Aligning Strategic Interests in an Academic Medical Center: A Framework for Evaluating GME Expansion Requests

Area of Science:

• Medical Education
• Health Systems Management
• Systems Engineering

Background:

• Maine Medical Center received numerous requests for new or expanded graduate medical education (GME) programs in 2017.
• A lack of a prioritization process hindered the allocation of scarce GME resources.

Purpose of the Study:

• To develop a strategic framework for assessing and prioritizing GME program expansion requests.
• To maximize benefits for patients, learners, and the institution while aligning with regional and societal priorities.

Main Methods:

• Applied a systems engineering methodology, "tradespace exploration," to a 6-step prioritization process.
• Utilized peer evaluation for program scoring and correlation analysis to assess category relevance.
• Incorporated stakeholder feedback for iterative refinement of the assessment process.

Main Results:

• Identified five key categories for GME expansion: institutional priorities, health care system priorities, regional/societal needs, program quality, and financial considerations.
• Most categories correlated well with final scores (R² range 0.413-0.662), excluding program quality.
• Recommended three of 18 requested programs for funding; stakeholder feedback indicated the process was perceived as unbiased and rigorous.

Conclusions:

• A systems engineering approach offers a reproducible framework for evaluating GME expansion requests.
• The framework enables comprehensive consideration of institutional, health system, and societal needs, alongside program quality and financial factors.
• This systematic method supports strategic resource allocation in graduate medical education.