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DEAN’S MESSAGE
Continued from page 37 The Future
What is the optimal number of residents per capita? With the
residency” program as identified in the National Health Care
Workforce Commission’s report; primary care is a key focus multiple and continuously changing factors associated with health
• Limits to 75 max new slots for any single hospital care in the U.S. today, there is no golden number. But it is clearly
• Favoring teaching hospitals, with priority given to the ones with higher than we have at present—particularly in light of popula-
new medical schools or branch campuses tion growth in Texas and with the aging of the “Baby Boomer”
generation. There is no central authority that determines ‘ideal’
Nevertheless, threats to Medicare and Medicaid GME funding numbers/percentages of physicians by specialty for the U.S. States
tend to appear in most congressional sessions and there is currently that are funding GME expansion generally have some view of
little optimism for these two bills. where state-specific needs are (and usually focus on primary care),
however the projected shortages range throughout the specialties
State Action of medicine.
With congressional action minimal, large states, including Texas,
Texas needs more residency positions, and the Legislature had
have begun funding more GME. The recent Texas legislative session done a great service with its recent funding.
(2015) took a great stride in addressing the shortage here, funding
the following: The Texas Medical Association worked hard to shepherd the state
• $53 million for GME expansion grant programs, almost $40 mil- GME funding through last year, along with many other actions ben-
eficial to physicians and healthcare in Texas. Nevertheless state-level
lion above 2014-15 funding levels efforts will be insufficient to ameliorate this problem.
• $7 million more for primary care physician pipeline programs
• $4 million—or 31 percent—above current funding for the exist- Next year will mark the 20th anniversary of the 1997 funding cap
on GME positions. In this time frame, the population of the United
ing family medicine residency programs States has grown from approximately 270 million to 327 million.
• $3 million to restart the Statewide Primary Care Preceptorship Texas has seen an increase of approximately 8 million people. We
are experiencing not just a physician shortage, but a healthcare short-
Program age. Action is long overdue to lift this cap and I encourage everyone
• $20 million, or a 22 percent increase in biennium per-resident to support new funding for GME as a crucial measure to address
our physician shortage and improve healthcare education and, ulti-
GME funding mately, healthcare in Texas.
• $50 million (additional funding), or 3 percent biennial increase,
Francisco González-Scarano Dean, School of Med-
in medical student formula funding (excluding small class sup-
plements) icine Executive Vice President for Medical Affairs Uni-
• $8 million for mental health workforce training programs in un-
derserved areas versity of Texas Health Science Center San Antonio
Our GME office submitted an application in November of 2015 John P. Howe, III, MD, Distinguished Chair in
for Texas Higher Education Coordinating Board (THECB) expan-
sion grants for a total request of approximately $2.2 million. The Health Policy Professor of Neurology.
THECB granted Internal Medicine an award of $1,540,000—for
22 resident positions—for this grant period with an increase per slot Related Links / Sources:
to $65,000. This amount per resident, while helpful, is insufficient
to cover all costs associated with training and accreditation, so it has Costs Associated with Residency Training” by Lois Bready, MD, & M.
been essential to partner with other funding sources. Philip Luber, Texas Medicine, Feb. 2016)
www.texmed.org/Template.aspx?id=35119
The grants are for two years each—corresponding to the Legisla-
tive biennial budget. With looming shortfalls anticipated in the next Texas Medical Association, 2015 legislation overview:
biennium, it is unclear at what funding level this program will con- www.texmed.org/Template.aspx?id=33973
tinue—another challenge for GME programs which are a minimum
of three years (programs must have funding for each resident to Texas Higher Education Coordinating Board Web Page / GME Expan-
complete the program). The total awards for this grant for all schools sion: www.thecb.state.tx.us/index.cfm?objectid=3FD8E859-9DF9-FD8A-
in Texas are approximately $49 million. 9E2C1F37D99CD78A
38 San Antonio Medicine • June 2016 Results and Data: 2016 Main Residency Match®
www.nrmp.org/wp-content/uploads/2016/04/Main-Match-Results-and-
Data-2016.pdf
American Association of Medical College Advocacy / legislation review:
www.aamc.org/newsroom/keyissues/physician_workforce/
American Association of Medical College 2015 State Physician Work-
force Data Book: www.aamc.org/data/workforce/reports/442830/state-
dataandreports.html
