Jackson Angela, Baron Robert B, Jaeger Jeffrey, Liebow Mark, Plews-Ogan Margaret, Schwartz Mark D
Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, 72 East Concord Street, A-208, Boston, MA, USA,
J Gen Intern Med. 2014 Nov;29(11):1546-51. doi: 10.1007/s11606-014-2847-4. Epub 2014 Apr 15.
The Graduate Medical Education (GME) system in the United States (US) has garnered worldwide respect, graduating over 25,000 new physicians from over 8,000 residency and fellowship programs annually. GME is the portal of entry to medical practice and licensure in the US, and the pathway through which resident physicians develop the competence to practice independently and further develop their career plans. The number and specialty distribution of available GME positions shapes the overall composition of our national workforce; however, GME is failing to provide appropriate programs that support the delivery of our society's system of healthcare. This paper, prepared by the Health Policy Education Subcommittee of the Society of General Internal Medicine (SGIM) and unanimously endorsed by SGIM's Council, outlines a set of recommendations on how to reform the GME system to best prepare a physician workforce that can provide high quality, high value, population-based, and patient-centered health care, aligned with the dynamic needs of our nation's healthcare delivery system. These recommendations include: accurate workforce needs assessment, broadened GME funding sources, increased transparency of the use of GME dollars, and implementation of incentives to increase the accountability of GME-funded programs for the preparation and specialty selection of their program graduates.
美国的毕业后医学教育(GME)系统赢得了全球的尊重,每年有超过8000个住院医师培训项目和专科医师培训项目培养出25000多名新医生。GME是美国进入医疗实践和获得行医执照的入口,也是住院医师培养独立行医能力并进一步制定职业规划的途径。GME职位的数量和专业分布决定了我国全国劳动力的总体构成;然而,GME未能提供适当的项目来支持我国社会医疗保健系统的服务。本文由普通内科医学协会(SGIM)健康政策教育小组委员会撰写,并得到SGIM理事会的一致认可,概述了一系列关于如何改革GME系统的建议,以便最好地培养一支能够提供高质量、高价值、基于人群且以患者为中心的医疗保健服务的医生队伍,使其符合我国医疗保健服务系统的动态需求。这些建议包括:准确的劳动力需求评估、拓宽GME资金来源、提高GME资金使用的透明度,以及实施激励措施,以提高由GME资助的项目在培养其项目毕业生和专业选择方面的问责制。