Rob Cunningham, Consultant & William J. Scanlon, PhD, Consultant
Concerns about the size and composition of the future physician workforce have existed for many years. The arrival of the baby boom generation in the Medicare program and the continuing unsustainable growth of all health care costs magnify the concern. How to achieve a health care workforce that meets societal needs has been much studied and debated by various bodies with multiple recommendations for reforming how physicians are trained. A central focus has been on graduate medical education (GME), the three or more years of training that newly minted MDs receive before beginning to practice without supervision. Currently, how the GME system functions is the result of an amalgam of decisions by many private and public sector entities. Public funding of GME is substantial, but public sector direction is limited. This Forum session reviewed suggestions for how GME might evolve to assure an adequate and appropriate supply and specialty mix of physicians for a changing health care system and beneficiary population. A variety of recommendations by the Medicare Payment Advisory Commission (MedPAC) and others to alter the organization and financing of GME were explored.
Glenn Hackbarth, JD, MA
Medicare Payment Advisory Commission
Debra Weinstein, MD
Vice President for GME
Partners Healthcare System (Boston)
Thomas J. Nasca, MD
Chief Executive Officer
Accreditation Council for Graduate Medical Education
Darrell G. Kirch, MD
President and Chief Executive Officer
Association of American Medical Colleges
For more information on GME, see see "Aligning Graduate Medical Education with Public Policy" (Background Paper No. 82, September 14, 2011).
See also John K. Iglehart, "The Uncertain Future of Medicare and Graduate Medical Education," New England Journal of Medicine, 365 (October 6, 2011): pp. 1340-1345.