The ACS has articulated principles to guide responses to
proposals to renew, replace, or reorganize the GME system.
The ACS has articulated principles to guide responses
to proposals to renew, replace, or reorganize the GME
30 First, the ACS supports the recommendation
from the Institute of Medicine (now the National Academy of Medicine) to establish a GME transformation
fund, which would aid in the development and assessment of new GME programs, performance measures,
and payment models. Second, the ACS is interested in
proposals for a regionalized GME governance system—
akin to existing systems used in organ procurement or
trauma care—that could respond more flexibly to the
changing demographics and health care needs of a specific population. Third, underscoring an ongoing need for
comprehensive, reliable evidence on the workforce, the
ACS supports the systematic collection and reporting of
national workforce data so that the projections on which
policies are crafted remain evidence-based.
Companion bills have been introduced in Congress to
address workforce deficiencies. The Resident Physician
Shortage Reduction Act (H.R. 2124/S. 1148) increases the
number of residency positions by 15,000 over five years
and, notably, recognizes the need for both primary care
and specialist physicians by directing that half of the new
positions be in critical need fields, such as the surgical
specialties. The legislation also outlines criteria for distributing the new positions, such as by giving priority
to states with new medical schools. As of June 2016, the
House bill had more than 100 bipartisan cosponsors; the
Senate version had 14 Democrat cosponsors.
Other bills have addressed GME issues through various
funding mechanisms, regulatory reforms, and programs
to study geographic variation in the projected shortage.
Continued review of legislation by surgeons and surgical
advocates will be critical to ensure that proposed reforms
are consistent with anticipated changes in the surgical
workforce and in patient needs.
The road ahead:
Inspiring future surgeon advocates
GME reform is not the only active issue that should be on
surgeons’ minds. A dozen other priorities, ranging from
cancer research appropriations to quality metrics being
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