Toward Graduate Medical Education (GME) Accountability

Measuring the Outcomes of GME Institutions

About the Research

Authors: Chen, Candice MD, MPH; Petterson, Stephen PhD; Phillips, Robert L. MD, MSPH; Mullan, Fitzhugh MD; Bazemore, Andrew MD, MPH; O’Donnell, Sarah D. MPH

Originally appearing in Academic Medicine, September 2013 – Volume 88 – Issue 9

Abstract

Graduate medical education (GME) plays a key role in the U.S. health care workforce, defining its overall size and specialty distribution and influencing physician practice locations. Medicare provides nearly $10 billion annually to support GME and faces growing policy maker interest in creating accountability measures. The purpose of this study was to develop and test candidate GME outcome measures related to physician workforce.

Results

Average overall primary care production rate was 25.2% for the study period, although this is an overestimate because hospitalists could not be excluded. Of 759 sponsoring institutions, 158 produced no primary care graduates, and 184 produced more than 80%. An average of 37.9% of internal medicine residents were retained in primary care, including hospitalists. Mean general surgery retention was 38.4%. Overall, 4.8% of graduates practiced in rural areas; 198 institutions produced no rural physicians, and 283 institutions produced no Federally Qualified Health Center or Rural Health Clinic physicians.

Click here to read on.