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Macy Foundation Awards $750,000 to Institute of Medicine for Study of Graduate Medical Education

New York, NY

Macy Grant Advances Experts’ Call for an Independent Review of the Governance and Financing of GME

The Josiah Macy Jr. Foundation has awarded the Institute of Medicine (IOM) $750,000 to study the governance and financing of graduate medical education (GME). An independent review of the goals, governance and financing of the system for training physician residents in the United States was one of several recommendations issued by experts at an October 2010 conference about GME reform sponsored by the Macy Foundation.

GME is largely responsible for the size and composition of the physician workforce in the U.S. But the education of doctors hasn’t kept pace with changes in health care delivery and practice. Over the past two years, the Macy Foundation has convened more than 50 national leaders in academic medicine, health policy, and medical education to help transform the GME system.

Medicare contributes $9.5 billion to GME; Medicaid about $3 billion. Because GME is a public good that receives a large share of public dollars, leaders convened by Macy over a series of two conferences agreed that the system “must be accountable to the needs of the public.” The first conference, co-sponsored with the Association of Academic Health Centers in October 2010, focused on the regulation, financing, and size of GME. In May 2011, the Macy Foundation hosted a follow-up conference focusing on the content and format of GME. Two reports capturing the conclusions and recommendations from these meetings were issued by the Foundation in 2011.

“Though the GME system in the United States has served us well and is a model for the rest of the world, it must evolve swiftly to adapt to a changing health care system and health care needs.” says George Thibault, president of the Macy Foundation. “We hope the IOM study will provide a roadmap that helps move us closer toward a graduate medical education system that ensures an effective physician workforce for the future.”

Calls for GME reform have echoed across the country for decades. The Foundation has itself examined this issue twice, in the 1980s and the 1990s. In December 2011, a bipartisan group of U.S. Senators called for an IOM review of GME funding and governance, mirroring recommendations in the Macy report, Ensuring an Effective Physician Workforce for America: Recommendations for an Accountable Graduate Medical Education System.

To conduct this study, IOM will appoint an 18-member committee with expertise in health care systems, health economics, health professions education, and GME financing and accreditation at all levels. The committee is anticipated to examine current regulation, financing, content, governance, and organization of GME and recommend how to modify the system to produce a physician workforce that meets current and future societal needs.

The Macy Foundation grant constitutes approximately half of the support that the IOM needs to carry out the study, and the other half will be provided by public and private entities. The study is expected to begin June 1, 2012 and be completed in Spring 2014.

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