Report Says Big Changes Are Needed In How Doctors Are Trained

The way American doctors are trained needs to be overhauled, an expert panel recommended Tuesday, saying the current $15 billion system is failing to produce the medical workforce the nation needs.  "We recognize we are recommending substantial change," says health economist and former Medicare Administrator Gail Wilensky, co-chairwoman of the nonpartisan Institute of Medicine panel that produced the report. "We think it's key to justifying the continued use of public funds."

The federal government provides more than $11 billion a year in payments to support the training of doctors who have graduated from medical school, mostly through the Medicare program. Most of that goes to the hospitals that sponsor interns and residents. States, through the Medicaid program, contribute nearly $4 billion more annually.  "The scale of government support for this phase of physician education is unlike that given to any other profession in the nation," said the report, which was funded by a dozen foundations with the support of a bipartisan group of members of Congress.

Even though the system has operated this way for decades, there are few data on how those funds are spent and how well they contribute to the preparation of a medical workforce needed for the 21st century, the panel found.  Despite a growing public investment in graduate medical education, there are persistent problems...