American Osteopathic Association

Advancing the distinctive philosophy and practice of osteopathic medicine

Single GME: Student Questions Answered

The following questions have been submitted by osteopathic medical students through a network of SOMA volunteers at each college of osteopathic medicine.

FAQ Topics

What is single accr​​editation?

Why is the system changing? Is the purpose to create more residency slots? 

Several factors influenced the decision made by the AOA, ACGME and AACOM to transition to a single accreditation system. The new approach will provide consistent methods for evaluation and accountability, enhance opportunities for all trainees and provide transparency to outside entities, including the federal government, licensing boards, credentialing committees and the public. 

Why is this happening if students are currently able to match in MD spots in ACGME programs?

In October 2011, the ACGME released new Common Program Requirements that severely limited DOs' ability to move from AOA residency training into advanced ACGME training. A major goal of the single GME accreditation system is to ensure that osteopathic students and graduates continue to have unrestricted access to training opportunities in specialties and locations of their choosing.  

Were students involved during this process?

Yes, students' representatives have served on the AOA Board of Trustees and House of Delegates, providing critical input throughout the transition process.  

What documents and agreements have transpired between AOA and ACGME?

A Memorandum of Understanding (MOU), which is a private legal document approved by the AOA, the ACGME, and AACOM, identifies the roles and commitments of each organization in transitioning to the single system. The MOU describes ACGME governance changes, review committee changes, and benefits for programs (and residents) applying for ACGME accreditation. Most of the information in the MOU has been communicated in the AOA and ACGME FAQs.  

DO vs. MD applicants

Will MD applicants be given preference over DO applicants in competitive residencies when there is one single accreditation system, since we will no longer have DO-only residencies?

Neither the AOA nor ACGME controls which applicants are chosen for specific programs. However, program directors are looking for residents who will complement and be an asset to their program. Competitive ACGME programs have sought and accepted osteopathic medical graduates for many years. We have every confidence that DO graduates are well qualified and will continue to have opportunities in competitive residency training positions.

Is the AOA able to predict if traditionally-MD residencies are going to accept more DO graduates after the merger, or are they still going to preferentially reserve spots for MDs? Some students are concerned there will be a surplus of DOs and a shortage of spots, especially if some DO residency programs are not accepting further students and/or not planning to apply for dual accreditation.

At the time of the MOU, approximately 50% of osteopathic graduates were training in ACGME (MD) residencies. The AOA is not able to predict if ACGME residencies are going to accept more DO graduates, but we believe that the single accreditation system builds on already positive impressions of DOs among ACGME programs. We do know that DO graduates are well qualified and should do well in the new environment. 

How do we know ACGME programs will accept us? 

Currently, almost half of all DO graduates enter directly into ACGME residency programs upon graduation from a college of osteopathic medicine. There is no reason for these programs to stop accepting DOs, and the positive environment fostered by the single accreditation system may open new possibilities with ACGME program directors who perceived an unfair imbalance when AOA-accredited programs accepted only osteopathic graduates. 

Will there be a parallel or subsequent increase in the number of residency spots at accredited programs? 

New programs continue to seek approval from AOA and ACGME. However, the transition to a single accreditation system on its own will not create new positions because as AOA programs gain ACGME accreditation, they will eventually drop AOA accreditation.   

Will other accredited sites have the resources to take a new resident into an existing class? 

This varies from site to site, depending on whether it has the facilities, patient volume and financial support needed to take additional residents. There must be adequate scope, volume and variety of cases for a training program to accept an additional trainee. However, facilitating the transition of residents from closing programs to accredited programs is not a new process or issue. Several dozen ACGME- and AOA-accredited postdoctoral programs close each year. Hence, there are established mechanisms to help move residents from closing programs. ACGME, AOA and AACOM all place emphasis on allowing residents to complete training in accredited settings and advance to board eligibility. In addition, the Centers for Medicare and Medicaid Services administers the majority of funds for residency training and has rules that allow for moving GME funds with the residents.

Resolution 42/internship year

What are the Residency Intern Year requirements for specific states?  For instance, I have heard there are specific requirements for Florida and Pennsylvania in regards to intern year that could potentially make you ineligible to work in those states if you do not meet the intern year requirements as a DO. I am a DO student completing an allopathic PM&R residency with a potential intern year in a different location from the PM&R residency.

There are two aspects of your situation that need to be considered. First, the PM&R Review Committee will allow programs to accept residents from either an AOA internship or an ACGME transitional year. Please see: Eligibility FAQs for Specialties with a Preliminary Yearwhich provides some advice on board certification considerations. 

Second, Florida and Pennsylvania require an AOA internship year in order to obtain a license in their state. The AOA has been working to advise these and other state licensing boards regarding the expected impact of the single accreditation system on AOA internships. ​If you complete an ACGME transitional year program, you will need to have your training recognized by the AOA. For more information, see AOA Recognition for ACGME Training.

The Match

After the transition, will there be two applications or one unified application system to apply for residency?

Once the transition to a single accreditation system is complete, the AOA Match will no longer be needed. Therefore, there will not be an AOA Match application. The primary Matching service for ACGME programs is the NRMP.  However, the NRMP is not the only match program. Others include the San Francisco Match, the Urology Match, and the Military Match. 

Will the class of 2020 be the last class to use two residency application services?

We anticipate that the class of 2019 will likely be the last class using two application services, unless we can accelerate our programs into the single accreditation system sooner, in which case the class of 2018 might be the last class to use two residency matches. Here’s why: The class of 2020 graduates from osteopathic medical schools in May 2020. All AOA programs at that time will be either ACGME programs or ineligible to accept new residents (because they will no longer have AOA accreditation after June 30, 2020). All 2020 graduates will be entering ACGME programs and will match through the National Residency Matching Service. 

Residency programs that do not meet deadlines or requirements for accreditation

Can four-year programs that do not apply for accreditation by Dec. 31, 2016, accept residents for PGY-2 year if the residents apply the following year?

An AOA training program may accept trainees if the trainees can complete their training by June 30, 2020. If the trainee would complete their training after June 30, 2020, the program must apply for ACGME accreditation by the date listed in Section X of the AOA Basic Documents for Postdoctoral Training.

Can you ensure residents will be transferred to an accredited program if their own program fails to receive accreditation upon their completion of the program? 

The AOA, ACGME and AACOM are committed to protecting residents during the transition to the single graduate medical education (GME) accreditation system. The terms of the single accreditation system require that the AOA no longer accredit GME programs after June 30, 2020. The three organizations recognize there may be unique circumstances whereby some programs make a good faith effort to achieve ACGME accreditation but still have not transitioned successfully to ACGME accreditation by that date. An agreement was reached by the three organizations to protect residents in such programs or situations so they have the ability to complete AOA-accredited training and advance to AOA board eligibility. The agreement gives the AOA restricted authority to extend the AOA accreditation date to allow any remaining resident in such programs to complete training in an accredited program.

Should a program not achieve ACGME accreditation by June 30, 2020, residents fellows in the program would be protected by the above agreement reached by AOA, ACGME, and AACOM.  The program’s AOA accreditation would be extended to allow any remaining resident/fellow to complete their training and advance to state licensure and AOA board certification.  In some cases, an opportunity may present itself that the residents would transfer to another accredited program.


Which scores will be released to residency programs during the application cycle? For instance, if a program is ACGME-accredited and the student applying takes both the COMLEX and the USMLE, will they be able to choose which scores are released to the programs? 

Please view pages 30-35 of the Electronic Residency Application Service (ERAS) 2019 User Guide​.

Osteopathic recognition and board certification

What is the outlook on the number of programs seeking osteopathic recognition? Are any traditionally allopathic residencies seeking recognition?

The outlook is promising. Keeping in mind that programs cannot apply for osteopathic recognition until they receive ACGME accreditation, we are pleased that more than 75 applications for osteopathic recognition from both AOA and ACGME accredited programs have already been filed. You can monitor the progress of osteopathic recognition applications onlineA number of ACGME-accredited residencies are pursuing osteopathic recognition. Not surprisingly, as of December 2016, the largest group applying for osteopathic recognition have been dually-accredited programs.

Are there avenues for residents to further their osteopathic training within a chosen specialty if they end up in a non-AOA residency program, and if so, would they be able to sit for AOA boards upon completion of their program?

The AOA currently has a process for recognizing ACGME training to allow DOs to become board-eligible in their respective specialties. You can view the list of requirements in the AOA Recognition for ACGME Training section. If you have additional questions on the recognition process, please feel free to contact our Trainee Services team.​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​