AAHC convened a series of seven roundtable discussions in various parts of the country, asking two important questions of participants:
- What are the top two GME-related issues or concerns with respect to your institution, state, and/or region?
- Is your current GME program adequate for training physicians to meet your area’s future healthcare needs?
We specifically chose to exclude a primary focus on divisive topics, such as geographic redistribution of funds and whether there is a physician shortage, in order to promote a full and comprehensive discussion. Participants, without exception, expressed their gratitude for the opportunity to come together with their peers and other stakeholders to discuss this important issue, and engaged generously and enthusiastically during the sessions. The seven regional sessions were held as follows:
- Southeast at Emory University in Atlanta
- Northeast at the University of Pennsylvania in Philadelphia
- Mid-Atlantic at AAHC offices in Washington, DC
- Mid-West in Chicago alongside our Senior Administrators/Fiscal Officers (SAFO) meeting
- South Central at the University of Texas Southwestern Medical Center in Dallas
- Mountain West at the University of Utah in Salt Lake City
- Western at Stanford University in Palo Alto
In addition to AAHC members, participants included associations, such as the Association of American Medical Colleges (AAMC), the American Association of Colleges of Nursing (AACN), the American Hospital Association (AHA), and the American Medical Association (AMA); accreditation bodies, such as the Accreditation Council for Graduate Medical Education (ACGME); local/regional experts, such as the new Jersey Hospital Association, the Georgia Board for Physician Workforce, the Utah Medical Education Council and The GME Initiative (otherwise known as Western and Midwestern Family Medicine Leaders for GME Reform); other organizations with GME interests, such as the National Institutes of Health (NIH) and the Uniformed Services University of the Health Sciences; and hospital, insurance, and provider systems, such as Intermountain Health Care and Kaiser Permanente. Overall, more than 100 participants joined the discussions, with representatives covering more than 30 states.
A number of themes emerged from the discussions consistently across the regions:
- There are deep-seated organizational conflicts between the sponsoring institution (hospital) and the medical school, even when under common ownership.
- There is a profound lack of awareness of and/or coordination with the private sector.
- Mental health needs of the community, as well as residents and faculty, are significant and increasing.
- There is great interest in having substantially increased flexibility in determining trainee curricula and the corresponding accreditation.
- Rural and underserved populations are in urgent need of better access to care.
- Partnerships and Interprofessional Training are seen as critical, though challenging, initiatives.
- There is inadequate analysis of actual healthcare workforce needs at every level—national, state, local, sub-local.
- The funding mechanism for GME needs modification.
AAHC will be following up in a variety of ways to capitalize on the information obtained from the GME Roundtable series and the positive stakeholder engagement developed through the process. AAHC does not have a position on GME reform per se and is pleased to serve as a neutral facilitator for continued dialogue on this important topic.