Right-side diverticulitis (RSD) is an uncommon disease in Western countries. We conducted a case-matched comparison of surgically managed right-side and left-side diverticulitis (LSD) from the Southern California Kaiser Permanente database (2007–2014). Of 995 patients undergoing emergent surgery for diverticulitis, 33 RSD (3.3%) met our inclusion criteria and were matched (1:1) to LSD based on age, gender, year of diagnosis, and Hinchey class. Mean age of the RSD group was 56 ± 13.9 years, and 24.2 per cent were Asian. RSD was classified as Hinchey class III or IV in 28.1 per cent and 9.4 per cent of cases, respectively. Right hemicolectomy was performed in 87.9 per cent and laparoscopy was used in 24.2 per cent of the cases. Surgically managed RSD patients were more likely to be Asian (25% vs 3.1%, P = 0.03) and have body mass index < 25 (31.3% vs 6.3%, P = 0.02) compared with LSD patients. Diverting stoma was less common in the RSD (6.3% vs 62.5%) ( P < 0.001). Hospital stay was shorter in RSD (7.6 ± 4.2 vs 12.8 ± 9.4 days, P = 0.006) and more common in the RSD group ( P < 0.01). Open surgery (90.6% vs 71.9%) and postoperative complications (37.5% vs 25%) were more common in the LSD group, but that was not statistically significant ( P > 0.05). Surgery for complicated RSD was associated with shorter hospital stay and decreased likelihood of diverting ostomy.

The 5 year transition period for American Osteopathic Association (AOA) training programs to apply for and receive Accreditation Council for Graduate Medical Education (ACGME) accreditation (i.e., the single graduate medical education system) was completed June 30, 2020. Of the previously AOA accredited programs that applied for or received osteopathic recognition (OR), only 24.5% are nonprimary care specialty programs according to the ACGME. The reluctance of specialty programs to apply for OR may be because osteopathic principles and practices (OPP) are not assessed. In order for programs to receive OR, they must have a standard method of assessment to assess osteopathic knowledge, including OPP and osteopathic manipulative treatment. In this Commentary, based on our assessment of the results of a literature review, we propose a model to provide a focused osteopathic assessment for the purposes of maintaining OR within residency training based on the ACGME six core competencies. Examples of multiple choice and essay questions are provided, as is a rubric for grading. The model is applied to the field of dermatology in this article and could serve as a blueprint to other subspecialties. With this framework, collaboration among programs will streamline the process to obtain OR in the ACGME single accreditation system.

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