Governance and Financing of Graduate Medical Education

Type: Consensus Study
Topics: Health Care Workforce, Health Services, Coverage, and Access, Select Populations and Health Equity
Board: Board on Health Care Services

Activity Description

There have been calls for broad reform of the Graduate Medical Education (GME) system to achieve a greater alignment of financing with the public’s health care workforce needs. The Josiah Macy Jr. Foundation and the Association of Academic Health Centers held a meeting in October 2010, calling for an independent external review of the governance and financing of GME, specifically suggesting that the IOM perform this review. The array of challenges to the governance and financing of GME in the 21st century include: a rapidly aging and increasingly diverse patient population; underserved rural and urban populations; growing prevalence of disability and chronic disease; an urgent need for a more cost-effective health care system; innovations in health care delivery; impacts of GME on state level policies and GME in state institutions; advances in diagnostics, therapeutics, and health information technology; and others.

An ad hoc IOM committee developed a report with recommendations for policies to improve graduate medical education (GME), with an emphasis on the training of physicians. Specific attention was given to increasing the capacity of the nation’s clinical workforce that can deliver efficient and high quality health care that will meet the needs of our diverse population. To that aim, in developing its recommendations the committee considered the current financing and governance structures of GME, the residency pipeline, the geographic distribution of generalist and specialist clinicians; types of training sites; relevant federal statutes and regulations; and the respective roles of safety net providers, community health/teaching health centers, and academic health centers.

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