Resource Center

Federal funds totaling $16 billion support 120 000 graduate medical education (GME) positions (1). However, too few physicians are trained to practice high-quality primary care that can improve outcomes and decrease costs (2). Consistent with recommendations of the Institute of Medicine's (IOM) recent review of the governance and financing of GME (3), we propose using existing funds to expand primary care positions that target urban and rural areas with shortages of health professionals. We also propose using recently approved Veterans Affairs (VA) funding to expand primary care and mental health residency positions that target VA clinical sites that need more health professionals.

Our budget-neutral proposal builds on the existing strength of our nation's academic medical centers, other teaching hospitals (including VA teaching facilities), community health centers, and rural health clinics. New partnerships among these participants, targeting areas of demonstrated need, would provide increased access to high-quality, cost-effective care while improving and expanding residency training opportunities for growing numbers of allopathic and osteopathic medical graduates in the United States (4–6). Residents who train in underserved settings are more likely to practice in them (7), and their retention could be further incentivized with debt repayment programs sponsored by the National Health Service Corps (5).

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