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CMA sponsors bill to increase primary care residency slots in California



March 21, 2014
Area(s) of Interest: Advocacy Physician Workforce Professional Development & Education 

Today is National Match Day, the day when thousands of California medical students learn 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.


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 there are not enough training positions 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.


The California Medical Association (CMA) and the California Academy of Family Physicians are cosponsoring AB 2458, which would create a graduate medical education (GME) fund to increase the number of medical residency slots in the state.


“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), the author of the bill. “The goal [of AB 2458] 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.”


The National Resident Matching Program matches graduating medical students with residency programs 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.


Federal, state and private funds pay for GME, with Medicare contributing the bulk, about $9.5 billion annually. However, 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.


“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 CMA President Richard Thorp, M.D. “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 was introduced in February and will be heard in the Assembly Health Committee on April 22, 2014, during CMA's Legislative Leadership Day.

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