Spotlighting Medical Resident Training and Education: GME Month

benzilDeborah L. Benzil, MD, FACS, FAANS, AANS (right)
Chair, AANS/CNS Communications and Public Relations Committee
Mount Kismo Medical Group
Columbia University Medical Center
Mt Kisco, New York

Graduate medical education (GME) provides the essential foundation for the future of medicine, including neurosurgery. As such, Neurosurgery Blog will devote the month of March to a comprehensive consideration of GME and the education and training of neurosurgical residents. In all of the vocal and contentious debate about health care reform, little attention has been given to the critical issues surrounding GME. However, there are few things in medicine with more potential to affect looming, long-term challenges in health care including medical workforce, patient safety, innovation, research and patient care.

In the United States, aspiring doctors typically devote four years to undergraduate study, followed by an additional four years in medical school. Upon graduation, a young physician will likely have mountains of debt (more than $180,000 based on the latest data) with a lifetime of repayments. Although graduates have earned the designation of “MD,” they still have years of specialized training and supervision ahead of them before qualifying for board certification and independent medical practice. This component of physician training is designated as “post-graduate” and encompasses the internship and residency training — all of which fall under GME rules and regulations.

Understanding the issues related to GME is challenging because the system has evolved piecemeal over the last 100 years. The following players, among others, all are directly involved in some aspect of GME:

Within neurosurgery, this complex system becomes even more challenging because of the length of post-graduate training — a minimum of seven years, followed by several additional years of fellowship training in areas such as spine, pediatrics and endovascular. Neurosurgical residents also provide a significant portion of first responders for trauma and emergency interventions. As these are overwhelmingly at night and on weekends, this complicates neurosurgical resident workforce and coverage needs.

matchMarch is the watershed month for senior medical students, when, on a single day mid-month — designated as “Match Day” — they will learn where they have acquired their residency training position. Because March is such a pivotal time in the lifecycle of medical education and training, the month is often considered “GME Month.” During the coming days and weeks Neurosurgery Blog will address many important topics related to GME, including:

  • Physician workforce;
  • GME funding;
  • Medical student debt;
  • Resident work hours; and
  • Innovation in training and education.

Neurosurgery is leading the way on many important GME issues such as educational innovation, responsible duty hour policy, and support for physician led clinical research. These efforts are working to ensure the future of medicine, especially in the areas of workforce, access to care, and quality outcomes.

Editor’s Note: During the month of March, we encourage everyone to join the conversation online by using the hashtag #gmemonth.

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