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November 19, 1997

Graduate Medical Education and Government Oversight

JAMA. 1997;278(19):1571. doi:10.1001/jama.1997.03550190035033

To the Editor.  —It strikes me as ironic that, at a time when baby boomers are about to retire and the needs of an aging population are going to markedly increase demands on the health care system, we are cutting back on graduate medical education slots as indicated in the article by Dr Dunn and Ms Miller.1 The idea that Medicare is paying hospitals not to train residents is ludicrous. Through research we have increased the knowledge base and specialization of medicine, which increases the need for specialists. We have an increasing and aging population, which also increases the need for all physicians. The inability of physicians to find jobs is attributable to maldistribution, not to excess numbers. For instance, here in eastern Kentucky, there are shortages of otolaryngologists, obstetrician-gynecologists, anesthesiologists, and other specialists. Simply because graduate training programs receive Medicare funding, there is scrutiny of the numbers of