ACP provided feedback to the congressional working group, suggesting an even further increase in the Medicare-funded GME residency spots
Feb. 21, 2025 (ACP) -- A bipartisan group of senators recently released draft legislation to improve Graduate Medical Education (GME) financing, and the American College of Physicians is chiming in to ensure the plan works for patients, primary care physicians and the health care system as a whole.
Estimates from the Association of American Medical Colleges project a shortage of 20,200 to 40,400 primary care physicians by 2036. As the U.S. physician pipeline is shrinking, the number of available Medicare-funded GME residency positions needs to be increased in rural and underserved areas and in specialties facing the biggest shortfalls.
“The number of available Medicare-funded GME residency positions has been set in stone since the late 1990s, but Congress added 1,200 spots between 2021 and 2023, which was helpful but is nowhere near what is needed to address the physician shortage,” said Jared Frost, ACP manager for legislative affairs and ACP Services PAC.
The draft legislation calls for adding 5,000 new Medicare-funded GME residency slots. Of these, at least 25 percent would be reserved for primary care and 15 percent would be earmarked for psychiatry or psychiatry subspecialties.
The legislation prioritizes GME slots for hospitals serving rural or underserved areas.
The aspects of the new legislation are a good start, but more is needed to avert a crisis, Frost said.
“Ideally, we would like to see at least 10,000 new slots. Critically, the distribution of those new slots needs to be restructured in a way that is responsive to the changing requirements of the health care system,” he said. “We should meet the needs of the physician shortage by better distributing the slots and allocating the specialties such as primary care.”
Shifting GME dollars to programs in areas where physicians are needed most might lead to an increase in training positions in underserved areas and a change in the distribution of physicians once their training is complete because most residents stay where they train, Frost explained.
The new legislation does call for the establishment of the Medicare GME Policy Council to advise the Department of Health and Human Services about the distribution of GME positions regarding physician shortages in geographic areas and physician specialties.
ACP also supports the use of GME in all training settings, not just the location of service relative to the sponsoring hospital or institution.
ACP is contacting the four senators in the working group with its feedback. “They are taking our input into account, but there is no time frame for a bill to be formally introduced,” Frost noted.
Another bill, the Resident Physician Shortage Reduction Act, aims to add 14,000 new Medicare-supported GME positions at the rate of 2,000 per year for seven years. “This is a bill that ACP has supported in the past. It does not go as far as the [draft legislation] to change the structure of the system to be more specific to needs and put residents where they need to be and allocating by specialty,” Frost said.
“We really need Congress to act urgently to both increase the number of physicians, and this will be better for the whole health care system,” he added.
ACP members can help make this legislation a reality. “Support the Resident Physician Shortage Reduction Act and continue to push for this newer legislation,” Frost said. “Don't lose hope and keep up the pressure. This the farthest we have gotten with the draft bill in recent history.”
Back to the February 21, 2025 issue of ACP Advocate