| 6350 Graduate Medical Education in Ambulatory Settings |
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| This report examines the affiliations between primary care residency programs and the ambulatory training sites associated with them. It studies the exchanges of personnel, capital, and finances between these entities in order to develop an understanding of how these residency programs operate within the current funding environment for graduate medical education (GME). Information collected in a series of interviews with a total of eight primary care residency programs (four family practice programs, two general internal medicine programs, and two general pediatrics programs) was synthesized according to several key elements, including: (1) organization; (2) operations; (3) residents; (4) supervising physicians; and (5) the health care marketplace. The interviews reveal that: (1) there is not a significant amount of cost sharing between the programs and their affiliated ambulatory training sites; (2) the programs operate fairly well within the current GME funding environment despite limitations to GME funding mechanisms; (3) programs are unaware of their resource costs for resident training and are unaware of how their affiliated teaching hospitals use Medicare GME funding in the medical education process; (4) programs have varied their responses to the changing health care marketplace: those involved in health maintenance organizations are active in their response to managed care while others are relatively passive; and (5) despite the fact that physicians employed by ambulatory training sites may not be as productive when they have to supervise residents, these physicians appear willing to participate in resident training. The report also notes that the number of graduating medical students seeking primary care residencies is growing, that funding for all residencies is decreasing, that outpatient placement opportunities are likely to decrease, and that cost pressure on ambulatory training sites may make them unwilling to absorb future training costs. | |
| Project Officer: | Townsend, Jessica |
| Health Resources and Services Administration | |
| 301-443-0371 | |
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