition of former 122 AOA-accredited FM residencies had on the ACGME and FM programs. RESULTS: Several osteopathic FM programs encountered challenges meeting ACGME accreditation standards. As of June 1, 2020, 89 of 122 accreditation applications received initial or continuing accreditation; the others had accreditation issues to resolve. The Osteopathic Recognition program emphasizing training in osteopathic principles and practices was a popular option in FM residencies. Fewer DOs serve as program directors in former AOA-accredited FM residencies. CONCLUSIONS: The SAS has shifted the balance in the percentages of MDs, DOs, and international medical graduates (IMGs) in FM. Trends in FM show that as more DOs enter the NRMP the percent of MDs and IMGs decreases. In the future, it is projected that DOs will outnumber MDs and IMGs in ACGME FM residencies. The 51 new medical schools started between 2010 and 2020 will generate a test for the integration of their graduates into GME. Increased competition for FM residencies is expected.

Building HCA Bridges.

Description On June 28, 2021, the incoming residents reported for their first day of orientation at HCA Florida Westside Hospital (HFWH). This GME program is a joint venture and requires the same level of commitment from HCA Florida Northwest Hospital (HFNWH). As a new employee, I was immediately impressed with the residents, leadership, and staff. Everyone was relaxed, excited, attentive, and cooperative. I met people from all over the world, from different religions, and of different sexual orientations. The following day the same group of residents attended orientation at HFNWH and the leadership and staff were equally impressive. I went home feeling energized by this extraordinary residency program where diversity, equity and inclusion were not just words but were embodied in both the residency program, and both hospitals. I created "Building HCA Bridges" as an abstract expression with feelings, movement, textures, and symbolic colors. When I stepped back, I realized that the painting was missing something. The next day, I spoke with the GME and hospital leadership and with their support, the painting was subsequently passed throughout both hospitals, and everyone was invited to sign. This small gesture created a sense of community, pride, and validation for all who participated in creating this incredible residency program and ultimately, unique piece of artwork. I am submitting the traveling painting, "Building HCA Bridges" on behalf of the inaugural GME programs at HFWH and HFNWH and for those who support the programs every day. We are blessed.