IOM Identifies GME Problems, Calls for Finance Changes

Cheryl Clark, July 30, 2014

Downplaying the physician shortage, an IOM report's recommendations for improving the graduate medical education system include refocusing areas of clinical emphasis and changing how GME is financed.

Hospital groups bridled at far-reaching recommendations issued Tuesday by an Institute of Medicine committee on graduate medical education. It said residency training programs do not need more federal money, but do require major reform and accountability if this country is to have enough doctors in the right specialties.

The report calls out dozens of problems in the current GME system, which uses Medicare funds from taxpayers to support what the report says are 117,000 residency slots per year. Key among the IOM committee's recommendations are several having to do with how GME is funded.

The IOM proposal, which would require Congressional approval, "would threaten the world's best training program for health professionals and jeopardize patients, particularly those who are the most medically vulnerable," said The Association of American Medical Colleges said in a statement issued Tuesday.

The American Hospital Association, in a statement of its own, said, "The IOM report "is the wrong prescription…(because it) proposes phasing out the current Medicare GME funding provided to hospitals and offering it to other entities that do not treat Medicare patients."

Because the report advocates training programs taking place in settings such as health centers and clinics rather than hospitals, the IOM strategy "would weaken the critical, diverse training students receive in hospitals where they learn to care for America's seniors," the AHA said.


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