Graduate Medical Education That Meets the Nation's Health Needs

2014 ◽  
2021 ◽  
Author(s):  
Arthur Kaufman ◽  
Mary Alice Scott ◽  
John Andazola ◽  
Danielle Fitzsimmons-Pattison ◽  
Laura Parajón

Because graduate medical education (GME) is largely publicly funded, it should be judged on how well it addresses the public’s health needs. However, the current system distributes GME resources inequitably by specialty and geography, and neglects to focus on training physicians adequately in the care of populations while reducing health disparities. Instead, GME continues to concentrate training in hospital-based academic centers and in subspecialties, which often exacerbates disparities in health outcomes and access to care. GME can be more socially accountable by shifting incentive structures to support primary care, creating more equitable distribution of residency slots and funding, and promoting training programs that focus on social and structural determinants of health.


2021 ◽  
pp. 019459982110042
Author(s):  
Jenny X. Chen ◽  
Shivani A. Shah ◽  
Vinay K. Rathi ◽  
Mark A. Varvares ◽  
Stacey T. Gray

Graduate medical education (GME) is funded by the Centers for Medicare and Medicaid Services through both direct and indirect payments. In recent years, stakeholders have raised concerns about the growth of spending on GME and distribution of payment among hospitals. Key stakeholders have proposed reforms to reduce GME funding such as adjustments to statutory payment formulas and absolute caps on annual payments per resident. Otolaryngology departmental leadership should understand the potential effects of proposed reforms, which could have significant implications for the short-term financial performance and the long-term specialty workforce. Although some hospitals and departments may elect to reduce resident salaries or eliminate positions in the face of GME funding cuts, this approach overlooks the substantial Medicare revenue contributed by resident care and high cost of alternative labor sources. Commitment to resident training is necessary to align both the margin and mission of otolaryngology departments and their sponsoring hospitals.


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