Texas Medical School Graduate Numbers Climb
Texas medical schools made history in the 2012-13 academic year by graduating close to 1,600 new physicians. December figures from the Texas Higher Education Coordinating Board report 1,587 medical students graduated, which represents an 8.5-percent increase over the prior year.
The Texas Medical Association projects the number of graduates will surpass 1,700 by 2015, as shown in the graph below. That means more graduates will be competing for the state's postgraduate year-one residency positions.
The National Resident Matching Program reports 1,564 allopathic postgraduate year-one positions were offered in Texas in 2013, and an additional 43 osteopathic postgraduate year-one residency positions were offered. Together, the total of 1,607 offered positions was only 20 above the number of graduates.
Texas Medical Graduates — Recent and Projected
(Assuming projected 97-percent four-year graduation rate)
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Bill Would Remove Funding Loophole for Caribbean Medical Schools
U.S. Sen. Richard Durbin (D-Illinois) filed the Foreign Medical School Accountability Fairness Act Dec. 13 to require all Caribbean medical schools to meet the same minimum requirements that every other medical school located outside the United States and Canada must meet to receive federal funding. This bill would remove current exemptions in the law for several Caribbean medical schools. As of early January, 24 U.S. medical schools issued letters of support for the legislation.
“Congress has failed taxpayers and students by subsidizing these Caribbean schools with billions in federal dollars for years without adequate accountability and oversight,” Senator Durbin said in a press release.
The bill would require all Caribbean medical schools to maintain a 75-percent pass rate on the U.S. Medical Licensing Exam and would require their student bodies to be made up of at least 60 percent non-U.S. citizens. According to Senator Durbin’s office, Caribbean medical schools received more than $450 million in U.S. Department of Education Title IV funding last year.
The Texas Medical Association and the state's medical schools convinced the 2013 legislature to pass a state law barring foreign medical schools from buying up core clinical training spots at Texas teaching hospitals and institutions.
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Medicare Pay Cut Reprieve for Physicians
Physicians received a three-month reprieve from a 24-percent Medicare payment cut that would have taken effect Jan. 1, 2014. President Obama signed a law Dec. 26 that gives Congress until March to address the Medicare Sustainable Growth Rate (SGR) formula.
TMA and eight other states in the Coalition of State Medical Societies said in a November letter to the chairs and ranking members of the Senate Finance Committee and House Ways and Means Committee that a bipartisan plan to repeal the Medicare SGR formula is a good start but still needs work.
“Another patch, another ‘doc fix,’ is not acceptable,” the coalition added in a follow-up memo to Congress.
TMA physician leaders and physicians from other coalition-member states spent several days in November meeting with senators and representatives from both parties, stressing mostly Medicare payment reform.
The Centers for Medicare & Medicaid Services released its final rule with the 2014 Medicare physician payment schedule on Nov. 27, 2013. It also posted a fact sheet on the rule.
The coalition, which represents 158,500 physicians and medical students in Texas, Arizona, California, Florida, Louisiana, Oklahoma, New York, North Carolina, and South Carolina, said in the letter that it supports five components of proposed legislation to “establish new payment systems that will help physicians keep their doors open to baby boomers and future Medicare patients”:
- Repeal the flawed Medicare SGR formula;
- Retain a fee-for-service program;
- Streamline current reporting programs and eliminate the current penalties related to the Physician Quality Reporting System, meaningful use, and the value-based modifier;
- Pay for complex chronic care management; and
- Provide timely performance feedback for physicians.
The letter also suggests ways the government can reduce the administrative and financial burden on physicians in Medicare. They include creating a “de minimis amount exception for the duty to return overpayments under threat of the False Claims Act as well as for recovery audits,” reversing the requirement that an ordering physician be enrolled in Medicare for the referred physician to be paid for his or her services, and allowing payment for telephone or email consultations after a face-to-face encounter.
In its follow-up memo, the coalition called on lawmakers to “take immediate action to work together” to repeal the SGR and not opt for another temporary fee freeze or small increase as it has done for several years.
The coalition’s message reminded lawmakers that the “track record for Congress is not very good. For 12 years, physicians have toiled under the SGR, which everyone knows is broken. Physician practices have been subject to short-term patches each year, crippling their ability to plan for the future, even making them wonder if they’ll be solvent for the current year. The decision to further delay only exacerbates the fiscal albatross around the necks of America’s physicians and the Medicare patients we serve. The vast majority of you say the SGR needs to be permanently fixed. Let’s do it. Now is the time for action.”
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Studies Project Primary Care Supply Won't Meet Demand
Two national studies detail new primary care workforce shortage projections. A report by the National Center for Health Workforce Analysis titled Projecting the Supply and Demand for Primary Care Practitioners Through 2020 reports the following:
- Primary care physicians will experience 8-percent workforce growth from 2010 to 2020 while demand for these physicians will increase 14 percent.
- This discrepancy in the primary care physician workforce will result in a projected shortage of 20,400 primary care physicians by 2020.
- Supply of primary care nurse practitioners (NPs) is projected to increase 30 percent, and supply of physician assistants (PAs) will increase a projected 58 percent by 2020.
- Projections show demand for NPs and PAs will grow 17 percent by 2020.
The American Academy of Family Physicians' Robert Graham Center projection of state primary care physician workforce shortages reports Texas will need an additional 6,260 primary care physicians by 2030 — a 47-percent increase over the state’s current primary care physician workforce — to maintain current utilization rates.
The workforce projections report for Texas calls on the state to address the current and growing demand for primary care physicians to adequately meet the health care needs of a “growing, aging, increasingly insured population.” The report suggests policymakers consider strategies to “bolster the primary care pipeline including reimbursement reform, dedicated funding for primary care Graduate Medical Education (GME), increased funding for primary care training and medical school debt relief.”
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Don't Miss JAMA's Medical Education Issue
The Journal of the American Medical Association published a special issue on medical education in December, and it includes research findings and editorials on the following:
- Changes to the U.S. Medical Licensure Exam and Medical College Admission Test,
- Medical education in the era of electronic medical records,
- The impact of resident duty hour caps on patient care and medical errors,
- Minority faculty development programs at U.S. medical schools, and
- Recent national statistics for residency programs and medical schools.
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Call for RRC, Specialty Board Nominees
Each year, the American Medical Association solicits recommendations for appointments to certain Accreditation Council for Graduate Medical Education (ACGME) residency review committees (RRCs) and nominations for vacancies on medical specialty boards of the American Board of Medical Specialties (ABMS). This year, AMA is seeking qualified nominees for the following 11 RRC positions:
- Allergy and Immunology, with additional expertise or fellowship certification in Internal Medicine and Pediatrics
- Colon and Rectal Surgery
- Obstetrics and Gynecology
- Pediatrics (some subspecialties are not eligible, as described in the AMA materials)
- Preventive Medicine, Aerospace Medicine
- Radiation Oncology*
- Transitional Year (must be certified by American Board of Family Medicine or American Board of Internal Medicine)
*Position specifications were unavailable at press time but will be posted when made available to AMA.
The American Board of Medical Specialties is also requesting AMA recommendations for six Board of Director vacancies in allergy and immunology, emergency medicine, family medicine, orthopedic surgery, psychiatry and neurology, and surgery.
Visit the AMA website for specific requirements and limitations. The application deadline is Feb. 7, 2014. All nominees must be current AMA members.
For more information, email Evelyn Sherrill, program administrator for the AMA Council on Medical Education, or call (312) 464-4515. Contact TMA's Director of Medical Education Marcia Collins at (800) 880-1300, ext. 1375, or email her to request a support letter from TMA.
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Join the Houston Conference for Medical Educators
Texas Children’s Hospital and Baylor College of Medicine are cosponsoring a conference for medical educators, Moving Up the Educational Ladder: Improving Your Skills and Building Your Career in Medical Education, Feb. 6-9 at the Pavilion for Women at Texas Children’s Hospital in Houston.
In addition to presentations by world-renowned speakers, there will be a poster session to showcase educational research and educational innovations and a "Hot Topics" lunch. Email Baylor staff for more information.
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Get AccessMedicine from the TMA Knowledge Center
The TMA Knowledge Center is adding a new textbook resource to its online databases. AccessMedicine from McGraw-Hill Medical is an innovative online resource that provides TMA members with access to more than 75 medical titles from the best minds in medicine, updated content, thousands of images and illustrations, interactive self-assessment, case files, time-saving diagnostic and point-of-care tools, a comprehensive search platform, and the ability to view from and download content to a mobile device.
Updated frequently and expanded continuously by world-renowned physicians, AccessMedicine provides fast, direct access to the information necessary for completing evaluations, diagnoses, and case management decisions, as well as for pursuing research, medical education, or self-assessment and board review.
AccessMedicine comprises respected and revered medical titles such as Harrison’s Principles of Internal Medicine, CURRENT Medical Diagnosis & Treatment, Tintinalli’s Emergency Medicine, Fitzpatrick’s Dermatology in General Medicine, and more.
Get AccessMedicine through the TMA Knowledge Center databases page. If you have problems logging into the TMA website, email or call the TMA Knowledge Center at (800) 880-7955.
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Join or Renew TMA Today: We Could Use Your Help!
TMA has been a longtime advocate for academic faculty and medical schools — monitoring legislation, determining the potential impact on patients, and lobbying for your interests.
The results of the last legislative session were outstanding for academic medicine. Our efforts in the session, including public testimony provided by TMA leadership at every applicable legislative committee hearing and personal visits with legislative members and staff, paid off. For example, lawmakers restored graduate medical education formula funding, which took a 31-percent hit in 2011, with a 15-percent ($8.8 million) increase this budget cycle.
Lawmakers also restored the Family Medicine Residency and State Physician Loan Repayment programs, which faced elimination in the past budget. Undergraduate medical education also received a 7-percent boost in per-student funding. TMA helped stop off-shore medical schools from buying up clerkship spots in Texas hospitals and repealed a 2011 law that forced international medical graduates to spend three years working in only medically underserved areas.
TMA is extremely successful in Texas for one reason only. TMA speaks with one strong, firm, and consistent voice, the voice of its members. Only with grassroots support — only with your support — can we continue to be successful.
Join or renew today at www.texmed.org/join and see what a difference TMA membership can make. Within your department and/or academic institution, funds may be available to cover the cost of your membership. Please check with your department administrator or chair.
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New-to-Texas Physicians Can Start Here
Are you a new Texas physician? Have you recruited a physician for your school, your practice, or your community from out of state?
TMA’s Welcome To Texas webpage can help new or returning Texans get their practices up and running. The page provides links that doctors need to obtain a Texas license, plus contact information for relevant state and federal agencies, and links to resources such as practice consulting for setups, health insurance plan contacts, and employee salary data.
TMA members can email the TMA Knowledge Center or call (800) 880-7955 for fast answers to questions about membership, TMA member benefits and services, practice management or legal information, and more.
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This Month in Texas Medicine
The January issue of Texas Medicine reports the results of a RAND survey about what makes physicians happy in practicing medicine and what makes them feel dissatisfied with their career choice. It also tells you how TMA's Physician Services Organization will equip physicians for the crucial role they will play in new health care models; explains the key role physicians play in educating patients about vaccines; discusses how an improved Medicaid provider portal has the potential to improve care, if done right; examines the impact of AMA’s declaration that obesity is a disease; and explains how TMA is helping physicians incorporate the Choosing Wisely® program into their daily practice.
Also, you can subscribe to RSS feeds for TMA Practice E-Tips, TMA news releases, Blogged Arteries, and Texas Medicine. More
It's Academic is for physicians in academic settings. For more information about TMA’s efforts on behalf of medical education and academic physicians, visit the TMA Council on Medical Education’s Subcommittee for Academic Physicians page on the TMA website.
Please share with your colleagues who are not TMA members and ask them to join.
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