The Importance of GME in Improving Patient Access to Care

The Consolidated Appropriations Act (CAA) of 2021 provided 1,000 new Medicare-supported Graduate Medical Education (GME) positions– the first such increase in nearly 25 years. These new GME positions are already benefiting communities across the country, helping to expand the physician workforce in rural and underserved communities and increase access to high-quality care for patients.

The AAMC recently hosted a briefing on Capitol Hill for lawmakers and their staff to learn more about Medicare support for GME, the impact of new GME positions nationwide, and the distribution of the additional positions awarded by the CAA, 2021. “Investing in GME and the Physician Workforce: A check-up on the CAA, 2021,” hosted by Reps. Terri Sewell (D-Ala.) and Brian Fitzpatrick (R-Pa.), showcased the unique impact of these GME positions at teaching hospitals in three states. Reps. Sewell and Fitzpatrick are the lead House sponsors of the bipartisan Resident Physician Shortage Reduction Act of 2023 (H.R. 2389/S. 1302), legislation that would address the nation’s physician shortage by expanding Medicare-supported GME positions by 14,000 over seven years.

Speakers at the event included:

• Danielle Turnipseed, JD, MHSA, MPP – Chief Public Policy Officer, AAMC
• Len Marquez – Senior Director, Government Relations and Legislative Advocacy, AAMC
• Katie Henderson, MD – Vice President and Chief Medical Officer, Barnes-Jewish Hospital
• Craig J. Hoesley, MD – Senior Associate Dean for Medical Education, UAB Heersink School of Medicine
• Paulette S. Wehner, MD, FACC, FCCP, FAHA, FACP – Vice Dean for GME, Designated Institutional Official, Marshall University School of Medicine

Rep. Sewell addressed attendees, emphasizing the importance of increasing access to quality, affordable health care. Rep. Sewell represents underserved and vulnerable communities in Alabama’s 7th Congressional District and serves as a fierce advocate for increasing the number of primary and specialty care providers and other medical professionals to better support the community and improve health care for all patients. Rep. Sewell shared a clear call to action: Be vigilant in insisting that every American has access to health care, stating, “It should not be for the privileged few, it should be a right for everyone. And in this great country, there’s no reason why it can’t be.”

Keep reading for key takeaways from the event and learn how you can advocate for the expansion of Medicare-supported medical residency positions in all communities.

New GME Positions Already Impacting Residency Programs

“GME positions increase the pipeline of career physicians and help reduce burnout and physician turnover.” - Katie Henderson, MD

The briefing panelists shared their firsthand experiences about how the new Medicare-supported GME positions provide significant opportunities to their institutions.

Medicare-supported GME positions can help fill gaps in care that exist in underserved areas and address the country’s dire physician shortage. Marshall University School of Medicine was awarded positions in neurology and general surgery at St. Mary’s Medical Center and orthopedic surgery positions at Cabell Huntington Hospital. The University of Alabama Health System received positions in reproductive endocrinology, addiction medicine, and physical medicine and rehabilitation. Barnes Jewish Hospital was awarded residency positions in psychiatry.

These additional medical residency positions help teaching health systems and hospitals serve their patients and communities. These academic medical centers have a broad reach, treating patients from multi-state regions needing high-quality, cutting-edge care, and their residency programs train the next generation of physicians in underserved areas, reducing patients’ need to travel long distances for care.

Importance of GME Positions in Rural and Underserved Areas

“These additional residency positions really allow us to increase patient care access, as well as provide additional care to rural patients.” -Paulette Wehner, MD

The physician shortage disproportionately impacts rural and underserved communities. Additional GME residency positions would help expand physician training for both primary and specialty care physicians and help support the costs for teaching health systems and hospitals to train residents.

Dr. Paulette Wehner noted how the new Medicare GME positions enabled Marshall University to help fill care gaps in underserved rural West Virginia. Marshall University is also home to the nation's first separately accredited rural surgery residency program, which matriculated its inaugural class in July 2023. This program is designed to impact underserved rural communities and address the growing need for general surgeons in rural communities through a training model that incorporates specific benchmarks unique to surgeons practicing in a rural setting.

AAMC-member institutions are working to reduce gaps in care found in rural areas nationwide by:

• Partnering with rural teaching hospitals in developing Rural Track Programs (RTPs);
• Increasing the number of physicians training in rural areas and improving rural health outcomes;
• Bringing mobile clinics to remote areas, serving more patients in need; and
• Advocating for increased Medicare-supported GME positions to address the physician shortage and help ensure a well-trained physician workforce to care for all communities

How Congress Can Continue to Support Rural Medicine

“Medicine is a team sport, and Congress is a part of that team” - Craig Hoesley, MD

One way that Congress can address the physician shortage,-- --invest in expanding the physician workforce and help improve access to care in rural and underserved areas is by co-sponsoring and passing the Resident Physician Shortage Reduction Act of 2023 (S.1302/H.R. 2389).

This bipartisan legislation would distribute an additional 14,000 new Medicare-supported GME positions over 7 years, with allocations specifically for teaching hospitals in rural areas, in states with new medical schools, serving patients in Health Professional Shortage Areas (HPSAs), and those already training over their resident cap.

As the briefing speakers noted, for academic medicine to adequately address the physician shortage, Congress must invest in new Medicare-supported GME positions to boost residency programs and reduce the financial burden on teaching health systems and hospitals by passing the Resident Physician Shortage Reduction Act. These new positions will help ensure more patients get the care they need when they need it.

You can advocate for expanding Medicare-supported GME residency positions by telling your lawmakers to cosponsor the Resident Physician Shortage Reduction Act.