News and Commentary Reflections from GME Summit in Spokane

The Graduate Medical Education (GME) Summit in Spokane held March 30 – April 1, 2016 was the 4th GME Summit held in the Northwest in the last six years. This year’s conference was co-hosted with the Josiah Macy Jr. Foundation and the University of Washington School of Medicine, as part of the Macy Regional Conferences on Innovations in GME series. This is one of six conferences around the country the Josiah Macy Jr. Foundation is co-hosting this year regarding innovations in GME. The conference focused on innovative ways for GME programs to help meet the unique workforce needs of states and regions that have large rural and frontier areas.

The conference featured comments from Mayor Condon of Spokane and Paul Ramsey, MD, Dean of the University of Washington School of Medicine. Other elected officials were also present as well as more than 100 conference participants.

After several speakers reviewed the history of GME, physician workforce challenges regionally and nationally and how to develop new or expand current GME programs, a panel examined innovations in GME that help address creating a physician workforce for rural and frontier areas. The speakers on the panel included Judy Benson, Director of Medical Education for Providence Sacred Heart Medical Center in Spokane; Matthew Hirschfeld, Medical Director of Maternal Child Health at the Alaska Native Medical Center; Frank Reed, faculty at the Family Medicine Residency of Western Montana; Brian Johnston, Chief of Pediatrics at Harborview Medical Center; and Peter Bates, Chief Medical Officer for Maine Medical Center. Some of the innovations they discussed were:

  • Utilizing a consortium as a sponsoring institution;
  • Describing the Alaska Pediatric Residency Track which is addressing workforce in pediatric physicians;
  • Creating a family medicine residency program with a rural focus for all residents;
  • Describing the Resident Education and Advocacy in Child Health pathway for pediatric residents; and,
  • Discussing an internal medicine rural training track.

The questions and answers during this panel presentation helped highlight the innovations happening to help produce a well distributed physician workforce.

The second panel consisted of four current residents and recent graduates. These represented recent graduates who came from a wide range of programs and pathways and who all had differing experiences working in rural settings. These panelists shared the importance of role models and mentors. They expressed the need for a place to work that shares their values and is forward thinking, as they want to train for the future healthcare system in which they will work.

In the evening, there was an interprofessional education (IPE) presentation from the Boise VA which highlighted that IPE done well takes hard work and time but the rewards are highly functioning teams that provide excellent care. Conference participants learned that while it is helpful to the team to understand the work done by the different professions and having everyone work to the top of their skill level, it is also important to maintain the distinct identities of each profession.

The final morning of the conference concluded with Scott Shipman, director of primary care initiatives and workforce analysis, presenting about the intersection of training and the changing health care system followed by George Thibault MD, President of the Josiah Macy Jr. Foundation, who summarized the conference and provided reflections. Dr. Thibault sees six themes emerging from the regional conferences that the Josiah Macy Jr. Foundation is co-hosting. These themes are: 1) Medicare is not the only source of funding for GME and finding local solutions to funding GME is important; 2) partnerships and collaborations are important between academic medical centers and communities to provide GME training in multiple settings; 3) residents can help with leading improvements in healthcare; 4) GME should be outwardly looking, to serve the community where the residents are training; 5) GME should be competency based and should match what the community needs to what the residents are learning; and 6) training in interprofessional teams is important.

The participants of the GME Summit plan to continue the conversation through regular communication with each other. They will come together again at the next GME Summit which will likely be in 2018.

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