November 2009
AMA Delegates to Debate GME Funding, Resident Hours
Two reports from the American Medical Association Committee on Medical Education that could impact the availability of funding for residency programs and resident duty hours will be considered by the AMA House of Delegates when it convenes at its 2009 interim meeting in Houston Nov. 7-10.
AMA Council on Medical Education Report 3
Securing Funding for Graduate Medical Education
The council's report assesses the current financing climate for graduate medical education (GME), with a primary focus on Medicare's policies, and shines a spotlight on innovative state financing programs, including Texas' state GME formula funding process, that the council feels could be models for implementation at the national level. The council recommends that the House of Delegates:
- Reaffirm three existing AMA policies that focus on GME as a common good that warrants public as well as private payer support;
- Direct AMA to remain vigilant while monitoring pending legislation, including health system reform proposals, that may change the financing of medical services and advocate for expanded and broad-based funding for GME from federal, state, and commercial entities; and
- Direct AMA to continue to advocate for GME funding that reflects the specialty-specific demographic and regional geographic needs of the nation.
AMA Council on Medical Education Report 2
Resident/Fellow Duty Hours, Quality of Physician Training, and Patient Safety
In this report, the council takes a position on duty-hour recommendations made by the Institute of Medicine (IOM) in December 2008, which the Accreditation Council for Graduate Medical Education (ACGME) is reviewing for possible adoption. The council offers 11 recommendations as new AMA policy in this report, which generally support current ACGME duty-hour standards for residents, and advocates continued research on duty hours, sleep, and resident and patient safety.
Out of concern for costs and potential risks to patient safety, the council opposes adoption of the IOM's recommended protected sleep period for residents. The council estimates that the cost for implementing the "nap rule" would range from $168 million to $559 million per year. This would occur while GME funding already is constrained and funding for more GME slots is needed to better accommodate the larger number of medical school graduates.
TMA's Delegation to the AMA will participate in the discussions on these reports. The outcome of the house debate will be reported in the December issue of It's Academic.
Full copies of these reports, as well as the other reports and resolutions to be considered at the meeting, are posted on the Reference Committee K, Professional Standards Advocacy (PDF) page of the meeting Web site.
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AAMC: Med School Enrollment Rising
Aided by the new Texas Tech University Health Sciences Center Paul L. Foster School of Medicine in El Paso, enrollment in U.S. medical schools continues increasing to meet the nation's need for more physicians, the Association of American Medical Colleges (AAMC) says in a news release. First-year enrollment rose this year by 2 percent over 2008 to nearly 18,400 students, AAMC said.
"The nation's medical schools are working hard to meet the growing demand for more physicians by boosting their enrollment," said AAMC President and Chief Executive Officer Darrell G. Kirch, MD. "But we must also increase the number of residency training slots to prevent a bottleneck in the pipeline of new physicians, and ensure access to care for the millions of Americans who hopefully will attain coverage under health care reform."
Tech's new school, plus Florida International University Herbert Wertheim College of Medicine in Miami; The Commonwealth Medical College in Scranton, Pa.; and the University of Central Florida College of Medicine in Orlando, seated their first entering classes this year, accounting for half of the 2009 enrollment increase, AAMC said. In addition, 12 existing schools expanded their 2009 class size by 7 percent or more.
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UT Southwestern Joins Project Access
The University of Texas Southwestern Medical Center is now part of the Project Access program in Dallas. Created in 2002 by the Dallas County Medical Society, Project Access is a network of physicians, hospitals, community health clinics, and additional support organizations that offer health care to the working poor.
UT Southwestern specialty physicians will consult with patients' primary care doctors, Bruce Meyer, MD, vice president for medical affairs, told UT Southwestern's Center Times newspaper. He added he expects most of the referrals will be for specialists in cardiovascular care, dermatology, neurology, and pulmonology.
Dr. Meyer said the medical center will contribute $1 million in faculty practices and resources.
Project Access patients must be uninsured, meet specific income guidelines, and live in Dallas County. And, either the patient or his or her spouse must work at least 20 hours per week.
The Travis County Medical Society has a similar program.
The TMA Project Access Resource Center has more information on Project Access.
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Congressional Caucus Promotes Academic Medicine
Two members of Congress, Rep. Allyson Schwartz (D-Pa.) and Rep. Patrick Tiberi (R-Ohio) have established the Congressional Academic Medicine Caucus in the U.S. House of Representatives. The bipartisan caucus will be dedicated to maintaining and strengthening medical schools and teaching hospitals.
Reps. Schwartz and Tiberi, who will co-chair the new caucus, told Association of American Medical Colleges that the new caucus “will also strive to educate other members on the unique health care, research, and training missions of teaching hospitals and medical schools.”
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Journal of Graduate Medical Education Debuts
The Accreditation Council for Graduate Medical Education is publishing a new peer-reviewed journal, the Journal of Graduate Medical Education (JGME). Its content includes original research, systematic reviews, and practical approaches related to graduate medical education that will inform, engage, and promote scholarship within the GME community.
The quarterly JGME is issued in March, June, September, and December. You can view the first and next (December) issues of the journal for free. A yearly subscription, with online issue access, is $160, and you may subscribe by sending a subscription request via e-mail through its Web site
The JGME is accepting manuscripts for its four 2010 issues. To be considered for inclusion in the March issue, manuscripts much be received by Nov. 10, 2009.
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TMA Longtime Advocate for Academic Faculty and Medical Schools –Join Today!
The need to increase state funding for both medical students and residents, as well as make improvements to the state's physician education loan repayment program, were among TMA's legislative priorities this session. When the Texas Legislature convened in 2009, TMA fought for and won the following:
- Allocated $26.8 million for primary care GME programs in the next biennium. This includes an additional $3.75 million or 21.5-percent more funding for the Family Medicine Residency Program.
- Increased GME formula funding by 18.1 percent, or $15.7 million. Texas medical schools now receive $6,653 per resident per year. The total state funding for GME programs in 2010-11 is approximately $120.9 million, including state GME formula funding ($78.5 million), primary care GME funding ($26.8 million), and specific allocations to some medical schools ($15.6 million).
- Increased the base rate used to calculate formula funding for medical students by 2.7 percent, from $51,527 to $52,896 per student — a 10-percent state gain totaling $62 million.
- Assigned new and improved funding for Texas' Physician Education Loan Repayment Program — the program now pays up to $160,000 over four years, almost four times more than the previous program.
- Added another loan repayment option through the Texas Health and Human Services Commission, which repays up to $140,000 over four years. It is not restricted to underserved communities for physicians caring for a certain level of Medicaid patients.
These are just a few examples of TMA's ability to work on your behalf, and our success reflects the important role that organized medicine plays in our profession. We urge you to forward this issue of It's Academic to your colleagues who are not TMA members and ask them to join TMA today. (They can use recruitment code ITSACA.)
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.
New-to-Texas Physicians Can Start Here
Are you a physician who is new to Texas? Have you recruited a physician for your school, your practice, or your community from out of state?
TMA created a New to Texas Resource Page to help new or returning Texans get their practices up and running. The page provides links doctors need to be licensed in Texas, plus contact information for relevant state and federal agencies, and links to resources such as practice consulting for set-ups, health insurance plan contact information, and employee salary data.
Last but not least, a link to the TMA Knowledge Center. TMA members can e-mail the 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 November Texas Medicine explains why you and your staff need flu shots, reports on a company some employers are hiring to recoup "overpaid" insurance claims, and warns you what can happen if a trusted employee turns out to be not so trustworthy. It also explains why some are skeptical about Blue Cross and Blue Shield of Texas' rating of physicians, and how TEXPAC is backing two physicians in the same election. It's Academic is designed for physicians in academic settings. Please share with your colleagues who are not TMA members and ask them to join.
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It’s Academic is designed for physicians in academic settings. Please feel free to share this issue with your colleagues.
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Last Published: 11/4/2009
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