Today, the Centers for Medicare & Medicaid Services (CMS) published its list of teaching hospitals that were awarded new Medicare-supported graduate medical education (GME) positions created under Section 126 of the Consolidated Appropriations Act, 2021 (CAA, 2021). These 200 additional residency positions will help grow the physician workforce and expand access to care for patients across the country. CMS identified that approximately 70% of the newly awarded positions will go to primary care and psychiatry residency programs.
“These new residency positions will have a tangible, positive impact on a diverse mix of communities across the nation, including traditionally underserved areas,” said AAMC President and CEO David J. Skorton, MD. “Medical school enrollment has continued to grow, but a commensurate increase in residency positions is necessary to help ensure that there are enough opportunities for medical school graduates to complete their training and practice independently.”
The AAMC projects that the United States will face a shortage of up to 86,000 physicians by 2036. Demographic factors —specifically, a growing and aging population and physician workforce that is aging as well—continue to drive an impending shortage of doctors and threaten the health of our population.
In 2021 and 2023 year-end spending packages—CAA, 2021 and the Consolidated Appropriations Act, 2023 (CAA, 2023), Congress voted to expand Medicare support for GME, the only increases since the Balanced Budget Act of 1997 capped the number of Medicare-supported residency positions. CMS in 2022 announced the initial distribution of the new Medicare-supported residency position awards and has distributed additional positions each year since. This is the third distribution of positions provided by the CAA, 2021. To date, CMS has awarded half of the 1,200 total positions made available under these two laws. In this round of distributions, 109 teaching hospitals across 33 states received slots, which will go into effect July 1, 2025.
“Teaching health systems and hospitals that choose to train medical residents incur real and significant mission-related costs beyond those typically associated with providing patient care,” said Jonathan Jaffery, MD, AAMC chief health care officer. “These residency positions are crucial to helping America’s academic health systems and other teaching hospitals invest in more physician training, increase access to care, and better serve patients nationwide.”
AAMC-member institutions self-fund the training of a large number of medical residents without any federal financial support. An increase in the number of Medicare-supported GME positions will enable health systems across the country to grow the number of physicians they currently train and expand the physician workforce, and the AAMC applauds CMS’s efforts to address this priority.
“The AAMC, our members, our partners in the GME Advocacy Coalition, and Congressional champions have worked tirelessly on increasing the number of Medicare-supported GME positions to help address the physician shortage and improve health for patients nationwide,” said AAMC Chief Public Policy Officer Danielle Turnipseed, JD, MHSA, MPP. “Both the CAA 2021 and 2023 were important initial steps toward helping to alleviate the national physician shortage, and chip away at the cap on slots that has been in effect for almost 25 years. Additional Medicare-supported GME slots are needed to ensure we have qualified physicians to meet the growing and ever-changing health care needs of patients everywhere.”
The AAMC urges Congress to build on the historic investments already made through the CAA, 2021 and 2023 by passing the Resident Physician Shortage Reduction Act of 2023 (S. 1302/H.R. 2389). This bipartisan legislation would gradually increase the number of Medicare-supported GME positions, enabling critical progress toward growing a sustainable physician workforce to meet the nation’s patient care needs.