1997年のバランスのとれた予算法 (Balanced Budget Act) の前後のアメリカ在住者研修
Edward Salsberg1, Paul H Rockey, Kerri L Rivers
1Center for Workforce Studies, Association of American Medical Colleges, 2450 N St NW, Washington, DC 20037, USA. esalsberg@aamc.org
JAMA
|September 11, 2008
まとめ
1997年のバランスのとれた予算法 (BBA) は当初,医科大学院 (GME) の医師養成の成長を一時停止させた. しかし,2002年から2007年にかけて,国際的な医学卒業生とサブスペシャライゼーションにより,その数は大幅に増加しました.
科学分野:
- 医療教育 医療教育について
- 医者の労働力開発について
- 医療政策分析 医療政策分析
背景:
- 卒業医学教育 (GME) は,将来の医師の労働力を形作るものです.
- 1997年のバランスのとれた予算法 (BBA) は,GMEに対するメディケアの資金提供に影響を与え,GMEの成長を阻害する可能性があることを懸念しました.
研究 の 目的:
- 1997年のバランス予算法 (BBA) の前後における在住者の訓練数と特徴を分析する.
- GMEの最近の傾向を専門分野,性別,教育環境によって調べる.
主な方法:
- アメリカ医学会とアメリカ医学部協会の全米GME国勢調査データを活用した記述的研究.
- 分析は,大学院医学教育認定評議会 (ACGME) 認定プログラムに参加している医師に焦点を当てた.
- 居住者数と特性の変化を調査した.BBA前と後の.
主要な成果:
- 医師の研修生数は1997年から2002年にかけて安定していたが,2007年までに8.0%増加した.
- GMEの増加は,主に国際医学卒業生 (IMG) の増加によるものです.
- 米国のMDは増加したが,より長いサブスペシャリティトレーニングにシフトし,プライマリケア医は減少し,プライマリケアではIMGが増加した.
結論:
- 1997年のBBAは,GMEの医師研修に一時的な停滞をもたらしたのかもしれない.
- ACGMEが認定したプログラムでは,2002年から2007年の間にレジデントとフェローの数が著しく増加しました.
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