0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Resident Physician Forum |

AMA-RFS Testifies on GME Funding FREE

Charles Rainey, MD, JD
JAMA. 1999;281(18):1761H. doi:10.1001/jama.281.18.1761.
Text Size: A A A
Published online

Medicare reform and its affect on graduate medical education (GME) funding is likely to be one of the major legislative issues for physicians and medical students this year. The AMA held an open hearing on GME funding and the physician workforce in March 1999 to hear testimony from its constituents and from other groups. The AMA-RFS presented testimony, which included the following points.

Compensation for Teaching Physicians Should Support Education

The Health Care Financing Administration's rules for compensating physicians who teach and supervise residents need to be revised. The current rules, which were summarized in the June 25, 1997, Resident Forum column, require teaching physicians to be present during a key portion of a procedure and require detailed documentation in the medical record. Several hospitals have been audited and found in violation of these rules. These actions threaten teaching physicians who may respond by performing more procedures themselves, and thus deny residents valuable training experiences.

Full Funding for Second Residencies Should be Restored

The current rules, which were described in the November 20, 1996, Resident Forum column, limit full funding to the number of years for board certification in the first specialty that the resident chooses. These rules are shortsighted and overly restrictive. They reward residents who initially choose surgery or other 5-year specialties. The RFS routinely receives calls from physicians who wish to train in a specialty other than the one in which they initially trained and are told there is not enough funding for them to do so. Recently, a surgeon in a rural community called because she could no longer practice surgery due to an injury. When she tried to apply to primary care residency programs, she was dissuaded from applying because the hospital would not receive full funding for her training.

Young Physicians Need Debt Relief

Although this is not a Medicare issue, it is a funding issue and a factor that weighs heavily on a physician's choice of specialty. Resident physicians must have student loan relief to allow them to choose less lucrative primary care specialties. Congress has little or no sympathy for physician debt, but Congress needs to be educated about the effects of having a student loan debt of as much as $150,000. The RFS strongly encourages reinstating the tax deduction on student loan interest and increasing loan forgiveness and repayment programs for physicians working in underserved areas.

Other AMA-RFS policies mentioned in our testimony were:

  • When discussing physician workforce planning, the government and other policymakers should not focus solely on residency programs but also on the medical school population.

  • The AMA-RFS supports an all-payer system for funding GME and believes that funds should come from a source more stable and less political than the annual appropriations process.

  • The AMA-RFS supports a voucher system that links funding to the individual resident and not the residency program, so as to provide residents with more program flexibility.

  • The AMA-RFS agrees with the recommendation that residency program applicants should not be discriminated against based on the country in which they received their medical education.

We will continue to report on developments in GME funding and workforce planning in future columns.

Figures

Tables

References

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles