Helping Students Navigate the Single Graduate Medical Education Accreditation System

To the Editor:

As we write, osteopathic medical students (ie, DO students) are preparing National Resident Matching Program (NRMP) applications in accordance with the single graduate medical education (GME) accreditation system. The 2020 single match process, which has generated considerable debate, is historic. Our purpose for writing is neither to debate merits of opposing views nor to dismiss either side. Instead, our purpose is to focus the osteopathic education community's attention on helping DO students effectively manage changes emanating from the single GME system.

The single GME accreditation system will trigger changes throughout osteopathic undergraduate medical education. For example, despite endorsement by the American Medical Association and the Accreditation Council of Graduate Medical Education (ACGME) of the Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA), some program directors and/or sponsoring institutions can continue to use the United States Medical Licensing Examination (USMLE) exclusively. Therefore, preclinical curricular content and additional costs of USMLE require monitoring.

Additionally, curriculum committees and clerkship directors should identify and evaluate strategies that optimize third- and fourth-year clinical rotations to ensure that DO students acquire the clinical skills, research experiences, and audition rotations that will enhance their competitiveness. All personnel at colleges of osteopathic medicine (COMs) should document and evaluate efforts to increase their knowledge of (1) ACGME standards, (2) entry requirements of all specialties, (3) the culture of ACGME programs, and (4) their personal networks of ACGME colleagues. Likewise, DO students should be encouraged to expand their communication networks with allopathic (ie, MDs) and international medical graduate students as both competitors and collaborators. Finally, COM faculty development should assist DO program directors and their faculty as they implement the current ACGME Common Program Requirements.

As is also the case for students, osteopathic medical educators should adapt to the changing GME environment without abandoning their osteopathic values. The simultaneous tasks of preparing DO students for ACGME while fostering osteopathic principles and practices deserve careful study. To that end, the effect of osteopathic recognition in GME programs and the board certification choices of DO graduates warrant ongoing monitoring and evaluation. A commitment to student-centric medical education under the single GME system demands that the DO profession use data-driven interventions to ensure student success in the NRMP. For example, if a student's data (eg, grades and evaluations, COMLEX-USA/USMLE scores) predict an unsuccessful match, there should be a timely and helpful intervention, rather than risk postmatch disappointment and possible disruption of a career path. Therefore, the DO profession's best strategy for meeting the challenges of single GME system is a multifaceted, data-driven approach that will help our students obtain the residencies they desire.