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IOM GME Committee Holds Second Public Meeting

December 28, 2012—The Institute of Medicine (IOM) Governance and Financing of Graduate Medication Education (GME) Committee Dec. 19-20 held its second public meeting. The committee, which is co-chaired by Donald Berwick, M.D., and Gail Wilensky, Ph.D., is tasked with developing a report with recommendations for policies to improve GME for the 21st century.

The committee began the meeting with a panel discussion that highlighted examples of national and regional workforce planning. During that panel, David Reines, M.D., vice chair of the Council on Graduate Medical Education (COGME), presented the recommendations from COGME’s twentieth report, which include producing a physician workforce that is at least 40 percent primary care, up from the current level of 32 percent.

The meeting continued with a panel on determining the sufficiency of the workforce. AAMC Chief Public Policy Officer Atul Grover, M.D., presented on the projected shortage of over 90,000 physicians across all specialties by 2020. To meet the needs of a growing, aging population and to accommodate the additional graduates from accredited medical schools, he recommended that the committee recommend an increase in the number of federally supported GME training positions by at least 4,000 new positions a year, half of which should be targeted to primary care.

The first day of the meeting concluded with testimony from representatives of a variety of specialty areas, including pediatrics, neurosurgery, urology, geriatrics, occupational and environmental medicine, and internal medicine, each of whom highlighted the workforce shortage in their respective areas.

The second day opened with a panel on innovation in health care and medical education and was followed by a discussion on accountability in GME. During that session, Thomas Nasca, M.D., chief executive officer of the Accreditation Council for Graduate Medical Education (ACGME), provided an overview of ACGME’s outcomes-based Next Accreditation System.

The final panel of the meeting focused on understanding the costs and financing of GME. Marc Boom, M.D., president and CEO of The Methodist Hospital, and Steven Safyer, M.D., president and CEO of Montefiore Medical Center, both highlighted the physician shortage and mentioned that GME payments do not cover the total costs of training physicians.

The IOM GME committee was tasked to review, among other topics: the numbers of residents, GME slots, and balance of primary care providers, specialists, and subspecialists; training sites; financing options; the accreditation process; relevant provisions of Titles III, VII, and VIII of the Public Health Services Act; and relationships among safety net providers, community health/teaching health centers, and academic centers [see Washington Highlights, Aug. 3].

The committee’s final report is expected to be completed by early 2014.


Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806


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Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806