Guest Post from Deborah L. Benzil, MD, FACS, FAANS
Vice President, AANS
Chair, AANS/CNS Communications and Public Relations Committee
Mount Kismo Medical Group
Columbia University Medical Center
Mt Kisco, New York
This is no joke. The future of the American health care system rests firmly on the shoulders of our graduate medical education (GME) system. This system provides the essential transition from the mostly theoretical education and necessary foundations in medical school through supervised, progressive responsibility of residency to independent practice. These are also the years that can serve as the foundation for the innovation that tomorrow’s doctors will bring for new treatment interventions and thus improved value and quality in patient care. Unfortunately, the GME system can also serve as a critical “bottleneck” to solving the looming physician shortage crisis, as the total number of currently available positions does not correspond to future needs. This last statement is, even more, concerning since many agree that it is true but we lack a precise method for predicting exactly how much of a gap we will have to expect.
Given the absolute importance of this system, we give our sincere thanks to all those who are devoted to making these GME programs succeed, especially the dedication of:
- Medical schools; and
- Academic Health Centers and Teaching Hospitals.
We also acknowledge the complex system of players who are directly involved in GME programs, just to name a few:
- Medical schools and academic medical centers/teaching hospitals, including the Association of American Medical Colleges (AAMC);
- Accreditation Council for Graduate Medical Education (ACGME), including the Residency Review Committees;
- American Board of Medical Specialties (ABMS);
- American Medical Association;
- Council of Medical Specialty Societies;
- U.S. Congress;
- Centers for Medicare and Medicaid Services;
- Veteran’s Administration;
- Council on Graduate Medical Education; and
- State governments, including State medical boards.
Perhaps most importantly, we thank our patients, many of whom put their faith in the hands of our nation’s teaching hospitals. Without you, we would not be able to train and educate the next generations of physicians.
Throughout the month of March (and part of April) — in rapid succession that led us to invoke similarities to National Collegiate Athletic Association (NCAA) basketball tournament’s “March Madness,” — we have focused on the breadth and depth of issues related to GME:
- An Overview of GME Month helped launch the entire series;
- A spectacular post from Atul Grover, MD, PhD, on Achieving Accountability for Graduate Medical Education;
- Representative Joe Crowley (D-N.Y.) gave us a post on Increasing Residency Slots to prevent the looming doctor shortage;
- Enhancing leadership education for residents was highlighted by Krystal Tomei, MD;
- Neurosurgery Leading the Way in GME education by Nate Selden, MD, tells the story of setting common foundations for budding residents using boot camps;
- Robert Harbaugh, MD, delivered an important Assessment of Resident Work-hour Regulations;
- Faces of Neurosurgery highlighted mentoring as a critical component of GME by Kris Kimmel, MD;
- Match Day for Neurosurgery by Clemens Schirmer, MD, gives perspective to Neurosurgery’s part in the match process;
- Neurosurgical GME Inspiring Innovation by Drs. Alan Friedman and Robert M. Friedlander, provides an in-depth view of The RUNN.
- March Madness: a special grand rounds summary of informative blogosphere items related to GME was compiled by Deborah Benzil, MD, and Clemens Schirmer, MD;
- An op-ed by H. Hunt Batjer, MD, tells why we need to Ensure an Adequate Specialty Physician Workforce for the 21st Century;
- Drs. Babu and Deutsch delivered the goods on the Medical School Debt Crisis and its impact on GME;
- An engaging GME focused animation which provides an overview of the match process, looming physician shortage and the importance of increasing GME funded residency training slots; and
- Two infographics were developed to clearly illustrate the Facts about the Looming Physician Shortage and 3 Ways it Affects Patients Access to Specialty Care.
Neurosurgery has been on the frontlines and in the trenches on many important GME issues notably innovation in education, responsible duty hour regulations and programs that encourage clinical research led by talented physicians. Our specialty will continue to play a crucial role in helping to educate stakeholders and understand better the complex GME system. We all need a system that ensures that we all will have excellent physicians to care for us in the future in case we need a doctor. Of all things uncertain in the future of healthcare, this is an almost certainty.
Editor’s Note: We encourage everyone to join the conversation online by using the hashtag #GMEMatters.