Addressing the Nation’s Physician Workforce Needs: The Society of General Internal Medicine (SGIM) Recommendations on Graduate Medical Education Reform

Abstract

The Graduate Medical Education (GME) system in the United States (US) has garnered worldwide respect, graduating over 25,000 new physicians from over 8,000 residency and fellowship programs annually. GME is the portal of entry to medical practice and licensure in the US, and the pathway through which resident physicians develop the competence to practice independently and further develop their career plans. The number and specialty distribution of available GME positions shapes the overall composition of our national workforce; however, GME is failing to provide appropriate programs that support the delivery of our society's system of healthcare. This paper, prepared by the Health Policy Education Subcommittee of the Society of General Internal Medicine (SGIM) and unanimously endorsed by SGIM's Council, outlines a set of recommendations on how to reform the GME system to best prepare a physician workforce that can provide high quality, high value, population-based, and patientcentered health care, aligned with the dynamic needs of our nation's healthcare delivery system. These recommendations include: accurate workforce needs assessment, broadened GME funding sources, increased transparency of the use of GME dollars, and implementation of incentives to increase the accountability of GME-funded programs for the preparation and specialty selection of their program graduates.

“We have been forced to move away from home”: print news coverage of Canadians studying abroad at Caribbean offshore medical schools

“…With regard to the difficulty faced by many CSAs returning to Canada for residency and ultimately practice despite reports of physician shortages, controlling the number of post-graduate positions is an instrumental way to control the make-up of the physician workforce [ 44 ]. Further, this framing also does not address the nature of physician shortages in Canada, which are better characterized as rural-urban physician mal-distributions [ 45 ].…”

Effectiveness of an Orthopaedic Trauma Research Fellowship to Produce Successfully Matching Residents

“…In addition, recommendations to increase the number of available medical school positions have yet to be met with a reciprocal expansion in residency positions. 4-10…”

The Evolution of General Internal Medicine (GIM)in Canada: International Implications

“…1,3,8,11,15,16 This concern about the viability of GIM and the struggle to define the discipline educationally and in scope of practice was reported simultaneously in multiple jurisdictions. [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] General internal medicine has evolved in terms of its operationalization across the world (primary care vs. consultant, ambulatory vs. inpatient), but the values inherent in GIM remain the same. 34 In Canada, as we have defined and implemented GIM within the educational structure of the national accrediting body (RCPSC), we have been able to standardize educational outcomes with an enhanced ability to describe and advocate for the role of the generalist specialist within the health care system.…”