Scarce GME funding has states, organizations on a scavenger hunt

Training opportunities for medical residents are becoming fewer and farther between, but the need for trained physicians isn’t changing, causing state medical organizations and governments to search for ways to find the funds to pay for graduate medical education (GME). Those concerned are leaving no stone unturned to find funding or cut costs in existing programs.

Most of the money to support GME programs comes from the federal government through the Medicare and Medicaid programs. The problem is that, like other health-care programs, Congress capped spending over the years to reduce the drain on the federal budget.

Children’s hospital GME funding

To address this lack of funding, organizations such as the American Hospital Association, the American Academy of Pediatrics, and Children’s Hospital Association are starting at the top when it comes to requesting money. Together, they urged President Obama to fully fund the Children’s Hospitals Graduate Medical Education program at the authorized level of $300 million allocated in the Department of Health and Human Services budget for fiscal year 2017.

“The 56 freestanding children’s hospitals that receive CHGME funding train approximately half of all future pediatricians and the majority of all residents in pediatric subspecialties,” the organizations wrote. “CHGME funding has decreased 17% since FY 2010, from $317.5 million to $265 million in FY 2015. The effects of continued diminished support for pediatric training are felt by children and their families. Serious pediatric workforce shortages persist, most acutely among pediatric subspecialties. Localized shortages of pediatric primary care also continue, particularly in certain rural areas. There are also several pediatric specialties at risk of sustaining tremendous losses as the current workforce retires and not enough new specialists are trained. Additionally, cuts have slowed the ability to grow in areas of need, which will result in fewer pediatric subspecialists across the country.”

Unified funding

Physician advocates for GME funding have also found another place to save money by developing a single accreditation system which should be fully implemented by July 2020. The system will allow graduates of osteopathic and allopathic medical schools to complete their residency and fellowship education in Accreditation Council for Graduate Medical Education (ACGME) accredited programs. Under the new system, all physicians in training will be able to demonstrate their achievements by meeting a common set of milestones and competencies.

“Over the years, we’ve had a number of GME programs that are dually accredited—they were accredited by the ACGME and AOA—and those programs had to answer to two different accrediting bodies and pay two different sets of accrediting fees,” Dr. Buser, American Osteopathic Association (AOA) Trustee and President-Elect Boyd R. Buser, DO said. “This is an unnecessary duplication and cost.”