• Like
  • Save
Tectonic Plates of GME- Fitzhugh Mullan
Upcoming SlideShare
Loading in...5
×
 

Tectonic Plates of GME- Fitzhugh Mullan

on

  • 133 views

This presentation was given at FMCC on April 7, 2014 as part of a panel on Workforce Development. The session focused on thr innovative Teaching Health Center program which supports family medicine ...

This presentation was given at FMCC on April 7, 2014 as part of a panel on Workforce Development. The session focused on thr innovative Teaching Health Center program which supports family medicine training.

Statistics

Views

Total Views
133
Views on SlideShare
130
Embed Views
3

Actions

Likes
1
Downloads
8
Comments
0

1 Embed 3

http://www.slideee.com 3

Accessibility

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment
  • Sources: MD 1970 - 2008: AAMC Data Book MD 2009-2013 - https://www.aamc.org/download/321532/data/2013factstable27-2.pdfDO 1970-2012 - http://www.aacom.org/data/graduates/Pages/default.aspxDO 2013 - http://www.aacom.org/data/studentenrollment/Documents/prelim%20enroll%20report%202013%20fast%20facts%20103013.pdf
  • Sources: MD 1970 - 2008: AAMC Data Book MD 2009-2013 - https://www.aamc.org/download/321532/data/2013factstable27-2.pdfDO 1970-2012 - http://www.aacom.org/data/graduates/Pages/default.aspxDO 2013 - http://www.aacom.org/data/studentenrollment/Documents/prelim%20enroll%20report%202013%20fast%20facts%20103013.pdf
  • 2008-2012 MD & DO Graduation Data – Actual Graduation data from: MD 2008: AAMC Data Book MD 2009-2013 - https://www.aamc.org/download/321532/data/2013factstable27-2.pdfDO 2008-2012 - http://www.aacom.org/data/graduates/Pages/default.aspxDO 2013 - http://www.aacom.org/data/studentenrollment/Documents/prelim%20enroll%20report%202013%20fast%20facts%20103013.pdfProjected Data: *MD & DO 2013-2017 Based on current enrollment data MD 2013-2017 - 2013 Applicant and Enrollment Data Charts - AAMChttps://www.aamc.org/download/358638/data/2013applicantandenrollmentdatacharts.pdfDO 2013-2017  First-Year Enrollment by Gender 1968-2013 - http://www.aacom.org/data/studentenrollment/Pages/default.aspx**MD & DO2017-2021 – Based on Enrollment data from https://members.aamc.org/eweb/upload/12-237%20EnrollmSurvey2013.pdfDoes not account for attrition
  • 2008-2012 MD & DO Graduation Data – Actual Graduation data from: MD 2008: AAMC Data Book MD 2009-2013 - https://www.aamc.org/download/321532/data/2013factstable27-2.pdfDO 2008-2012 - http://www.aacom.org/data/graduates/Pages/default.aspxDO 2013 - http://www.aacom.org/data/studentenrollment/Documents/prelim%20enroll%20report%202013%20fast%20facts%20103013.pdfProjected Data: *MD & DO 2013-2017 Based on current enrollment data MD 2013-2017 - 2013 Applicant and Enrollment Data Charts - AAMChttps://www.aamc.org/download/358638/data/2013applicantandenrollmentdatacharts.pdfDO 2013-2017  First-Year Enrollment by Gender 1968-2013 - http://www.aacom.org/data/studentenrollment/Pages/default.aspx**MD & DO2017-2021 – Based on Enrollment data from https://members.aamc.org/eweb/upload/12-237%20EnrollmSurvey2013.pdfDoes not account for attrition
  • MD PGY-1 Positions - http://www.nrmp.org/match-data/nrmp-historical-reports/DO PGY1- Positions - https://natmatch.com/aoairp/aboutstats.html
  • 3% Attrition Rate GME Projections2014 – 2020 based on a 1% annual growth MD PGY-1 Positions - http://www.nrmp.org/match-data/nrmp-historical-reports/DO PGY1- Positions - https://natmatch.com/aoairp/aboutstats.html2009-2012 MD & DO Graduation Data – Actual Graduation data from: MD 2009: AAMC Data Book MD 2009-2013 - https://www.aamc.org/download/321532/data/2013factstable27-2.pdfDO 2009-2012 - http://www.aacom.org/data/graduates/Pages/default.aspxDO 2013 - http://www.aacom.org/data/studentenrollment/Documents/prelim%20enroll%20report%202013%20fast%20facts%20103013.pdfProjected Data: *MD & DO 2013-2017 Based on current enrollment data MD 2013-2017 - 2013 Applicant and Enrollment Data Charts - AAMChttps://www.aamc.org/download/358638/data/2013applicantandenrollmentdatacharts.pdfDO 2013-2017  First-Year Enrollment by Gender 1968-2013 - http://www.aacom.org/data/studentenrollment/Pages/default.aspx**MD & DO2017-2021 – Based on Enrollment data from https://members.aamc.org/eweb/upload/12-237%20EnrollmSurvey2013.pdfAll data based on enrollment data – does not account for attrition 2010-2013 MD, DO and Combined graduates – based on real graduation data2013-2017 MD, DO and Combined graduated – based on real enrollment data – no account for attrition MD Graduation Projections2016-2021 – AAMC 2013 Enrollment
  • 3% Attrition RateGME Projections2014 – 2020 based on a 1% annual growth MD PGY-1 Positions - http://www.nrmp.org/match-data/nrmp-historical-reports/DO PGY1- Positions - https://natmatch.com/aoairp/aboutstats.html2009-2012 MD & DO Graduation Data – Actual Graduation data from: MD 2009-2013 - https://www.aamc.org/download/321532/data/2013factstable27-2.pdfDO 2009-2012 - http://www.aacom.org/data/graduates/Pages/default.aspxDO 2013 - http://www.aacom.org/data/studentenrollment/Documents/prelim%20enroll%20report%202013%20fast%20facts%20103013.pdfProjected Data: *MD & DO 2013-2017 Based on current enrollment data MD 2013-2017 - 2013 Applicant and Enrollment Data Charts - AAMChttps://www.aamc.org/download/358638/data/2013applicantandenrollmentdatacharts.pdfDO 2013-2017  First-Year Enrollment by Gender 1968-2013 - http://www.aacom.org/data/studentenrollment/Pages/default.aspx**MD & DO2017-2021 – Based on Enrollment data from https://members.aamc.org/eweb/upload/12-237%20EnrollmSurvey2013.pdfAll data based on enrollment data – does not account for attrition 2010-2013 MD, DO and Combined graduates – based on real graduation data2013-2017 MD, DO and Combined graduated – based on real enrollment data – no account for attrition MD Graduation Projections2016-2021 – AAMC 2013 Enrollment
  • UPDATED – Bazemore – 1/12/09Source: N Engl J Med. 2001 Jun 28;344(26):2021-5.Message: First demonstrated by Kerr White in the classic ecology of medical care studypublished in 1961, and updated by the Robert Graham Center in 2000, physician’soffices remain the largest platform of formal health care in the United States.In a typical month in the US in 2000, of every 1000 individuals: 800 reported symptoms,327 considered seeking medical care, 217 visited a physician’s office (113 of whichwere seen in a primary care office), 65 were seen by a complementary or alternativecare provider, 21 visited a hospital outpatient clinic, 14 received home health care, 13visited an emergency department, 8 were hospitalized, and less than one was seen inan academic health center. The continued focus of education and research onhospitals and the problems seen within them persists and invites policy revisions thatbetter balance education, research, and service toward the needs of the entirepopulation.More information can be found at:1) http://www.grahamcenter.org/online/graham/home/publications/onepagers/2001/op10-contemporary-ecology.html2) http://www.grahamcenter.org/online/graham/home/publications/onepagers/2003/op25-carechildren.html3) www.grahamcenter.org/online/graham/home/publications/articles/2005/byawnmsusing-ecology.html4) http://content.nejm.org/cgi/content/extract/344/26/2021

Tectonic Plates of GME- Fitzhugh Mullan Tectonic Plates of GME- Fitzhugh Mullan Presentation Transcript

  • Fitzhugh Mullan, MD Murdock Head Professor of Medicine and Health Policy George Washington University
  • Number of MD and DO Medical School Graduates from 1970 - 2013 Year NumberofGraduates 0 5000 10000 15000 20000 25000 MD DO Total
  • Academic Year MD Graduates DO Graduates Total Graduates 1980-1981 15,632 1,151 16,783 1990-1991 15,427 1,534 16,961 2000-2001 15,796 2,510 18,306 2001-2002 15,676 2,536 18,212 2002-2003 15,531 2,607 18,138 2003-2004 15,829 2,713 18,542 2004-2005 15,760 2,756 18,516 2005-2006 15,927 2,708 18,635 2006-2007 16,140 3,000 19,140 2007-2008 16,168 3,364 19,532 2008-2009 16,467 3,588 20,055 2009-2010 16,836 3,631 20,467 2010-2011 17,362 4,159 21,521 2011-2012 17,343 4,458 21,801 2012-2013 18,156 4,726 22,882 Number of MD and DO Medical School Graduates from 1980 - 2013 Sources: AAMC and ACCOM
  • 1st Year MD and DO Enrollment In 2003 Compared With Projected 2017 Enrollment Figures 2003 2017 # and % Increase MD 16,541 21,434 4,893 29.6% DO 3,308 6,675 3,367 101.8% _______________________________________________ Combined 19,849 28,109 8,260 41.2% Sources: AAMC Results of the 2012 Medical School Enrollment Survey, May 2013; AAMC Enrollment Data 2008 https://www.aamc.org/download/60740/data/enrollmentdata2008.pdf AACOM – Trends in Osteopathic Medical School Applicants, Enrollment and Graduates
  • Graduates and Projected Number of US MD and DO Graduates from 2008-2021 0 5000 10000 15000 20000 25000 30000 MD DO Total NumberofGraduates Year | Extrapolated | | Projected |
  • Academic Graduation Year MD Graduates DO Graduates Total Graduates 2008-2009 16,467 3,588 20,055 2009-2010 16,836 3,631 20,467 2010-2011 17,362 4,159 21,521 2011-2012 17,343 4,458 21,801 2012-2013 18,156 4,726 22,882 2013-2014* 18,665 5,428 24,093 2014-2015* 19,230 5,788 25,018 2015-2016* 19,517 5,986 25,503 2016-2017* 20,055 6,449 26,504 2017-2018** 20,654 6271 26,925 2018-2019** 21,053 6,222 27,275 2019-2020** 21,255 6,179 27,434 2020-2021** 21,434 6,675 28,109 MD and DO Medical School Graduation Projections from 2008 - 2021 Sources: AAMC and ACCOM *Notes extrapolated data **Notes projected data
  • New Entrants into GME: Entrants into GME Without Prior GME 2010-2013 Sources: NCHWA analysis of data from AAMC and AACOM, April 2012; Number for 2011 is provisional; Number for 2013 is from NRMP and AOA 25,105 25,151 25,384 25,617 25,574 25,959 26,084 26,220 26,692 27,198 27,489 28,450 28,871 29,292 20,000 21,000 22,000 23,000 24,000 25,000 26,000 27,000 28,000 29,000 30,000 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Entrants Year
  • Projected US MD and DO Medical School Graduates (with 3% Attrition Rate) and 1st Year Entrants into GME (2009-2021) Year 2014-2021 data are based on a 1% annual increase in entrants into GME 15,000 17,000 19,000 21,000 23,000 25,000 27,000 29,000 31,000 33,000 2009 2010 2011 2012 2013 2014* 2015* 2016* 2017* 2018** 2019** 2020** 2021** 1st Year Entrants into GME US Medical School Graduates with 3% Attrition Rate
  • Match Year 1st Year Entrants into GME US MD and DO Medical School Graduates (3% Attrition Rate) Difference 2009 27,198 20,055 7,143 2010 27,489 20,467 7,022 2011 28,450 21,521 6,929 2012 28,871 21,801 7,070 2013 29,292 22,882 6,410 2014* 29,585 23,370 6,215 2015* 29,881 24,267 5,613 2016* 30,180 24,738 5,442 2017* 30,481 25,709 4,772 2018** 30,786 26,117 4,669 2019** 31,094 26,457 4,637 2020** 31,405 26,611 4,794 2021** 31,719 27,266 4,453 Projected US MD and DO Medical School Graduates (with 3% Attrition Rate) and 1st Year Entrants into GME (2009-2021) *Notes extrapolated data **Notes projected data 2014-2021 data are based on a 1% annual increase in entrants into GME
  • Teaching Health Centers and THCGME
  • White K. et al, The Ecology of Medical Care, NEJM, 1961
  • L. Green et al., The Ecology of Medical Care Revisited, NEJM, 2001
  • • GME History • Teaching in Health Centers • The ACA opportunity • Section 5508 of the ACA established the Teaching Health Center Graduate Medical Education (THCGME) program Teaching Health Centers
  • • The program is funded at $230 million from FY2011 to FY2015, a five year initiative. • Administered by the Health Resources and Services Administration (HRSA). • Under the jurisdiction of the Senate Health Education Labor and Pension (HELP) Committee, and the House Energy and Commerce Committee. THCGME Program
  • • There are 44 THCs in 21 states across the country. – 3 states (Colorado, Florida and Tennessee) will be added in the 2014 THC cohort. • THCs are located in underserved communities in rural and inner city areas. • Each year new THCs are added to the program. – In 2011 - 11 total THCs – In 2012 - 22 total THCs – In 2013 - 44 total THCs Current THCs
  • THC Residency Numbers 2011 2012 2013 Number of THC Programs 11 22 44 PGY-1 THC Residents 44 154 273 # of residents per year in steady state 132 462 819
  • Specialty Number of THCs Dental 2 Family Medicine 29 Internal Medicine 5 OB/GYN 2 Pediatrics 3 Psychiatry 3 THC Residency Specialties
  • THC Accreditation THC Year ACGME AOA ACGME/AOA CODA N/A 2011 5 1 4 1 0 2012 0 9 1 1 0 2013 8 11 2 0 1 Total 13 21 7 2 1
  • • GW was awarded the Evaluation and Initial Assessment of HRSA Teaching Health Centers contract. • This is a five year contract to better understand this model of community-based residency training, including an examination of the: – costs of training in THCs – contributions to the primary care workforce, particularly in underserved communities. THC Evaluation Project
  • • THC funding will end in 2015. • THC classes that began in July 2013 do not have funding for the last 9 months of their training. • Future classes will have even less time funded. • THC programs may only be able provide partial training to residents, and are hesitate to recruit or continue to expand their training programs. Challenges for Teaching Health Centers
  • • On November 23, 2013 Senator Bernie Sanders (I-VT) introduced Senate Bill 1759, Teaching Health Center Reauthorization Act, which provides $800 million in funding to reauthorize the THCGME program for an additional five years. • House staffers are examining a short-term funding patch. This patch will provide approximately $90 million to allow THCs to maintain full funding for all residents in their programs for academic year 2015-2016. Options to Extend Funding for THCs
  • • The President’s FY 2015 Budget increases funding for primary care residency positions. • THCGME program is not specifically sustained within any new targeted support for GME in the FY 2015 Budget. FY 2015 President’s Budget
  • THCs are: • Dedicated primary care education centers • De-institutionalized medical training • A means of increasing residency training without “feeding the monster” • Transformative and revolutionary: you pick! Message for the Hill