IOM to recommend reforms in residency physician training
The Institute of Medicine is putting the $15 billion the federal government spends each year on physician training under its microscope. On July 28, it will release a report on how to reform graduate medical education financing, governance and accountability.
The panel, which began its work in September 2012, is led by two former Medicare chiefs: Gail Wilensky, who served under President George H.W. Bush, and Dr. Don Berwick, who served under President Barack Obama and is now running for Massachusetts governor as a Democrat.
GME funding has been flat since 1997. New medical schools have been opened and existing institutions have increased capacity, but this growth means little without a corresponding increase in residency positions.
The IOM has said its report would focus on increasing the clinical workforce, geographic distribution of primary-care and specialty physicians, training sites, federal laws and regulations, and the roles safety net providers, community health centers and academic medical centers have in training new doctors.
Because $9.7 billion of GME funding comes from Medicare, Dr. Kelly Caverzagie, an associate dean at the University of Nebraska Medical Center, said residency training programs fear the loss of Medicare funding and training slots. “Where is the money going to come from if Medicare funding is lost?” he said.
On the other hand, money alone is not the answer. He would like to see the IOM link funding to filling gaps in geographic workforce and specialist distribution. “We need aggressive reform of GME funding and solutions that don’t perpetuate the problems that currently exist,” he said.