Lawmakers in the nation’s capital were seeing white on Wednesday when more than 1,000 osteopathic physicians and medical students marched on Capitol Hill to advocate for continued federal funding of graduate medical education in Teaching Health Centers (THCs), the small, often rural sites that train residents to become primary care physicians in underserved communities.
Federal funding for Teaching Health Centers was established with the Affordable Care Act. The Medicare Access and CHIP Reauthorization Act of 2015 provided $60 million per year for THC GME for 2016 and 2017, though this year’s funding will sunset in September. DOs and medical students urged lawmakers to sponsor legislation to continue, and expand, federal funding for THC GME, noting that these residency positions put primary care physicians in areas where access to care is often limited.
“More than 70% of new physicians remain in the area where they complete their residency training, which means we have the opportunity to bring doctors to communities where they are most needed,” says AOA President Boyd R. Buser, DO. “This type of policy solution not only addresses the primary care shortage, it also helps ensure that rural Americans have access to care in their area.”
There are currently more than 740 residents at nearly 60 THCs in 27 states and Washington, DC. These positions are mainly funded by the Health Resources and Services Administration. The U.S. currently has a shortage of GME positions, which means these slots are even more important to preserve. Also, more than half of these residency programs are osteopathic.
John Sealey, DO, is the director of medical education for Authority Health, a teaching health center in Detroit. Dr. Sealey helped create Authority Health’s residency programs, which now train 71 residents. Teaching health center residency positions are different from hospital-based residency positions in that they are run by nonprofit or community organizations and there’s often more freedom to innovate and flexibility to respond to the needs of the community, Dr. Sealey says.
“We have made our residency programs reflect what is needed in the community,” Dr. Sealey says, noting that his residents receive extra training in, and earn a certificate in, population health. “Our residents become familiar with and understand the resources in this community, so they can better connect patients with them. When our residents are done, they’ll be totally practice-ready for this area and won’t need to learn on the job.”
Dr. Sealey traveled to DC to spend DO Day meeting with his representatives and explaining to them the vital community care his residents are being trained to provide. He also will speak on a panel with media about the importance of teaching health center GME.
Also in DC Wednesday was Valerie Sheridan, DO, director of clinical education for A.T. Still University-School of Osteopathic Medicine in Arizona, which embeds all students in community health centers for clinical training starting in their second year. Many of the school’s students train in teaching health centers.
“The funding for these THC residencies flows directly to the residency programs instead of to the large teaching hospitals,” Dr. Sheridan notes. “This allows primary care residents to train in the setting in which they are more likely to practice. This opportunity better prepares residents for practice and can increase the likelihood of residents opting to remain in high-priority shortage areas after finishing their training.”