The Balanced Budget Act of 1997 and rural training supported by medicare graduate medical education funds

The Balanced Budget Act of 1997 promised a number of changes in medical edu cation to benefit rural communities. The changes suggested that physician t raining would be more available in rural communities, programs training phy sicians for work in rural communities would be better supported, and reside ncy programs would be allowed to be separate from hospitals. The regulation s developed by the Health Care Financing Administration to implement the ac t are reviewed in the context of these expectations. Limitations in the reg ulations indicate that rural communities will see little benefit from this legislation. This article is a commentary on the expectations and reality o f the effects of the Balanced Budget Act of 1997 on rural training supporte d by Medicare.