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Graduate medical education, 1998-1999: a closer look.
R S Miller1, M R Dunn, T Richter
1Operations and Data Analysis, Accreditation Council for Graduate Medical Education, Chicago, IL 60610, USA. rmiller@acgme.org
JAMA
|September 9, 1999
Summary
Physician workforce planning faces challenges due to long training times. Recent data show a slight decrease in resident numbers and shifts in graduate sources, potentially impacting future physician supply.
Area of Science:
- Medical Education
- Health Workforce Analysis
- Physician Supply Dynamics
Background:
- The physician workforce faces critical imbalances in total numbers and specialty distribution.
- Graduate medical education (GME) training length hinders rapid correction of workforce imbalances.
- Existing GME data collection lacks systematic planning mechanisms.
Purpose of the Study:
- To analyze Graduate Medical Education (GME) activities and trends from 1998-1999.
- To identify subtle but potentially significant changes in the physician workforce.
- To inform future physician workforce planning and policy.
Main Methods:
- Analysis of the American Medical Association Annual Survey of Graduate Medical Education Programs (1998-1999).
- Examination of trends in resident physician numbers, program growth, and graduate sources over 3-6 years.
- Comparison of International Medical Graduates (IMGs) and US medical graduates' participation and training duration.
Main Results:
- Total resident physicians decreased slightly in 1998, while GME programs increased.
- US medical graduate entry remained stable; osteopathic graduates increased significantly; IMGs decreased.
- IMGs pursued longer training durations; primary care specialty growth plateaued; residents leaving programs early increased.
- A significant portion of IMGs entering GME are US citizens or permanent residents.
Conclusions:
- Despite apparent stability, subtle shifts in GME participation and graduate sources warrant attention.
- Reduced GME funding and other factors may influence these trends.
- Identifying and monitoring factors affecting the physician workforce is crucial for future planning.
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