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Monday, February 9, 2009

TMA Legislative Issue Brief: Graduate Medical Education

Texas has a shortage of physicians, both primary care physicians and specialists. The state currently ranks 43rd out of 50 states and the District of Columbia. Even though medical liability reforms have brought more than 14,000 new physicians to Texas, we still don’t have enough physicians to keep up with the state’s robust population growth.

Texas medical schools are doing their part to expand medical student enrollments, but unless graduate medical education (GME) programs grow in the same fashion, many of our newest physicians will move to other states. GME is a necessary part of a physician’s preparation for medical practice. Physicians who complete both medical school and GME in Texas are three times more likely to remain in the state to practice.

Medical schools and teaching hospitals have limited funding available to expand GME. The shortage of GME slots virtually guarantees some medical students will be forced to leave the state upon graduation. Those leaving likely will not return to Texas. They will take with them more than $200,000 of state investment in their medical school education.

In 2007, Texas lawmakers recognized the need to support medical school efforts to expand GME by authorizing $62.8 million in state formula funding for new GME slots and as partial payment for faculty costs. Although this funding resulted in the creation of new GME positions, it is not sufficient to pay for needed growth. The current state GME formula funding represents less than one-third of estimated faculty costs for GME in Texas. In addition, to retain our Texas medical students, we must add an estimated 250 new GME slots over the next four years — 1,000 new slots in total.

Medicine’s 2009 Agenda
  • Produce more homegrown physicians through adequate state formula funding of medical school expansions and GME slots.
  • Reinvest state funds in Medicaid GME and restore the state’s ability to draw down additional federal matching dollars.

Medicine’s Message

  • Texas needs more GME slots to train the number of physicians required to care for our rapidly growing population and reverse our overdependence on other states and countries.
  • The lack of adequate GME funding jeopardizes Texas’ economic future.
  • It is not good fiscal policy to make a state commitment of $200,000 for each Texas medical student over four years, and then force graduates to leave the state for GME. Those new physicians very likely will never return to Texas.

Check out the Doctor’s Orders video to get a more complete view of TMA’s 2009 legislative agenda. You can see all of TMA’s 2009 legislative issue briefs on the TMA Web site.

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