AMA Wire

Friday, March 29, 2013

For Residents

Daschle, congressional leaders weigh in on GME

Reforming graduate medical education (GME) for the future will require a multifaceted approach, according to former U.S. Sen. Tom Daschle in a recent editorial for Health Affairs.

A complex problem is emerging as medical school enrollment continues to increase, residency spots and GME funding remain stagnant and the United States increases its dependence on international medical graduates, said Daschle, the former senator from South Dakota and co-author of the 2008 book Critical: What We Can Do About the Health-Care Crisis.

His recommendations for addressing the problem include both systematic shifts and changes at the program level. For one, the entire health sector requires more transparency, which should illuminate where resources are being used inefficiently. This includes efficiency in training proficient practitioners, including the possibility of qualified residents "testing out" of certain levels of training to accelerate their residency experience and reduce costs. Meanwhile, policy makers should encourage primary and team-based care and broaden the funding base for GME programs to include the private sector.

Controversially, Daschle also recommends that the United States de-emphasize its increasing reliance on IMGs, which he believes exacerbates primary care shortages in the developing world.

Several policymakers have recently taken up the task of reforming GME. Earlier this month, Reps. Aaron Schock, R-Ill., and Allyson Schwartz, D-Pa., and Sen. Bill Nelson, D-Fla., introduced bills in the U.S. House of Representatives and the Senate that would increase residency positions by 15,000 over five years.

The AMA continues to advocate for GME to protect access to care and address physician shortages in undersupplied specialties and underserved areas. Specifically, the AMA calls on Congress to increase federal funding for GME and lift the federal cap on residencies.

Visit the AMA's Save GME campaign website to learn more about what the AMA is doing, and what you can do, to support GME.

Duty hours reform needed, Canadian residents say

Physicians and health care leaders from around Canada shared ideas about resident duty hours during a national dialogue on the subject hosted by the country's National Steering Committee on Resident Duty Hours. Participants voiced a range of opinions but all agreed that current policy must change.

"There was unanimous agreement at this conference that the status quo is not acceptable," National Steering Committee Chair Kevin Imrie, MD, said in a statement. "Resident duty hours are being debated and discussed across Canada and we're committed to developing a collective, pan-Canadian response."

Canada has no formal system, standards or principles regulating resident duty hours, leading to significant variability across the country.

During the two-day event, attendees examined the potential impacts that changing resident duty hours could have on patient safety, medical education, wellness of residents and faculty, professionalism, health systems and contemporary events in Canada. In the coming months, the National Steering Committee will develop a final report to help establish a pan-Canadian framework on resident duty hours to help inform medical residency programs across Canada.

Across the border, American residency programs continue to grapple with recent changes to the resident duty hours standards set by the Accreditation Council for Graduate Medical Education, as evidenced by a recent point-counterpoint article featured in the Wall Street Journal. Learn more about the debate with the AMA's reports on resident duty hours.

View new education program webcasts on leadership

Learn about physician leadership, ethical leadership and newly integrated medical practices by viewing new webcasts from the AMA Organized Medical Staff Section. These webcasts have been approved for AMA PRA Category 1 Credit™. Titles include:

  • "Physician leadership during challenging times"
  • "Leadership and the AMA Code of Medical Ethics"
  • "Lessons learned from newly integrated medical practices: Two case studies"

AMA members can view these webcasts for free; nonmembers can watch them for $30 per credit hour. If you're not an AMA member, join today.