Graduate Medical Education that Meets the Nation's Health Needs


Book Description

Intro -- FrontMatter -- Reviewers -- Foreword -- Acknowledgments -- Contents -- Boxes, Figures, and Tables -- Summary -- 1 Introduction -- 2 Background on the Pipeline to the Physician Workforce -- 3 GME Financing -- 4 Governance -- 5 Recommendations for the Reform of GME Financing and Governance -- Appendix A: Abbreviations and Acronyms -- Appendix B: U.S. Senate Letters -- Appendix C: Public Workshop Agendas -- Appendix D: Committee Member Biographies -- Appendix E: Data and Methods to Analyze Medicare GME Payments -- Appendix F: Illustrations of the Phase-In of the Committee's Recommendations.




Graduate Medical Education


Book Description

This book explores and offers solutions to critical issues in graduate medical education, including how students are taught and evaluated and how their educational programs are funded. It will be key reading for medical educators, policy makers and all individuals and organizations with an interest in medical education.




Issues Regarding Graduate Medical Education


Book Description

The Subcommittee met in the first of a series of hearings on graduate medical education aimed at developing a new Medicare health professional education and teaching hospital payment policy. The hearing examined new policies for training future health professionals, future medical manpower needs, and the financing of teaching hospitals. Current Medicare payment mechanisms for graduate medical education and teaching hospitals were also reviewed. Among the witnesses were representatives of the American College of Surgeons advocating continued support for teaching hospitals, the American Dental Association advocating continued funding for hospital-based graduate dental education, the American Medical Association in favor of adding third-party payers' support for graduate medical education, the American Nurses Association advocating increased support for graduate nursing education, the American Osteopathic Association advocating limiting residency funding to 110 percent of total graduates, the American Podiatric Medical Association in favor of all third-party payers sharing in the support of graduate training, the Harvard Community Health Plan advocating different allocation to training sites, and the Association of American Medical Colleges on two specific Medicare payments. Also appearing were Doctor Kenneth Shine, Doctor Robert Heyssel, Professor Ruth S. Hanft, and Nurse Michael A. Carter. Includes the prepared testimony of witnesses and six submissions for the record. (JB)




Contemporary Topics in Graduate Medical Education


Book Description

Graduate medical education (GME) continues its decades-long evolution. Evidence-based approaches are increasingly transforming the way we educate, evaluate, and promote GME trainees. Key to this transformation is our ability to recognize that “medical education” constitutes a true lifelong continuum, beginning with pre-medical education, then proceeding to medical school, residency (and potentially subsequent fellowship) training, and then finally the so-called maintenance of certification that continues throughout one’s entire professional career. This book explores a broad range of important topics, including the novel concept of “coping intelligence,” the important role of “work-life integration,” professional coaching and mentorship, professional development and career-long learning, patient-provider relationship, the impact of the COVID-19 pandemic on medical education, as well as the introduction of modern technologies to ameliorate the effects of social distancing. The book further discusses two important aspects of GME program management: the process of establishing new GME programs as well as the highly intricate process of merging residency programs. Different aspects and perspectives are incorporated, including those of residents, faculty, and program leadership. The book ends with chapters on diversity, equity and inclusion, and the importance of community-based medical education.




Graduate Medical Education Outcomes and Metrics


Book Description

Graduate medical education (GME) is critical to the career development of individual physicians, to the functioning of many teaching institutions, and to the production of our physician workforce. However, recent reports have called for substantial reform of GME. The current lack of established GME outcome measures limits our ability to assess the impact of individual graduates, the performance of residency programs and teaching institutions, and the collective contribution of GME graduates to the physician workforce. To examine the opportunities and challenges in measuring and assessing GME outcomes, the National Academies of Sciences, Engineering, and Medicine held a workshop on October 10â€"11, 2017, in Washington, DC. Workshop participants discussed: meaningful and measurable outcomes of GME; possible metrics that could be used to track these GME outcomes; possible mechanisms for collecting, collating, analyzing, and reporting these data; and further work to accomplish this ambitious goal. This publication summarizes the presentations and discussions from the workshop.




Issues Regarding Graduate Medical Education


Book Description

The Subcommittee met in the first of a series of hearings on graduate medical education aimed at developing a new Medicare health professional education and teaching hospital payment policy. The hearing examined new policies for training future health professionals, future medical manpower needs, and the financing of teaching hospitals. Current Medicare payment mechanisms for graduate medical education and teaching hospitals were also reviewed. Among the witnesses were representatives of the American College of Surgeons advocating continued support for teaching hospitals, the American Dental Association advocating continued funding for hospital-based graduate dental education, the American Medical Association in favor of adding third-party payers' support for graduate medical education, the American Nurses Association advocating increased support for graduate nursing education, the American Osteopathic Association advocating limiting residency funding to 110 percent of total graduates, the American Podiatric Medical Association in favor of all third-party payers sharing in the support of graduate training, the Harvard Community Health Plan advocating different allocation to training sites, and the Association of American Medical Colleges on two specific Medicare payments. Also appearing were Doctor Kenneth Shine, Doctor Robert Heyssel, Professor Ruth S. Hanft, and Nurse Michael A. Carter. Includes the prepared testimony of witnesses and six submissions for the record. (JB)







Teaching Hospital and Other Issues Related to Graduate Medical Education


Book Description

This document reports testimony presented on Medicare financing of graduate medical education, as proposed by the Balanced Budget Act of 1995. Witnesses included: (1) Timothy M. Golddfarb, Director, Healthcare Systems (Oregon), who noted the importance of graduate medical education funding to teaching hospitals; (2) Leo P. Brideau of Strong Memorial Hospital (Rochester, New York) who was concerned with protecting the program's viability; (3) Larry Wickless of the American Osteopathic Association, who hoped for increased support for graduate osteopathic programs; (4) Spencer Foreman, who spoke on behalf of the Greater New York Hospital Association concerning the importance of international medical graduates to institutions serving poor populations; (5) William E. Jacott, who spoke for the American Medical Association, which supports changes in the graduate medical education program; (6) Patrick B. Harr, who spoke for the American Academy of Family Physicians, about the physician surplus; (7) Leslie S. Cutler, University of Connecticut Health Center, who suggested establishment of medical education consortiums; (8) Anthony M. Marlon and Jerry Reeves of Sierra Health Services (Las Vegas, Nevada), who described a private-public pilot program to fund education of medical residents; (9) Mary O. Mundlnger, Columbia School of Nursing (New York), who sought funds for graduate nursing education; and (10) Lynn E. Caton, representing the American Academy of Physician Assistants, who sought to make physician assistant programs eligible for such funding. In addition to the testimony, discussions between witnesses and the committee members are also transcribed. (CH)







Graduate Medical Education Re[Think] Re[Claim] Re[Design] Re[Create]


Book Description

Graduate Medical Education needs a stress test now to improve and enhance the health and well-being of its community members. As a member of the GME community for a decade, I found that no matter where in the U.S. I worked or in which specialty I was overseeing, I encountered the same barriers to the foundation of GME, the same challenges faced by trainees, and the same threats to members' health and well-being. After a decade in the GME community, I felt compelled to formally analyze its challenges and devise improvements for its processes, practices, structure, and oversight, from medical school candidates for residency to accreditation to the GME Office to residency and fellowship programs and their learning environments. Professional, successful, knowledgeable GME administrators are seeking safer, less stressful, and more rewarding positions outside the GME community. Practicing physicians are experiencing violence in their workplaces. More alarming, medical students, residents, fellows, and practicing physicians exhibit and share their suicidal ideation. I hope my readers will feel and respond to my sense of urgency for transforming the GME community's challenges into enhancements and improvements. This book is my call to action for all members of this community as well as to the general public who may be or may become patients seeking medical treatment. I have shared experiences I encountered as examples that illuminate areas that need immediate correction. These are concrete problems and issues pervasive in the GME community. I have included scientific support and metrics for readers to examine and contemplate. I have revealed the realities of working in the GME community to bring attention to the current, continual challenges its members face daily. I sincerely hope readers will become advocates for change to improve the culture of the GME community by: Promoting transparency within GME. Developing strategies to improve the culture of the GME community. Enhancing wellness in medical school and residencies. Improving the medical school and trainee learning environments. Aiding residency candidates in navigation through recruitment and fostering understanding of their role in GME. Assisting residency candidates in the transition to residency. Encouraging programs to strive to be more successful. Assisting residents and fellows to succeed in GME and be prepared for a career transition to practice. Acknowledging the connection between failing programs and lack of training for administrative staff. Changing the current perception of the residency coordinator role to one of administrative director, supervisor, or manager. And also: Trainee Career Transition: Topics include negotiating a contract, interview questions, professional identity formation, marketing your practice, and building referrals. Medical Students: Topics include a behind-the-scenes look at the Match and ERAS from the program point of view, learning what programs look for in a personal statement, get interview questions, and how to be successful during residency.