Pursuing Osteopathic Recognition: A National Survey on US Program Director Perspectives

<b>Background</b> Osteopathic Recognition (OR) by the Accreditation Council for Graduate Medical Education single accreditation system expanded almost 7-fold from 36 programs in 2015 to 259 in 2021 but has plateaued since then. <b>Objective</b> To assess the interest to pursue OR, perceived barriers and values, and relationship between interest and program demographics in formerly US American Osteopathic Association (AOA)-accredited residency programs. <b>Methods</b> We conducted a national survey in 2023 of all formerly AOA-accredited residency programs that had not applied for OR. The anonymous survey contained 20 five-point Likert scale questions, 11 short-answer demographic questions, and 1 open-ended resource question, was informed by prior work, and was pilot tested with a few program directors for clarity and content. The relationship between levels of interest in pursuing OR and perceived barriers, values, and demographics were analyzed via contingency table analysis. Thematic analysis was performed by 2 authors on the open-ended question. <b>Results</b> Of 458 program directors, 178 (38.9%) responded to the survey, and the majority (103, 57.9%) expressed "Yes" or "Maybe" interest in obtaining OR. Thirteen barriers were important, including lack of interest and support from potential applicants or colleagues; lack of time, funding, or facility space; and uncertainty over administrative work; these showed differences among the groups of different levels of interest with medium to large effect sizes (0.24<Cramer's V<0.35). The groups also showed differences in their perception of the value of pursuing OR (0.21<Cramer's V<0.29). <b>Conclusions</b> Program directors' perceived available resources and the value of OR to attract applicants to a program influenced their level of interest in pursuing OR.