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MUCH OF THIS MEETING has dealt with the impact that managed care will make on global issues, such as the workforce and future practice plans. I am going to talk about a specific subject, namely, the impact on funding for graduate medical education (GME). I want to answer four questions. How is GME funded now? What will be the impact of managed care? How will surgical programs cope? And, what is the position of the American Association of Medical Colleges (AAMC) in all this? Whenever we discuss funding for GME, we think about the workforce because these two variables are intimately related. Overall, the federal government pays about $20 billion for GME. Of this, Medicare accounts for $5.2 billion, and the National Institutes of Health for $8.9 billion (mostly for research). Hence, the Medicare subsidy as far as graduate surgical education is concerned is by far the most important. Other