Medical education in a changing world: thoughts from California

Area of Science:

• Medical Education
• Health Services Research
• Primary Care Training

Background:

• Healthcare delivery system changes impact medical education.
• Family practice training programs face unique challenges serving underserved populations.

Purpose of the Study:

• To identify and address six major issues impacting family practice graduate medical education (GME) in California.
• To propose strategies for sustaining GME programs within managed care environments.

Main Methods:

• Commentary and analysis of current trends in healthcare and medical education.
• Identification of six key challenges facing primary care GME programs.

Main Results:

• Eroding patient base for training programs.
• Limited or no graduate medical education (GME) funding within Medicaid managed care.
• Barriers to resident utilization in managed care systems.
• Disproportionate share funding and capitated programs do not adequately support GME.
• Healthcare market consolidation threatens training sites.

Conclusions:

• Primary care GME programs must partner with community-based sites to enhance patient care, education, and revenue.
• Redesigning delivery systems for efficiency and cost-effectiveness is essential.
• Increased advocacy by family medicine educators is needed to secure direct GME funding.