Residency slots reallocated to relieve doctor shortages

Some 2,000 to 3,000 positions could be shifted by the federal government.

By Myrle Croasdale, AMNews staff. Sept. 27, 2004.

In an effort to address the uneven distribution of physicians in the United States, the Centers for Medicare & Medicaid Services, which heavily subsidizes graduate medical education, is tracking down unused resident positions and reallocating them to hospitals it deems the most in need of more physicians.

This won't change the supply of physicians in the United States, since the number of resident slots will stay capped at the 1996 level of 98,000. But it should ease the pressure some hospitals are experiencing and bring more doctors to underserved regions.

The redistribution is expected to be completed before the next residency training year starts July 1, 2005.

The Assn. of American Medical Colleges, however, said the health care system would be better off if the cap were lifted so hospitals could respond to the needs of their communities, such as adding a new cardiology program or expanding emergency medicine. It's unclear though, what this would cost. The federal government, through CMS, spends roughly $8 billion a year on graduate medical education or $80,000 per resident.

The AAMC said the rules CMS has set up for the audit will unfairly penalize some hospitals.

Karen Fisher, associate vice president for health care affairs at the AAMC, explained that if Medicare's administrative requirements are not met precisely, not every resident is counted, which lowers the amount of federal money the program gets.

"In the past, this would mean a year when you weren't paid for a resident," Fisher said. "The next year you could fix it." During this audit year, that mistake is permanent.