Heart of Health Policy | Looming Cuts in GME Funding Threaten Next Generation of Cardiology

In addition to training the next generation of physicians, nurses and other health care professionals; encouraging the world’s best and brightest students to enter into a medical career; and meeting the needs of a growing and aging population, teaching hospitals and their residents perform vital services to underserved communities and populations, as well as veterans and their families. In addition, on the global front, international graduates comprise nearly 27 percent of medical residents and fellows in the U.S. Many of these residents are interested in much-needed primary care specialties and work in underserved communities within large cities or in rural areas.

Unfortunately, impending cuts in support for graduate medical education (GME), are posing significant obstacles to meeting the ever-growing demands for health care services. Already the number of available residency training programs funded by Medicare is capped as a result of the Balanced Budget Act of 1997, but an additional $11 billion in federal funding cuts over the next 10 years is included as part of the Obama Administration’s proposed budget for the 2014 fiscal year.

While several medical schools are expanding enrollment to meet future needs, these caps on Medicare GME funds and massive proposed cuts are leading the nation down a path where soon (i.e. 2015) medical school graduates will exceed the number of available residence slots. This year alone, 528 U.S. medical graduates did not match into a residency program – more than double the number from 2012. According to the American Medical Association (AMA), this occurred “despite the fact that 99.4 percent of the available residency slots were filled— the highest percentage ever.”

“These cuts are limiting opportunities for the next generation of cardiologists and other health care professionals, at a time when we need them the most,” according to ACC President John Gordon Harold, MD, MACC, ACC President-Elect Patrick O’Gara, MD, FACC, and Joseph A. Hill, MD, PhD, FACC, and Marvin A. Konstam, MD, FACC, co-chairs of the ACC’s Academic Section Advisory Council, in a recent President’s Page published in the Journal of the American College of Cardiology (JACC).

To help address this issue, the ACC is working closely with the Association of American Medical Colleges and the AMA on overarching policy recommendations, as well as ongoing efforts to support legislation in both the U.S. House of Representatives and the U.S. Senate that will help residency programs across the country train enough doctors to keep up with the expanding and aging Medicare population.

Both the bipartisan Training Tomorrow’s Doctors Today Act (H.R. 1201) and the Resident Physician Shortage Reduction Act of 2013 (H.R. 1180) in the House, as well as the Resident Physician Shortage Reduction Act of 2013 (S. 577) in the Senate, would lift the cap on the number of Medicare-supported residency positions. They would also increase the number of residency positions that receive support through Medicare GME payments by 15,000. Read more on this topic in the Oct. 15 issue of JACC.

Keywords: Physicians, Education, Medical, Graduate, Medicine, Schools, Medical, Primary Health Care, United States, Hospitals, Teaching

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