ASPS Supports Legislation for Graduate Medical Education

The American Society of Plastic Surgeons sent a letter of support to Representative Kathy Castor (D-Fla.-14) regarding her legislation, the Creating Access to Residency Education Act of 2015 (H.R.1117).

This legislation would require The Centers for Medicare and Medicaid Services to make grants available to states to support the creation of a new medical residency training program or slots within existing programs. Federal funding will be available to states with fewer than 25 medical residents per population of 100,000, and funding will only be made available to public or nonprofit teaching hospitals or accredited graduate medical education training programs. Grants will be made available for both primary care residency training programs and for specialty medicine programs.

ASPS also sent a letter of support to Representative Raul Ruiz (D-Calif.-36) regarding his legislation, the Building a Health Care Workforce for the Future Act (H.R.1006).

This legislation would make grants available to states in order to implement a scholarship program for full-time students at an accredited educational institution in a program leading to a degree in medicine or other health profession. Students must complete an accredited residency training program, become licensed in the State where they applied for the grant, and serve for one year in a health professional shortage area or medically underserved area.

The legislation requires the state to pay for all tuition and costs associated with the program and other reasonable educational expenses like fees, books and lab expenses, and a cost of living stipend for the student. The State is also required to match amounts awarded through the federal grant. Grants will be made available for both primary care residency training programs and for specialty medicine programs.

ASPS strongly supports the expansion of funding to improve physician training. The number of Medicare funded GME positions in the United States has remained capped since the Balanced Budget Act of 1997. Still, there has never been such a need to increase the number of residency slots available, as an unprecedented number of Americans have access to health services through the Affordable Care Act, as more than 100,000 seniors become eligible for Medicare every day, and as the number of American medical school graduates is poised to reach record numbers.

According to the Association of American Medical Colleges, an overall shortage of 91,000 physicians will occur by 2020. By 2025, the shortage is expected to reach 130,000. While there is undoubtedly serious concern for access to primary care providers, one-half of this shortage will come from specialty physicians.

A recent American College of Surgeons Health Policy Research Institute study shows that there is an average of two plastic surgeons per 100,000 individuals in the United States. This is particularly concerning when considering a plastic surgeon's role in the treatment of breast cancer, which is the second leading cause of death in women. It is estimated that over 230,000 new cases will be identified each year. Several studies have found a direct correlation between the rates of women in a given geographic location who receive breast reconstruction and the number of plastic surgeons practicing in that location.

The Women's Health and Cancer Rights Act of 1998 mandates that reconstructive procedures be offered, yet shortages of qualified surgeons have and will continue to limit availability and proper care for the patient.

ASPS will continue to support measures that ensure access to highly trained medical graduate students and the funding of graduate medical education.