Bill to add 14,000 new GME positions picks up support

Timothy M. Smith , Contributing News Writer

In case you lost track of the scale of the physician shortage in the U.S., check this out: According the Association of American Medical Colleges, it will swell to between 37,800 and 124,000 physicians by 2034. This includes as many as 48,000 primary care physicians and 77,100 specialists. The rise in physician burnout—stemming in part from the additional stress and burden of the COVID-19 pandemic—is a key factor.

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To help provide sustained relief from the workforce crisis and the associated burnout it produces, the AMA sent letters in support of H.R. 2389/S. 1302 (PDFs), the “Resident Physician Shortage Reduction Act of 2023.” The bipartisan legislation would provide 2,000 new Medicare-supported graduate medical education (GME) positions per year over seven years, for a total of 14,000 new GME positions.

The bill stipulates that at least 10% of the slots must be distributed to hospitals that are within rural or noncontiguous areas, such as Alaska and Hawaii, training over their GME cap, located in states with new medical schools or branch campuses, and serve designated health-professional shortage areas, with priority given to hospitals affiliated with historically Black medical schools.

The bill was introduced in the House by Reps. Terri Sewell, D-Ala., and Brian Fitzpatrick, R-Pa.. The companion bill in the Senate was introduced by Sens. Robert Menendez, D-N.J., Majority Leader Charles Schumer, D-N.Y., John Boozman, R-Ark., and Susan Collins, R-Maine. Sens. Menendez, Boozman Collins, and Majority Leader Schumer, as well as Rep. Sewell, have been longtime leaders on this legislation.

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“Prior to the COVID-19 pandemic, the U.S. was already facing a rising shortage of physicians largely due to the growth and aging of the general population and the impending retirement of many physicians,” AMA Executive Vice President and CEO James L. Madara, MD, explained in the letters, citing federal government data showing that 100 million Americans live in primary medical health-professional shortage areas.

The legislation builds upon the 1,200 new Medicare-supported GME slots that Congress enacted via the Consolidated Appropriations Act, 2021 and Consolidated Appropriations Act, 2023—“the first such increases in nearly 30 years,” the letters note.

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The “Resident Physician Shortage Reduction Act of 2023” is focused on overcoming the negative impact of provisions included in the Balanced Budget Act of 1997, which put caps on the number of federally funded residency positions that were available in the mid-1990s.

“Until the cap is significantly raised, the shortage of physicians will never be truly resolved,” Dr. Madara wrote. “Therefore, it is essential that we invest in our country’s health care infrastructure by providing additional GME slots so that more physicians can be trained and access to care can be improved.”

These individual letters of support also come on the heels of the AMA's joining almost 80 other national medical and hospital associations as a co-signer of a GME Advocacy Coalition-led letter to the lead House and Senate sponsors of the “Resident Physician Shortage Reduction Act of 2023.”

This grassroots advocacy is already having a measurable effect, with H.R. 2389 gathering more than 100 bipartisan co-sponsors since its introduction in the spring.