GME Funding

Bill adds 1,000 GME slots to address drug-overdose epidemic

Jennifer Lubell , Contributing News Writer

What’s the news: There is growing momentum on Capitol Hill to advance legislation that would help address the physician shortages that are making it harder for patients to access care, especially patients with substance-use disorders.

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One of those bills is H.R. 7050, the Substance Use Disorder Workforce Act, which would provide an additional 1,000 Medicare-funded supported graduate medical education (GME) slots for residency programs in addiction medicine, addiction psychiatry or pain medicine.   

This could substantially boost the physician workforce trained to treat patients struggling with substance-use disorder amid an epidemic of drug-related overdoses that killed more than 107,000 Americans in 2022.

H.R. 7050 authorizes these new GME slots for a total of five years. It allocates 500 of these positions to hospitals that are planning to establish approved residency programs in addiction medicine, addiction psychiatry or pain medicine between 2025 and 2028. Another 500 are for hospitals that already have residency programs in these areas in 2024. 

The bill was introduced by Brad Schneider (D-lll.), David Valadao (R-Calif.), Ann Kuster (D-N.H.), Mike Carey (R-Ohio), and Mike Kelly (R-Pa.). The AMA will continue advocating the reintroduction of the Senate companion bill, the Opioid Workforce Act, in this session of Congress. 

The AMA also is backing H.R. 6980/S. 2719, the Directing Our Country’s Transfer of Residency Slots Act—called the DOCTORS Act for short. The legislation would reallocate unused waivers from the Conrad 30 waiver program to states that use their maximum number of slots, while ensuring that all states still have 30 slots each year.

Why it’s important: The U.S. should be moving on all fronts to address the twin crises of physician shortages and the illicit drug-overdose epidemic.

The Conrad 30 program allows international medical graduates (IMGs) to obtain a H-1B visa following residency if they practice in a medically underserved area for at least three years. The DOCTORS Act “would allow for additional physicians to benefit from this program while helping to alleviate the shortage of physicians overall, especially in rural and underserved areas,” wrote James L. Madara, MD, the AMA’s executive vice president and CEO, in letters to the bill’s respective sponsors in the Senate (PDF) and House (PDF).

The DOCTORS Act could be an important addition to the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4942/ S. 665), which reauthorizes and modifies the Conrad 30 program.

In his correspondence, Dr. Madara underscored the important role IMGs play in delivering care in areas of the country with higher rates of poverty and chronic disease. More than 10,000 J-1 IMGs have worked in underserved communities over the past 15 years, he noted.

The U.S. faces a shortage of between 37,800 and 124,000 physicians within 12 years, the Association of American Medical Colleges projected in 2021.

The crisis will get worse unless action is taken now, AMA President Jesse M. Ehrenfeld, MD, MPH, said in a National Press Club address last fall. Dr. Ehrenfeld also has written about the need to act quickly and decisively to end the overdose epidemic.

Learn more: The AMA is supporting several bills, including the Conrad State 30 and the Physician Access Reauthorization Act, that would expand residency training options, provide greater student loan support and create smoother pathways for foreign-trained physicians. Visit AMA Advocacy in Action to find out what’s at stake in clearing IMGs' route to practice and other advocacy priorities the AMA is actively working on.

The AMA believes that science, evidence and compassion must continue to guide patient care and policy change as the nation’s opioid epidemic evolves into a more dangerous and complicated illicit drug overdose epidemic. Explore further at the AMA’s End the Epidemic website