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IOM Report on GME Affirms Continuation of Medicare Funding; Recommends More Public Accountability

New York, NY

IOM Report on Graduate Medical Education Affirms Continuation of Medicare Funding of GME and Recommends a More Publicly Accountable System

The Josiah Macy Jr. Foundation welcomes the IOM’s call for a more publicly accountable graduate medical education enterprise in its report Graduate Medical Education that Meets the Nation’s Health Needs, released today, and looks forward to the participation of all stakeholders in a constructive discussion about the reform of the GME system.

GME is a public good that is significantly financed with public dollars: Medicare contributes $9.7 billion to GME; Medicaid about $3.9 billion. But many feel that the graduate education of physicians has not kept pace with changes in medicine and health care delivery, and consequently our physician workforce is not adequately prepared to meet contemporary medical needs.

The U.S. needs a GME system that encourages innovation and is more diversified in site and content of training to prepare physicians to care for our increasingly diverse and aging patient population. The Macy Foundation supports the direction of the IOM’s recommendations toward a GME system that is more accountable, more transparent and that has the appropriate incentives to better meet the health needs of the public.

“Calls for GME reform have occurred in every decade since the 1940s but very little significant change has occurred to make GME more responsive to public’s health needs,” said George Thibault, president of the Macy Foundation. “With all the change occurring in health care today, it is even more urgent that we reform how we structure and fund programs to prepare our physician workforce. If we fail to act, the misalignment between the workforce and our health care needs will only worsen.”

In October 2010, The Macy Foundation hosted a conference focused on the regulation, financing, and size of GME. In May 2011, the Macy Foundation hosted a follow-up conference focused on the content and format of GME. Two reports, Ensuring an Effective Physician Workforce for America and Ensuring an Effective Physician Workforce for the United States, capturing the conclusions and recommendations from these meetings were issued by the Foundation in 2011. Following those conferences, the Macy Foundation in April 2012 asked the Institute of Medicine to study the governance and financing of GME, and became the principal sponsor of the study.

About the Josiah Macy Jr. Foundation:
Since 1930, the Josiah Macy Jr. Foundation has worked to improve health care in the United States. Founded by Kate Macy Ladd in memory of her father, prominent businessman Josiah Macy Jr., the Foundation supports projects that broaden and improve health professional education. It is now the only national foundation solely dedicated to this mission. Visit the Macy Foundation at

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