Health Resources and Services Administration and Veterans Affairs Funding Intersections Expand Graduate Medical...

This article examines intersections of complementary efforts by the US Department of Veterans Affairs (VA) and the Health Resources and Services Administration (HRSA) to expand and sustain physician training in medically underserved areas and populations. Since 2011, HRSA has supported workforce development initiatives like Teaching Health Center Graduate Medical Education (THCGME), Rural Residency Planning and Development (RRPD), and Teaching Health Center Planning and Development (THCPD). Since 2008, VA has funded the Veterans Access, Choice, and Accountability Act, the MISSION Act, and other graduate medical education (GME) bolstering initiatives.

First, this report describes HRSA and VA investments in rural and community-based GME programs over two decades. Second, it summarizes specialty distribution, VA-supported full-time equivalent (FTE) positions, and resident training time at VA and rural sites across HRSA-funded residency programs with VA affiliations.

Under Aim 1, we identified characteristics of three HRSA and five VA GME financing initiatives focused on rural and community-based settings. Under Aim 2, we identified 29 GME programs funded by HRSA and affiliated with 19 VA Medical Centers (VAMCs) (AY 2011-2025), primarily in family medicine, psychiatry, and internal medicine. VA-funded resident FTEs increased markedly across all HRSA-funded residencies, led by THCGME awardee growth from 5.0 to 102.4 FTEs between AY 2011 and 2025. Median VAMC training time was 11.1, while rural residencies spent a median 57.0% of training time in rural settings.

VA-HRSA funding intersections have contributed to rural and community-based GME program expansion over the past two decades, which can improve access to care for both rural and veteran populations.