The Graduate Medical Education Crisis

Help prevent a tragic ending to medical training By Sameer Vohra, MD, JD

I always enjoy telling people the story of the path that I took to become a doctor. The story is a simple one—the first-born son of a first-generation American family studying hard to achieve his American dream. It is filled with scary old chemistry professors, mountains of debt, crippling anxiety over exams, the birth of babies, and some of the most inspirational moments of my life. Despite all the characters, sub-plots, and emotional climaxes, my medical story has been a happy one. I am in the final year of my pediatric residency, set to embark on a career dedicated to improving the lives of the children of Chicago.

However, what if all those years of study, racking up nearly $200,000 in debt, and the incredible anxiety did not lead to the ability to practice medicine? What if graduating medical school did not even allow you to become a doctor? Would anyone want to take the risk? Would our best and brightest no longer want to become physicians? Would we even have enough doctors to treat our growing population?

Training Slots Don’t Mirror Demand

These are not hypothetical questions. The U.S. health care system is facing a crisis where countless numbers of newly graduated physicians cannot practice medicine. The number of graduate medical education (GME) positions, which provide medical graduates with the training to become practicing physicians, are no longer keeping up with the growing U.S. population that physicians need to serve. Congress is instead supporting increased cuts to the GME budget. We have the ability to stop Congress from cutting this important funding. Patients, physicians, and the entire medical community need to mobilize to hold our legislators accountable.

GME positions currently are partially funded by Medicare. Since medical training is dependent on medical graduates receiving appropriate specialty training, the federal government provides hospitals with special payments to cover costs directly related to educating residents. For many years, these GME positions mirrored the demand required to serve our nation’s population. However, those numbers are changing and they are changing fast.

Predicting Big Physician Shortages

The Association of American Medical Colleges predicts a shortage of 62,900 physicians by 2015. That number will rise to 130,000 physicians in all specialties by 2015. The medical school community has responded to this growing shortage by increasing class size and opening new medical schools. However, with Congress refusing to expand and even discussing funding cuts for GME, the net result is patients without appropriate medical care and hundreds of newly graduated physicians without the training spots needed to provide patients the care they need.

Mobilizing Through Medical Societies

Your support—patients, physicians, and concerned citizens—is needed to prevent Congress from enacting GME funding cuts. The mobilization of concerned citizens will motivate legislators to stop thinking short-term. Instead, we can force them to focus on long-term solutions that address the financial stability of Medicare; maintain access to care for patients; and preserve physician residency programs. The Chicago Medical Society (CMS) and the Illinois State Medical Society (ISMS) will work with you to advance legislation that protects GME, but the initial push must come from all of you. It is crucial that all our members unite to educate legislators on the issues our medical students and residents are facing.

I am often asked if the trials and tribulations of my medical journey were worth it. Although I acknowledge that not every moment was wonderful, my answer is always “yes.” Being a doctor is unlike any other profession.

I have the ability to heal the sick, mentor the well to stay that way, and be a guiding hand during both the happiest and saddest days of people’s lives. I feel privileged every day to have this career, and I would repeat that difficult course every single time.

My medical story is a happy one, but Congressional action to cut GME funding will make the medical story of my friends and countless other future physicians end very tragically. Please contact your legislator today so that the next generation’s medical stories have happy endings.

Dr. Sameer Vohra earned a dual degree in medicine and law at Southern Illinois University. He is currently completing his final year in a pediatrics and public policy residency at the University of Chicago. Dr. Vohra was a Fulbright Scholar in 2009-2010, conducting needs assessments for children’s hospitals in India. He has also worked at the Centers for Disease Control. This year he began a term on the Chicago Medical Society’s Board of Trustees. A recipient of the American Medical Association Foundation’s 2014 Excellence in Medicine Leadership Award, Dr. Vohra plans to devote his career to improving child health and achivement.