Response to “Further insight on AOA ophthalmology residency program closure data”

Harris Ahmed; Kim Vo; Wayne Robbins

doi:10.1515/jom-2022-0102

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Response to “Further insight on AOA ophthalmology residency program closure data”

Harris Ahmed , Kim Vo and Wayne Robbins

Published/Copyright: June 8, 2022

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From the journal Journal of Osteopathic Medicine Volume 122 Issue 9

To the Editor,

We appreciate the response from the authors [1] regarding our publication [2] on former American Osteopathic Association (AOA)-accredited ophthalmology and otolaryngology programs and their transition to the Accreditation Council of Graduate Medical Education (ACGME). We agree that financial factors likely influenced individual graduate medical education (GME) institutions’ decision to pursue accreditation of a particular specialty program over another.

Of note, the authors mention in their letter [1] that two of the former AOA-accredited urology programs that transitioned successfully and five of the ophthalmology programs that did not transition successfully were affiliated with a single university. Due to the affiliation of these five programs (representing 62.5% of the ophthalmology programs that did not get accredited by the ACGME per the authors) with a single institution, the authors feel that the data regarding the failure of many ophthalmology programs to successfully transition may be misleading. They seem to suggest that since these five programs were affiliated with one university, it should be considered that only one program did not achieve accreditation rather than five.

To understand this issue, it is important to remember the nature of AOA accreditation, GME, and the Commission on Osteopathic College Accreditation (COCA)-accredited medical schools. Together, these institutions previously implemented an “Osteopathic Post Graduate Training Institution (OPTI) model.” The OPTI was a representative body composed of members from AOA affiliate organizations created to ensure that “postdoctoral training programs were operating within approved standards, rules and regulations, and were providing educational training satisfactory to the public interest” [3]. It was commonplace for a DO medical school to be affiliated with various independent GME programs, with a regional accreditor and oversight process, such as the OPTI.

While the authors do not cite which five programs were affiliated with one university, we believe they are referring to the five programs that were affiliated as part of a “Consortium of Osteopathic Residencies in Ophthalmology (CORO)” with single midwestern university [4]. The CORO was founded in 1989, predating the university’s modern statewide campus system. CORO featured some shared academic elements, such as didactics and access to a surgical simulator. However, sharing such resources was and is not unique to the CORO or even the state of Michigan, as Henry Ford ophthalmology is home to a state-of-the-art wet lab and has granted access to neighboring ophthalmology programs.

Despite the five programs sharing a loose affiliation with a single university, these were all separate programs, independently accredited, with distinct program directors and department chairs, without interdependence on one another for accreditation. The mutually exclusive nature of these five programs was so well understood that when we obtained the program roster from the American Osteopathic Colleges of Ophthalmology and Otolaryngology – Head and Neck Surgery prior to the single accreditation process, the programs were listed separately. As such, we feel that the data presented in the initial study regarding the percentage of ophthalmology programs gaining ACGME accreditation is an accurate representation.

Corresponding author: Harris Ahmed, DO, MPH, Department of Ophthalmology, Loma Linda University, 11370 Anderson Street #1800, Loma Linda, CA 92354, USA, E-mail: hahmed@llu.edu

Research funding: None reported.
Author contributions: All authors provided substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; all authors drafted the article or revised it critically for important intellectual content; all authors gave final approval of the version of the article to be published; and all authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Competing interests: None reported.

References

1. Bradshaw, JT, Parker, LM, Wong, WJ, Gawrys, SP. Further insight on AOA ophthalmology residency program closure data. J Osteopath Med 2022;122:489–90.https://doi.org/10.1515/jom-2022-0042.Search in Google Scholar PubMed

2. Ahmed, H, Vo, K, Robbins, W. AOA ophthalmology and otolaryngology program closures as a model to highlight challenges of maintaining GME in high need areas. J Osteopath Med 2021;122:79–84. https://doi.org/10.1515/jom-2021-0088.Search in Google Scholar PubMed

3. American Osteopathic Association. OPTI accreditation handbook. Available from: https://osteopathic.org/wp-content/uploads/2018/03/opti-accreditation-handbook.pdf [Accessed 18 May 2022].Search in Google Scholar

4. Michigan State University. Consortium of osteopathic Residencies in ophthalmology. Available from: https://neurology.msu.edu/consortium-osteopathic-residencies-ophthalmology-coro [Accessed 18 May 2022].Search in Google Scholar

Received: 2022-05-16

Accepted: 2022-05-17

Published Online: 2022-06-08

This work is licensed under the Creative Commons Attribution 4.0 International License.