This Month's News
"Something has to be done"—Experts consider solutions to GME crisis
As the U.S. physician workforce and system of training have reached what experts are calling a "critical point," dozens of the nation's medical education leaders met last month during the AMA Interim Meeting to discuss new ways to solve the growing problem.
"We're in a time of crisis but also a time of opportunity," said William McDade, MD, chair-elect of the AMA Council on Medical Education.
The United States is expected to have a shortfall of nearly 160,000 physicians by 2025—even as allopathic medical schools have increased their class sizes by 30 percent, the number of osteopathic medical schools has multiplied in recent years and thousands of international medical graduates (IMGs) have been certified by the Educational Commission for Foreign Medical Graduates.
The increase in medical school graduates has not been met by an increase in graduate medical education (GME) funding, leaving a need for additional residency slots that would enable these graduates to enter practice.
Simple changes to the current system won't be enough, panelists at the forum explained.
"We need to think outside the box and look at alternative funding mechanisms," said Christopher Wee, a fourth-year medical student at Wayne State University School of Medicine. Wee has been working with the Michigan State Medical Society on a proposal that would allow for greater flexibility and direct state GME funding to where it's needed most.
George Bone, MD, who serves on the Maryland Health Services Cost Review Commission, explained how his state has carried out a more sustainable system for GME funding, which involves all payers and includes GME expenses in hospitals' payment rates.
In Ohio, an innovative proposal created by the deans of the state's seven medical schools is under consideration by the state government. The new model would aim to keep the best and brightest of Ohio's medical graduates in state and serving in specialties and locations with the greatest need.
Jeffrey Gold, MD, chair of the Council on Medical Education, also noted that some large practices, health systems and hospitals are bringing growth to American GME by self-funding programs.
"GME is important because it is a societal good that needs to be looked at in terms of societal benefits," said Alice Coombs, MD, a past president of the Massachusetts Medical Society. "The bottom line is being able to care for our patients."
"We are about to cross the line where the Medicare trust fund will be underfunded," Dr. Coombs added. "Something has to be done."
In other Interim Meeting news, the AMA House of Delegates considered a number of items related to medical education. Read the annotated report of Reference Committee K to learn more.