Blog | Wednesday, July 30, 2014

QD: News Every Day--GME education should shift to places where patients seek care, report says

A report about a fundamental shift in the way graduate medical education is funded has ACP members taking notice.

The U.S. should significantly reform the federal system for financing graduate medical education (GME) programs because the current methods requires little accountability, allocates funds independent of workforce needs or educational outcomes, and offers insufficient opportunities to train physicians in the health care settings used by most Americans, the Institute of Medicine said in a press release.

The report stated that public financing of GME should remain at its current $15 billion annual level, but Congress should move funding from the teaching hospitals that have traditionally received most of the funding into the clinics or community-based settings where most people now seek care.

Among other reasons for the shift is that physician training slots may be more driven by the needs of the individual teaching hospitals rather than of the populace, the report says. Between 2003 and 2013 there was a disproportionate increase of physicians being trained as specialists despite a greater demand for generalists. Training opportunities are highly concentrated in specific geographic regions and urban areas, and the training system is not increasing the number of physicians willing to locate to rural areas or treat other underserved populations, the release stated.

To encourage training at a variety of sites, funds should be distributed directly to the organizations that sponsor physician training programs including hospitals, clinics, and universities, and the payment methodology should be replaced with a single national, per-resident amount. The committee suggested a 10-year transition period to fully implement its recommendations, because of the complexity of GME education.

ACP members were at the announcement in Washington, D.C., or were following it online, and were tweeting from it:

Tyler Cymet, DO, FACP

Humayun J. Chaudhry, MD, MACP

Susan Hingle, MD, FACP