Last week, we released the Foundation’s latest report on graduate medical education in the United States. The report calls for major changes in the way we train residents. A broad panel of leaders generated the recommendations, focusing on how to ensure that physicians are trained more effectively and efficiently to meet public needs in today’s health care system.
The recommendations we released complement the report we released in February calling for reforms in the financing and governance of the GME system, which receives nearly $10 billion in federal support. Our latest recommendations, emerging from a meeting we convened in May in Atlanta, seek to make GME more publicly accountable. We suggest engaging consumers in its design, reexamining old assumptions about how long doctors are required to undergo training, and training nurses, doctors, and other medical professionals together so that they emerge ready to provide care together.
As we write in the report, “It is no longer sufficient to say that producing competent physicians meets GME’s responsibility to the public. The GME system must also be a responsible steward of public funds and ensure that the process of education is efficient, cost-effective, and evidence based.”
Maintaining the historic trust granted to health professionals requires that we be willing to examine and reform our well established GME system. Changes must take place to respond to changes in patient demographics and disease burden, the transformation of the healthcare delivery system, the explosion in healthcare and information technology, and the unsustainable growth of healthcare costs. All of these changes demand new competencies from practitioners, whose preparation for practice must follow suit.
Those of us in the academic medical community share a responsibility to be self-critical and to demonstrate a willingness to change. The recommendations in this latest report are designed to show not only that we understand this, but also that we can produce constructive proposals to accelerate reform.
Copies of “Ensuring an Effective Physician Workforce for the United States: Recommendations for Reforming Graduate Medical Education to Meet the Needs of the Public” and its predecessor report, “Ensuring an Effective Physician Workforce for America: Recommendations for an Accountable Graduate Medical Education System,” are available here and here.