Graduate Medical Education That Meets the Nation's Health Needs

Today's physician education system produces trained doctors with strong scientific underpinnings in biological and physical sciences as well as supervised practical experience in delivering care. Significant financial public support underlies the graduate-level training of the nation's physicians. Two federal programs--Medicare and Medicaid--distribute billions each year to support teaching hospitals and other training sites that provide graduate medical education.

Graduate Medical Education That Meets the Nation's Health Needs is an independent review of the goals, governance, and financing of the graduate medical education system. This report focuses on the extent to which the current system supports or creates barriers to producing a physician workforce ready to provide high-quality, patient-centered, and affordable health care and identifies opportunities to maximize the leverage of federal funding toward these goals. Graduate Medical Education examines the residency pipeline, geographic distribution of generalist and specialist clinicians, types of training sites, and roles of teaching and academic health centers.

The recommendations of Graduate Medical Education will contribute to the production of a better prepared physician workforce, innovative graduate medical education programs, transparency and accountability in programs, and stronger planning and oversight of the use of public funds to support training. Teaching hospitals, funders, policy makers, institutions, and health care organizations will use this report as a resource to assess and improve the graduate medical education system in the United States.

• Front Matter
• Summary
• 1 Introduction
• 2 Background on the Pipeline to the Physician Workforce
• 3 GME Financing
• 4 Governance
• 5 Recommendations for the Reform of GME Financing and Governance
• Appendix A: Abbreviations and Acronyms
• Appendix B: U.S. Senate Letters
• Appendix C: Public Workshop Agendas
• Appendix D: Committee Member Biographies
• Appendix E: Data and Methods to Analyze Medicare GME Payments
• Appendix F: Illustrations of the Phase-In of the Committee's Recommendations