BALANCE AND LIMITS - MODELING GRADUATE MEDICAL-EDUCATION REFORM BASEDON RECOMMENDATIONS OF THE COUNCIL ON GRADUATE MEDICAL-EDUCATION

National commissions, medical philanthropies, scholars, and policy ana lysts agree that the key to improved health care access and cost conta inment is a physician workforce built on a generalist foundation. They propose a national system to allocate a specific and limited number o f graduate medical education (GME) positions. The Council on Graduate Medical Education recommended that training positions be limited to 11 0 percent of the graduates of U. S. allopathic and osteopathic medical schools and that the system graduate 50 percent into primary care pra ctice (50/50-110 proposal). The 50/50-110 option would significantly m odify GME training: surgical and support specialty positions would be reduced, and increased numbers of medical and pediatric residents woul d enter general practice. This workforce composition would facilitate provision of universal health care access and help control costs-the b asic tenets of reform.