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Freezing the Number of Residency Positions

Robert G. Luke, MD
JAMA. 1995;274(9):682. doi:10.1001/jama.1995.03530090012004.
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To the Editor.  —Dr Shine,1 president of the Institute of Medicine, argues that Congress should instruct the Health Care Financing Administration (HCFA) to freeze the total number of residency positions supported through Medicare at 1994 levels for a 5-year period.As chairman of the Medical Education Finance Committee of the Association of Professors of Medicine (the national organization of chairs of departments of internal medicine at the 125 US medical colleges and several of their affiliated teaching hospitals), I have also supported a freeze.2 Besides making policy sense, limiting the number for residency positions would help rationally reduce Medicare payment for graduate medical education (GME). To reduce the federal budget deficit, Congress is considering a series of Medicare reductions, including cuts in the program's direct medical education payment and indirect medical education adjustment. Deep concern that indiscriminate Medicare GME reductions will have an adverse effect on physician workforce


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