Letters to the Editor
To the Editor:
The Medicare program provides about $9.5 billion a year to teaching hospitals in direct graduate medical education (DGME) and indirect medical education (IME) payments to cover some of the costs of training residents and the patient care mission. As someone who works on Medicare GME funding issues, it has always struck me as important for residents to understand the purpose of this funding. If you ask the average resident to tell you what the Medicare program pays for, I suspect he or she will know it provides insurance for elderly Americans. But I doubt many could name their own training as one of the things Medicare helps to cover. While it may be understandable that the average American doesn’t know about this federal funding, shouldn’t the residents, whose training is in part being financed by these programs, know?
Residents’ curricula are certainly jam-packed with requirements, and getting anything on the overworked resident’s radar is always a challenge, but I don’t think the education on this subject has to be elaborate. Of course, it would be great if information about this funding were presented as part of residents’ orientation or built into required courses, but I think there are other ways of communicating the message. Perhaps welcome packets for new residents could include a description of how the missions of teaching hospitals are funded. Or, every student could be provided with a summary about this funding (see, for example, the guide published by the Association of American Medical Colleges entitled Medicare Payments for Graduate Medical Education: What Every Medical Student, Resident, and Advisor Needs to Know1—a publication that will be updated later this year).
In the academic medicine community, we do ourselves a disservice by not ensuring that our residents at least know the important role the federal government plays in their training. We continually struggle to educate new members of Congress on the value of DGME and IME payments to teaching hospitals. But how much more effective would our message be if it included the voices of the nation’s residents? It strikes me that it’s difficult to fight a battle when the foot soldiers don’t even know they’re part of the army.
Lori Mihalich-Levin, JD
Director, Hospital and GME Payment Policies, Association of American Medical Colleges, Washington, DC; firstname.lastname@example.org.