« Scientific Assembly... | Main | Shaping the Future... »

Friday Oct 25, 2013

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‚Äôs 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
  • geriatrics
  • general internal medicine
  • general surgery
  • pediatric subspecialties and
  • psychiatry.

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.


The AAFP has had in the past a very good program to promote more interest in FM, and I do not know why it was discontinued. It was the "Adopt a future Family Physician". We signed up to have high school students to shadow us in our offices and experience first- hand our practices. I also think that there should be more programs of committment to the needed specialties, for at least 3years for loan payback incentives. Perhaps a one-year intensive FM training, and then working in a PRODUCTIVE PCMH with practicing preceptors, continuing like "apprentices", will work.

Posted by Robert Nicewander on October 28, 2013 at 02:56 PM CDT #

You must be logged in to post a comment. Login

Sign Up

Subscribe to receive e-mail notifications when the blog is updated.


Our other AAFP News blog

Fresh Perspectives - New Docs in Practice


The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. All comments are moderated and will be removed if they violate our Terms of Use.