March 21, 2014
Area(s) of Interest: Physician Workforce Professional Development & Education
Sacramento – Thousands of California medical students learn on Friday, national Match Day, whether they can begin their practice of medicine here or must move to training programs in other states. National Match Day is the day graduating medical students nationwide learn the location of their residency programs, the next step in training after four years of medical school.
Medical students select a residency program based on the medical specialty they plan to pursue as well as the specifics of a program, which may include particular aspects of training or simply geography.
Because of funding constraints, California – where significant areas of the state already face physician shortages, especially in primary care – lacks a sufficient number of primary care residency opportunities for graduating medical students. This means that scores of well-qualified new physicians who would like to train here, instead must leave the state because not enough training positions are available to accommodate them.
Legislators and physician organizations in California are partnering to help relieve this shortage of family medicine and other primary care residency program positions and thereby address the primary care physician shortage.
“As millions more Californians gain coverage under health care reform, we will need more physicians to care for them,” said Assemblymember Susan Bonilla (D-Concord). “Because our state already faces a shortage of primary care physicians, I’ve introduced Assembly Bill 2458 to create a Graduate Medical Education Fund. The goal is to increase the number of medical residency slots in physician training programs that graduate primary care physicians and serve the underserved. This will help address the shortage and ensure that patients can find physicians to provide the care they need.”
AB 2458 is co-sponsored by the California Academy of Family Physicians (CAFP) and the California Medical Association (CMA).
“Numerous areas of California already are formally designated by the state as primary care shortage areas where there are too few primary care providers to adequately meet the health care needs of the people who live there,” said Mark Dressner, M.D., CAFP president. “We are co-sponsoring AB 2458 because of this urgent need for more family physicians and other primary care doctors. California must make this a priority this year and in the future to ensure access to care for patients. Research shows that people in communities with full access to primary care physicians are healthier, thanks to the preventive care and expert care for chronic conditions we provide.”
“As millions of patients enter the health care delivery system, we need to ensure that access for medical attention is more than an empty promise with an insurance card,” said Richard Thorp, M.D., CMA president. “Increasing funding for residency programs in California means immediate relief, as hundreds of physicians will be able to remain in California rather than being forced out of state to begin their medical careers. AB 2458 is a start to ensuring that more physicians will be able to treat patients across California.”
About the Match
The National Resident Matching Program® (NRMP®) is a nonprofit organization founded in 1952 by medical students seeking to standardize the residency selection process and establish a uniform date of appointment to positions in graduate medical education (GME) training programs. NRMP conducts its matches using a mathematical algorithm that pairs the rank-ordered preferences of applicants and program directors to produce a “best fit” for filling available training positions.
Graduate Medical Education (GME) is the hands-on training phase of physician education that is mandatory for doctors to obtain licenses for independent practice. Federal, state and private funds pay for GME, with Medicare contributing the bulk, about $9.5 billion annually.
The Medicare portion of the funding has been frozen since 1997, despite a 20 percent growth in California’s population during that time. In addition, many residency program leaders say that funding received from Medicare and Medicaid does not fully cover the cost of even the current residency training slots, so sponsoring institutions must absorb residual costs.
AB 2458 was introduced in February and will be heard in Assembly Health Committee on April 22, 2014.