Share this article on:

Looking at Graduate Medical Education Through a Different Lens: A Health Care System’s Perspective

Roemer, Beth M. MPH; Azevedo, Theresa; Blumberg, Bruce MD

doi: 10.1097/ACM.0000000000000828

In the era of the accountable care organization, U.S. models of physician practice are shifting from the solo, independent practitioner to the physician who is part of a multispecialty group practice or is employed by a health care institution, and from paper-based small offices to practice settings that emphasize technology-enabled, team-based systems of care. In this light, Kaiser Permanente’s (KP’s) long experience as an integrated, population-based health care delivery system makes it an increasingly relevant model in which to consider how graduate medical education (GME) can best prepare physicians for 21st-century health care. KP’s multiple perspectives—as a GME setting, a health care delivery system, a health research enterprise, a community benefit organization, and the nation’s largest private, multispecialty group practice of physicians—provide a multifaceted opportunity to consider GME in the context of health care transformation. The authors suggest that all participants in medical education have a role to play in preparing physicians for this future. They recommend that partnerships between universities and health care delivery systems serve as a highly effective model for education; that to better serve the needs of society, medical education institutions must adopt a broad community benefit mindset; and that, when medical groups and other institutions that employ physicians take the baton from GME, they need to commit to ongoing development and lifelong learning to enable their new physicians to reach their full potential.

B.M. Roemer is executive director of medical education implementation strategy, Kaiser Permanente Program Office, Oakland, California.

T. Azevedo is associate institutional director of graduate medical education, Kaiser Permanente Northern California, Oakland, California.

B. Blumberg is institutional director of graduate medical education, Kaiser Permanente Northern California, Oakland, California.

Funding/Support: None reported.

Other disclosures: B.M. Roemer is an employee of Kaiser Foundation Health Plan, Inc. B. Blumberg is a shareholder of the Permanente Medical Group, Inc. T. Azevedo is an employee of Kaiser Foundation Hospital. All entities are part of Kaiser Permanente’s integrated system.

Ethical approval: Reported as not applicable.

Correspondence should be addressed to Beth M. Roemer, Kaiser Permanente, One Kaiser Plaza, Suite 1804, Oakland, CA 94612; telephone: (510) 271-2375; e-mail:

© 2015 by the Association of American Medical Colleges