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US panel calls for sweeping changes to funding of graduate medical education

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g4968 (Published 01 August 2014) Cite this as: BMJ 2014;349:g4968
  1. Michael McCarthy
  1. 1Seattle

The US system for funding physician training should be overhauled to ensure that it produces a workforce better matched to the nation’s needs, says a new report from the Institute of Medicine.1

Currently, US taxpayers provide $15bn (£8.9bn; €11.2bn) a year, primarily through Medicare, to pay for postgraduate medical training. Most of that money goes to teaching hospitals, with few strings attached. “This funding is essentially guaranteed—regardless of whether the funded programs reflect local, regional, or national healthcare priorities,” the 21 member panel wrote.

This has resulted in a physician workforce with too many specialists and too few doctors who were prepared to work in primary care or in underserved communities, the panel said. It added that hospital based training left many physicians unprepared to practice in the ambulatory care settings …

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