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State budget includes $7 million for primary care residency slots



June 17, 2014
Area(s) of Interest: Physician Workforce Professional Development & Education 

Following the unprecedented grassroots advocacy by the physician and medical student community, the Legislature approved a state budget that includes $7 million for primary care residency slots. The budget is now on Governor Brown's desk awaiting his signature. The California Medical Association is urging all physicians to contact the governor's office and urge him to maintain this critical funding, which will help California meet the increased demand for medical services now that millions of additional patients are insured under the Affordable Care Act.

Three million dollars would be applied to expand the Song-Brown program to all primary care specialties (family medicine, internal medicine, obstetrics-gynecology and pediatrics). The additional $4 million will fund residency programs that wish to expand and train more residents. The budget act requires priority be given to programs that have graduates of California-based medical schools, reflecting the overwhelming data that physicians who obtain their medical degree and complete training in California are very likely to practice in the state.

Although federal, state and private funds pay for graduate medical education (GME), federal contributions through Medicare contribute the bulk, about $9.5 billion annually nationwide. Unfortunately, this federal funding source has been frozen since 1997 despite California’s population having grown by 20 percent in the same timeframe.

Our state has a trove of primary care physicians who want to train here, including those who have graduated from California medical schools, but who are forced to leave the state because training slots at medical residency programs are limited. Given the inaction by the federal government to address this issue coupled with the immediate need to train additional physicians, California needs to take the lead to ensure our state has an adequate physician supply. Unfortunately, California has only 26.3 residents per 100,000 people, severely lagging behind the national average of 36.6.

The California Medical Association (CMA) is thrilled with the inclusion of this funding in the state budget and sees it as a significant achievement, representing the first real investment of state funding to support GME.

Now we must convince the Governor that this important funding should be maintained. In California, the Governor has the power to reduce expenditures in the state budget (often referred to as “line-item veto” authority), while signing the underlying budget act. We need to demonstrate the overwhelming support this funding has and argue why it’s particularly important given California’s ongoing physician shortage.

We ask that you and your colleagues call or fax the governor's office or visit his website and urge him to support increased funding for GME.

More information, including talking points and a sample letter are available in CMA's grassroots action center.

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