ACOOG and AOBOG Partner to Improve Certification Outcomes

The American College of Osteopathic Obstetricians and Gynecologists (ACOOG) and the American Osteopathic Board of Obstetrics and Gynecology (AOBOG) have joined forces to tackle challenges in board certification and improve physician competence. Together, the work conducted addresses the decline in board applications and certification pass rates resulting from recent shifts in residency accreditation.

Why the Collaboration Was Needed

Beginning in 2015, the full transition to the Single Accreditation System (SAS) by the Accreditation Council for Graduate Medical Education (ACGME) in 2020 marked a significant change in U.S. medical education, merging allopathic (MD) and osteopathic (DO) residency programs. While this unification brought several benefits, it created unique challenges for osteopathic medicine. Post-SAS analyses revealed declining residency match rates across specialties for DO candidates. Program directors from MD backgrounds, lacking formal training in osteopathic principles and practice, struggled to effectively train and evaluate residents in these essential skills. The transition also affected board certification paths, with many DO residents receiving guidance from their MD program directors to pursue allopathic board certifications, often due to limited awareness of osteopathic board options. This shift particularly impacted the American Osteopathic Board of Obstetrics and Gynecology (AOBOG), which saw board exam applications plummet by 24% and 29% in the first two years of SAS implementation, alongside decreased pass rates. These outcomes highlighted the need for targeted support to maintain robust certification standards in osteopathic medicine.

ACOOG and AOBOG recognized these trends as urgent and moved to prevent any further impact on physician readiness and patient care. They formalized a partnership focused on three main goals:

1. Boost Board Applications: Increase the number of applications by aligning education with candidate needs.
2. Close Competence Gaps: Address specific areas of deficiency by tailoring education to content areas of specific concern.
3. Elevate Pass Rates: Improve overall pass rates by providing supportive educational resources and programs.

The collaboration sought to serve multiple stakeholders, including ACOOG members, certification board candidates, residency program directors, students and residents.

Defining Roles and Clear Focus

To ensure clarity and efficiency, the partnership defined specific roles:

• AOBOG’s Role: Identify challenges and collect data to highlight competency gaps.
• ACOOG’s Role: Develop educational resources tailored to the identified needs, including CME programming, webinars and direct candidate outreach.

A feedback loop kept the initiatives agile, allowing the partners to refine and adjust their efforts based on results and evolving needs.

Targeted Education Strategies and Programs

Several targeted initiatives became the cornerstone of this collaboration:

• Board-related Conference Content: Key conference sessions addressed core exam topics and common competence gaps. General board deficiency areas served as needs assessments for conference planning.
• Specialized CME Programs: Focused on high-need areas to ensure candidates received direct support in areas impacting pass rates.
• Monthly Webinar Series: Provided a steady stream of board-relevant content, accessible to busy professionals preparing for certification.
• Residency Director Resources: Residency program directors received resources to assist trainees in board prep, creating a supportive environment early in their training.
• Dedicated Tracks for Students and Residents: Conferences and virtual sessions included specific tracks to build board awareness and foundational knowledge for early career obstetricians and gynecologists.

These efforts created a structured and supportive pathway for certification readiness, accessible across career stages.

Results and Key Metrics

The collaboration has already demonstrated measurable success. Key outcomes (as of September 2024) include:

• 24.56% Increase in Board Applications: Well above the initial target of a 15% increase.
• 5.75% Improvement in Overall Certification Pass Rates: Surpassing the target of 5% improvement, demonstrating more candidates were not only applying but also succeeding.
• 15.38% Improvement in Key Competency Areas: Significantly above the target of 10%, indicating a stronger, more focused board candidate pool.

The reach of this initiative extended across the United States, with a total of 2,723 participants benefiting from the various programs, including 1,961 physicians, 61 residency directors, 488 students and 213 residents.

How Other Associations Can Collaborate: A Model for Success

The success of this collaborative effort provides a roadmap for other associations seeking to partner in similar ways. Key steps include:

1. Identify and Address Specific Needs: Start with data to define clear goals and objectives.
2. Define Roles Early: Assign responsibilities to leverage each organization’s strengths.
3. Design Effective Education: Design CME content based on board-relevant clinical gaps.
4. Incorporate Feedback Loops: Regularly update and adjust educational initiatives based on participant feedback and changing needs.
5. Monitor and Report Results: Track progress to evaluate the partnership’s impact and share successes. A plan-do-study-act (PDSA) or similar model can be beneficial.

This structured approach promotes efficiency and ensures that educational resources directly address the needs of board candidates, leading to stronger outcomes in board certification and clinical readiness.

Takeaways for CME Providers

1. Focus on Competency-based Education: Align CME content with board exam content areas to reinforce core competencies and practical knowledge.
2. Utilize Multiple Learning Formats: Offer learning opportunities in multiple formats to maximize impact.
3. Equip Residency Directors and Faculty With Tools: Give residency leaders the resources to support candidates’ board preparation early on.
4. Implement Continuous Feedback Cycles: Use participant feedback to refine and evolve content to stay relevant and effective.
5. Track and Share Outcomes: Measure success with clear metrics to gauge impact and justify continued support. Share your results so others can replicate them.

Looking Ahead: Lasting Impact and Future Opportunities

The ACOOG x AOBOG collaboration demonstrates how specialty colleges and certifying boards can work together to drive meaningful improvements in professional development without compromising the integrity of the certification exam. This partnership has enhanced professionalism, teamwork and clinical readiness, reinforcing the critical role of certification in maintaining high healthcare standards. The work strengthens the osteopathic community and sets a precedent for similar partnerships in other fields, underscoring the value of collaboration in improving medical education and patient outcomes.

The success of ACOOG and AOBOG highlights the potential for shared efforts to make a lasting impact on healthcare.

 

References

History of the Transition to a Single GME Accreditation System: https://www.acgme.org/about/transition-to-a-single-gme-accreditation-system-history/#:~:text=The%20transition%20to%20a%20single%20US%20graduate%20medical%20education%20(GME,of%20Osteopathic%20Medicine%20(AACOM)%E2%80%94

Brazdzionis J, Savla P, Oppenheim R, Kim GJ, Conrad-Schnetz K, Burns B, Beier A, Connett DA, Miulli DE. Comparison of Osteopathic (DO) and Allopathic (MD) Candidates Matching Into Selected Surgical Subspecialties. Cureus. 2023 Jun 17;15(6):e40566. doi: 10.7759/cureus.40566. PMID: 37465803; PMCID: PMC10351620.

Cummings M. The Impact of the ACGME/AOA Single Accreditation System on Osteopathic Surgical Specialties, Residents, and DO Students. J Surg Educ. 2021 Sep-Oct;78(5):1469-1475. doi: 10.1016/j.jsurg.2021.02.006. Epub 2021 Mar 22. PMID: 33766543.

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Authors

Andrew Crim, M.Ed., CHCP, FACEHP, is the director of education & professional development for the American College of Osteopathic Obstetricians and Gynecologists.
Mary Cameron Tallman, MA, is the senior director for the American Osteopathic Board of Obstetrics and Gynecology.