GME in the United States: A Review of State Initiatives

Product: report 

Authors: Julie C. Spero, MSPH; Erin P. Fraher, PhD, MPP; Thomas C. Ricketts, PhD, MPH; Paul H. Rockey, MD, MPH

The debate on how best to reform and fund Graduate Medical Education (GME) is moving up the health policy agenda. Most of the proposals are coming from national organizations offering national solutions. Often absent from the discussion is the important role states play in reforming GME.

The Program on Health Workforce Research and Policy, part of The Cecil G. Sheps Center for Health Services Research at The University of North Carolina at Chapel Hill, with support from the American College of Surgeons and the North Carolina Area Health Education Centers (NC AHEC) Program, conducted a study of state-level GME initiatives. GME in the United States: A Review of State Initiatives examines the extent to which states are using health workforce data, implementing novel GME financing initiatives, creating governance structures, and establishing policies or measures to encourage accountability of public funds invested in GME.

A total of 39 interviews were conducted with 45 participants in California, Florida, Georgia, Illinois, Maryland, Massachusetts, Michigan, New Jersey, New York, North Carolina, Tennessee, Texas, Utah, Vermont, and WWAMI states. The interviews paint a picture of states having much to risk and much to gain, but perhaps missing out on important opportunities to reform GME.

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