U.S. GME Results Not Aligned With Need
The U.S. birth rate hit an all-time low in 2012, dropping to 63 babies per 1,000 women aged 15 to 44. That's a little more than half the birth rate the nation experienced at the tail end of the baby boom.
This recent news
from the CDC coincides with a new report from the AAFP's
Robert Graham Center for Policy Studies in Family Medicine and Primary Care showing how our
country’s graduate medical education (GME) system has not kept up with the
needs of our changing population. Despite the declining birth rate and an
increasing need for a larger adult primary care workforce, our nation's medical
schools and residency programs are producing general pediatricians at a much
higher rate than family physicians and general internal medicine physicians.
Our aging boomer population -- coupled with expanding access to health insurance -- poses a potential crisis. People are living longer with more chronic diseases, but who will provide their care?
We know that new medical schools are opening, and many
existing schools are expanding their class sizes. But our goal can't be to just
graduate more physicians. Our country's goal for medical education should be to
produce the types of physicians our health care system actually needs.
The Graham Center's one-pager illustrates an excellent example of how primary care research can help drive health care policy. It reinforces an August report from the Council on Graduate Medical Education (COGME) recommending that GME funding be prioritized to align the health care workforce with population and health delivery needs. Specifically, COGME said increases in GME funding should be directed to the following high-priority specialties:
- family medicine
- general internal medicine
- general surgery
- pediatric subspecialties and
The United States spends nearly $13 billion a year on GME funding, an investment made with our country's tax dollars. For this level of investment, we deserve a workforce that meets our country's needs.
Jeff Cain, M.D., is Board Chair of the AAFP.