Workforce Graduate Medical Education
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The US healthcare system has an imbalance of specialists versus primary care physicians and a maldistribution of practitioners geographically. Physician education involves premedical education, medical school, graduate medical education (GME), and continuing education. GME determines a physician's specialty and around 16,000 physicians enter GME programs each year, though there is no system to ensure the appropriate distribution of specialties. Nonphysician clinicians are playing a larger role in the system and their numbers are projected to double by 2010.
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Workforce Graduate Medical Education
- 1. Workforce Graduate Medical Education Brian Wells
- 21. Workforce GME: Workforce Trends and Supply and Demand
- 34. Physicians per 100,000 people Source: Grumback, Kevin. Fighting Hand to Hand over Physician Workforce Policy. Health Aff 21(5):13-27, 2002. Available at: http://www.medscape.com/viewarticle/440692
- 35. Physicians per 1,000 people
- 36. Progression of Physicians from 1965 to 1993
- 47. Future Workforce Trends for Physicians Source: Cooper, Richard et al. Economic and Demographic Trends Signal an Impending Physician Shortage, Health Aff., 2002, Vol. 21, No. 1
- 49. Future Trends for Nonphysician Clinicians
- 50. Future Trends for Nonphysician Clinicians
- 56. Other supply and demand factors
- 61. Graduate Medical Education Reform
- 76. Do you think that the government should subsidize GME?
- 92. Which policy change do you think would be the best?
- 93. What do you think are some of the affects on the population if the policy changes on GME funding?
- 100. Questions
Notes de l'éditeur
- Direct quote from JAMA 1998, Cooper et al 734
- JAMA editorials 1998 vol 280, 9 pp. 746
- From CME Report 10-A-A-99 page 4
- Medicare patient load” The hospital's Medicare patient load is the fraction of its total number of inpatient days that Medicare beneficiaries represent. Adjusted number of full-time-equivalent (FTE) residents The adjusted number of FTE residents is calculated by considering each resident in an approved training program based at the hospital, calculating the degree to which that resident is in the program full time, and then multiplying by an adjustment weight The weight equals 1.0 for residents who are in their "initial residency period" (IRP) and who have not been in training for more than five years.1 (Residents in geriatric fellowships may receive a weight of 1.0 for two additional years.) Other residents receive a weight of 0.5. Graduates of foreign medical schools must have passed a competency exam to be counted toward DME payments. Allowed amount per resident. The allowed per-resident amount differs among hospitals Based on the direct graduate medical education costs per resident incurred by the hospital in a period roughly corresponding to fiscal year 1984, increased by 1 percent and updated for changes in the consumer price index for urban consumers (CPI-U).
- Under the formula, the hospital's payments increase with the resident-to-bed ratio (the ratio of the number of FTE residents in approved training programs who work in the hospital to the number of beds) A hospital receives approximately 7.7 percent more in payments for each 0.1 increase in the ratio of residents to beds The various provisions that reduce the weight of many residents in the calculation of DME payments do not apply to the count of FTEs that is used to calculate the indirect adjustment.
- Allow more flexibility in the course of the Professional that appeared most relevant to them More competition for Professionals by Teaching Hospitals
- That quicker response would address concerns that the market adjusts too slowly or that participants in the market lack the information needed for relying on the marketplace to allocate the number and types of physicians.