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Address correspondence to Scott Dalhouse, Department of Education, American Osteopathic Association, 142 E Ontario St, Chicago, IL 60611-2864. E-mail: sdalhouse{at}osteopathic.org

Recognizing the need for a new system to structure and accredit osteopathic graduate medical education (OGME), the American Osteopathic Association (AOA) established the Osteopathic Postdoctoral Training Institutions (OPTI) program in 1995.¹

Each OPTI is a community-based training consortium composed of at least one AOA–accredited college of osteopathic medicine and one AOA–accredited hospital. Additional hospitals and ambulatory care facilities may also form a partnership within an OPTI. Community-based health care facilities such as ambulatory care clinics, rehabilitation centers, and surgicenters may now have the resources and support necessary to provide physician training with an OPTI's assistance.

Although final implementation of the OPTI program went into effect in July 1999, ^1,2 the AOA continues to refine procedures for all OGME programs to be incorporated into the OPTI system. In response to the results of on-site accreditation surveys and the surveys' anticipatory self-study documents, as well as data collected from the annual reports required of all OPTIs, the AOA has recently begun the process of studying trends in accreditation-cycle data.

	Recent OPTI Activities at the AOA

Top Recent OPTI Activities at... Accreditation Cycles References

 
Proposed National Osteopathic Education Center and OPTI Clearinghouse
James E. Zini, DO, AOA Past President, proposed a national osteopathic education center and OPTI clearinghouse in 2001. Both projects are currently under development within the AOA's Department of Education (DOE). The major goal of the clearinghouse would be to disseminate information about the AOA's educational structure and processes to members of the osteopathic medical profession and the public.

To facilitate the AOA accreditation and approval processes, the proposed clearinghouse would provide resources to the osteopathic medical profession and the DOE by developing and implementing resources to ensure that OPTIs' data needs are met and enhanced. These new resources would include a national database, Internet resources for public and private (OPTIs only) use, and staffing levels sufficient to fulfill the administrative needs of the OPTIs. The clearinghouse will also conduct continuous needs-assessment analysis for data collection, as the DOE and their related councils, committees, and bureaus use these materials.

Additionally, the proposed clearinghouse is charged with providing OPTIs with appropriate information for their use in determining the effectiveness of the OPTI system as an OGME mechanism that is intended to enhance and increase the quality of osteopathic postdoctoral training. This information may include completion rates, certification board pass rates, and the length of program approvals.

Utilizing statistical design tools and methods, the clearinghouse will further be able to study, analyze, and maintain information, making formal recommendations on how educational issues affect workforce trends, OPTI development, trends in internship and residency training, certification, the effects of continuing medical education requirements on AOA membership, and the effects of hospital closures on the osteopathic medical profession.

It is also hoped that the OPTI clearinghouse will serve as an electronic resource for OPTIs to share best practices, ideas, faculty development programs, and general information benefiting osteopathic postdoctoral training.

Committee on Osteopathic Postdoctoral Training Institutions
As a result of the work of the Task Force to Study the Structure of the Department of Educational Affairs, ³ the Committee on Osteopathic Postdoctoral Training Institutions (COPTI) was created and committee members were appointed in February 2004. The Committee on Osteopathic Postdoctoral Training Institutions is the successor committee to the COPT (Council on Postdoctoral Training) Subcommittee on OPTI Evaluation and Oversight.

The new Committee has retained the charge of reviewing the effectiveness and functionality of the OPTI system as an OGME mechanism and the secondary charge of on-going review of OPTI accreditation standards, policies, procedures, and administrative guidelines. The Committee supports the Bureau of Osteopathic Education (BOE) in its OPTI accreditation actions and is the initial review body at the AOA for OPTI accreditation issues.

The Committee on Osteopathic Postdoctoral Training Institutions also deliberates site survey reports and annual reports. As inital review body for OPTI accrediation, COPTI also addresses other facets of accreditation, including providing policy recommendations and recommendations for accreditation actions to the BOE.

Survey reports are deliberated at two levels, by the COPTI and by the BOE. At publication, COPTI and the BOE have reviewed and approved a total of four 2004 on-site accreditation survey reports. Action is currently pending on the reaccreditation processes for three other OPTIs and will be placed before the Committee for their initial consideration.

Annual OPTI Workshop
The work of COPTI is instrumental in developing the program for the Annual OPTI Workshop. The 2004 program was held on March 23, 2004, at the Hilton Marco Island Beach Resort in Marco Island, Fla. The workshop theme was "Building OPTI Success."

The 2004 sessions focused on developing an OPTI business plan, achieving collaboration in faculty development, building a telecommunications infrastructure, and an update on the use of the AOA's Trainee Information, Verification, and Registration Audit system (TIVRA) for verifying enrollment in internship and residency training programs.

The 2005 Annual OPTI Workshop will be held in early May 2005, at the Hilton Tucson El Conquistador Golf and Tennis Resort in Arizona. At publication, the session's theme has yet to be determined.

	Accreditation Cycles

Top Recent OPTI Activities at... Accreditation Cycles References

 
The first OPTI, the Centers for Osteopathic Research and Education in Athens, Ohio, was accredited in 1998.¹ With two exceptions (ie, Appalachian Osteopathic Postgraduate Training Institute Consortium [Pikeville, Ky] and Kansas City University of Medicine and Biosciences–College of Osteopathic Medicine's Educational Consortium [Mo]), all OPTIs have been resurveyed at least once (Table).

As the OPTI system has matured, the terms (ie, length of time) for which individual OPTIs are granted accreditation status have grown exponentially. The first OPTI survey and accreditation "cycle," which includes 17 OPTIs, began in August 1997 and ended in June 2003. During this period, for a first-time survey cycle and accreditation process, these 17 OPTIs had been granted accreditation, on average, for a 2-year term.

The second survey and accreditation cycle—conducted roughly from August 1999 through September 2003, though still pending for the two aforementioned newer OPTIs—revealed that the resurveyed and reaccredited OPTIs had been granted ongoing accreditation for an average term of 2.86 years. As noted, this is a first resurvey (ie, second survey) for 15 (88%) of the 17 OPTIs.

Though data are far from complete, the results from the second resurvey cycle (ie, third survey), which began in February 2002, are indicating thus far that OPTIs are currently being granted accreditation for an average term of 3.5 years. Only 4 of the 17 (24%) OPTIs have reached this point in the resurvey and reaccreditation cycle.

The Table summarizes the survey cycles and the accreditation and reaccreditation actions from August 1997 through August 2004, based on current AOA records and statistics. As noted, these data demonstrate a gradual increase in the length of time for OPTI-accreditation terms.

The COPTI and its predecessor, the COPT Subcommittee on OPTI Evaluation and Oversight, have studied the AOA's OPTI accreditation cycle and standards. Through scrutinizing the accreditation document, OPTI committees have refined and clarified the language of OPTI standards while maintaining the integrity of standards and the OPTI accreditation process.

Mr Dalhouse is assistant director of the Division of Postdoctoral Training in the Department of Education, American Osteopathic Association.

	References

Top Recent OPTI Activities at... Accreditation Cycles References

 
1. Dalhouse S. Osteopathic postdoctoral training institutions. J Am Osteopath Assoc. 2001;101:673-674. Available at: http://www.jaoa.org/cgi/reprint/101/11/673. Accessed November 18, 2004.

2. Dalhouse S. Osteopathic postdoctoral training institutions. J Am Osteopath Assoc. 2003;103:539-542. Available at: http://www.jaoa.org/cgi/reprint/103/11/539. Accessed November 18, 2004.

3. Dalhouse S. Osteopathic postdoctoral training institutions. J Am Osteopath Assoc. 2002;102:607-608,613-614. Available at: http://www.jaoa.org/cgi/reprint/102/11/607. Accessed November 18, 2004.

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