Federal Support for Graduate Medical Education: An Overview

Summary

Access to health care is, in part, determined by the availability of physicians, a function of the physician supply. Policymakers have demonstrated a long-standing interest in access to care, both in general and for specific populations. Moreover, federal support for medical residency training (a.k.a., graduate medical education [GME]) is the largest source of federal support for the health care workforce. Although the health workforce includes a number of professions, the size of the federal investment in GME—estimated at $15 billion in FY2012—makes it a policy lever often considered to alter the health care workforce and impact health care access.

This report describes federal programs that provide GME support. Although these programs may also support training for other health professions, this report focuses on training for physicians. The report examines GME support in Medicare, Medicaid, the Department of Veterans Affairs, the Department of Defense, and programs administered by the Health Resources and Services Administration, such as the Children’s Hospital and Teaching Health Center GME payment programs. The report details the mechanisms that various federal programs use to support GME and provides data, when available, on funding and the number of trainees. Although some federal advisory groups have raised concerns about the transparency of federal GME investments, this report does not address such concerns; instead, it discusses some of the data gaps relevant to each of the federal GME programs.