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Allopathic programs function within their accredited sponsoring institutions, and oversee specialty training via so- called residency review committees (RRCs), composed of members nominat- ed by the American Medical Association, the medical specialty’s board, and the designated national medical specialty so- ciety. AOA requires osteopathic programs to belong to an intermediary organiza- tion called an osteopathic postdoctoral training institution (OPTI). The regional consortium, comprised of at least one college of osteopathic medicine and one hospital, oversees quality and provides on-site educational resources to support community-based training. All of the 21 Texas osteopathic training programs are affiliated with TCOM’s OPTI. The ACGME is “very interested in that [consortium] style and how it might be adapted into their system,” Dr. Peska said. On the other hand, ACGME stan- dards use what he described as a more “prescriptive” approach to which AOA programs may have to adapt. For example, AOA requires “ample” call space and study facilities for its programs, but ACGME specifies how big that space must be. Osteopathic pro- grams primarily use volunteer faculty, whereas ACGME requires minimum pay- ments. And the two organizations have different minimum requirements for the number of residents that programs need to remain accredited.

Some uniformity will have to be es- tablished, but most of the forthcoming modifications will require what Dr. Peska characterized as subtle changes for os- teopathic programs. “One of my host CEOs said it’s ‘nothing big, but a lot of little things that will cost me money.’” Meanwhile, the merger could be a boon to residency programs dually ac- credited in both osteopathic and allo- pathic training. Because many of these programs are in family medicine, prima- ry care training also could get a boost. About half of the AOA-accredited family medicine programs and a majority of pe- diatric residencies are in dually accred- ited institutions. Those Texas osteopathic programs

that are dually accredited have the sup- port of both a local university and an

January 2013 TEXAS MEDICINE 45

OPTI, says Lisa R. Nash, DO, associate dean for educational programs at TCOM. In addition, “70 to 80 percent of our graduates go into ACGME programs and have for a number of years, so I don’t see this [merger] as a game changer” for Texas institutions.

Instead, the collaboration could re- duce headaches for dually accredited programs that would no longer have to

deal with two sets of inspections, paper- work, and fees to comply with accredita- tion requirements. Nor would these programs have to

hire two residency program directors, says Ron Cook, DO, chair of the Depart- ment of Family and Community Medi- cine at Texas Tech University Health Sciences Center and former director of the family medicine residency program.

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