AOA and ACGME Statement on Joint Principles for Physician Education and Training during the COVID-19 Pandemic

Rationale

The American Osteopathic Association (AOA) and the Accreditation Council for Graduate Medical Education (ACGME) are working together to address the concerns of residents and fellows about their Board eligibility during a time of disruption in their education and training. Both organizations acknowledge the tireless dedication of residents and fellows who, at great personal risk, have sacrificed some of their formal education and training to care for patients afflicted with Coronavirus Disease 2019 (COVID-19). We appreciate the concern of residents and fellows on how these disruptions will affect their ability to become certified in their field of medicine, and how this uncertainty could potentially undermine their overall well-being and effectiveness as caregivers. The AOA and ACGME are providing this statement of joint principles to help clarify for residents/fellows and programs the issues related to board certification that have arisen through the circumstances of the COVID-19 pandemic.

1. The AOA and ACGME are deeply committed to creating and supporting a strong national physician workforce.

2. The AOA and ACGME, which set professional standards for physician certification and accredit residency and fellowship programs respectively, understand that the unique situation brought on by the COVID-19 pandemic requires flexibility and creativity to maintain both organizations’ shared commitment to the public by ensuring that osteopathic physicians practice medicine safely and efficaciously.

3. The AOA and ACGME endorse and rely upon the authority and judgment of Clinical Competency Committees (CCCs) and graduate medical education (GME) program directors to determine readiness for unsupervised practice and to inform the AOA specialty board decisions regarding eligibility for initial board certification. This authority and judgement are especially important during times of crisis when traditional time- and volume-based educational standards may be challenged.

4. Program directors and CCCs have the ability to assess resident and fellow readiness for unsupervised practice in a variety of different ways, including utilization of Milestones data, Entrustable Professional Activities (EPAs), and review of data from a variety of assessment methods (in-training examinations, clinical evaluations, case/procedural logs, multi-source feedback, direct observation in real or simulated situations, etc.). While the types of competency assessments may vary across specialties, programs, and institutions, the AOA and ACGME do expect programs to use rigorous, valid, and reliable combinations of assessments that are appropriate within each specialty.

5. The AOA and ACGME understand and affirm that the judgment made by program directors and CCCs to assess osteopathic residents and fellows constitutes a vital responsibility that affects residents, fellows, and most importantly, the care of the public.