For Residents

Residency funding targeted for cuts; contact Congress

Tell your members of Congress today that the Jan. 1 cut to graduate medical education (GME) funding must be averted.

Without congressional action, the 2 percent sequester cuts to Medicare will adversely affect GME funding. This funding reduction would compromise access to care for patients and further limit the number of residency positions for an ever-growing number of medical students.

According to estimates, the United States will experience a shortage of more than 90,000 physicians by 2020. That number is expected to surpass 130,000 by 2025.

It only takes a moment to urge your elected officials to preserve current levels of GME funding. Send an email through the AMA Physicians Grassroots Network today.

To learn more about the AMA's work with Congress this legislative session, including efforts to protect GME funding, read a recent blog post by AMA President Jeremy A. Lazarus, MD.

Fellows: Duty-hours rules need improved research

Now nearly a year and a half since the most recent rounds of duty-hour restrictions from the Accreditation Council of Graduate Medical Education (ACGME) took effect, debate still swirls over the efficacy of the reforms.

Two fellows at the New England Journal of Medicine have added to the discussion with a recent article calling for improved comprehensive research on the actual effects of resident and fellow duty-hour restrictions. Despite a mass of academic articles on the subject, they explain, researchers have yet to definitively connect resident fatigue with adverse patient outcomes.

Meanwhile, the ACGME has been extremely hesitant to grant programs exemptions for experimentation and research because of the political climate surrounding the issue and the looming threat of federal intervention. The authors believe that research exemptions are the only way to produce the quality studies needed to fully understand the impact of duty hours and the best course going forward. But they agree that this "is partly predicated on convincing the public that a more sophisticated understanding of medical education requires formal research," they write.

As physicians they believe the onus is on the profession, and not just the ACGME, to change the public perception of resident duty hours, and the need to even back-track on existing reforms if necessary.

"In our political system, trainee education, which is not disease-specific, lacks a powerful lobby," they write. "The ACGME alone cannot change public sentiment. As a profession, we must not only develop methods for evaluating our educational systems, but also convince the public that informing this understanding is critical to their health."

Although the verdict on duty hours and patient outcomes remains elusive, patient safety remains a hot topic. The AMA offers resources to help residents navigate patient safety and improve handoffs.

Higher med school enrollment is only part of the solution

While medical school enrollment continues to grow and become more diverse, it is only half of the solution to the problems expected to be caused by the nation's predicted physician shortage, according to a recent article in American Medical News.

American Medical News reports that first-year admissions are up almost 3 percent from 2011 at U.S. osteopathic colleges and 1.5 percent at allopathic schools. That's encouraging news, Stephen C. Shannon, DO, president and CEO of the American Association of Colleges of Osteopathic Medicine, told American Medical News.

"There is widespread acknowledgement that physicians are going to be needed and that it's a good career pathway, even with the changes and challenges that are coming," he said.

But there will not be enough residency training positions to accommodate these students when they graduate unless Congress acts to increase the number of training positions, which have been capped since the 1990s. Meanwhile, the Affordable Care Act significantly increases coverage across the nation, which analysts predict will lead to a physician shortage of 90,000 by 2020.

The AMA has been a vocal advocate of increasing graduate medical education training slots and recently wrote a letter of support for H.R. 6562, the Resident Physician Shortage Act of 2012. This bill, sponsored by Rep. Joseph Crowley, D-N.Y., would expand current residency positions by 15 percent and provide for an additional 3,000 funded resident spots per year for five years, totaling 15,000 new resident positions.