Community residency training program struggles after cuts

Amid uncertainty for the future of the program, a study published by the New England Journal of Medicine found training a Teaching Health Center resident costs an average of over $157,000 a year, far less than the funds left to the program after recent cuts.

When the Teaching Health Center Graduate Medical Education (THCGME) program was launched in 2010, it was intended to increase the number of community-based primary care residents over a five-year period. Last year it was extended two years (with a 40 percent budget cut) and is now set to end next September, but the reduction left numerous programs on financial life support. Currently, 59 THC programs are responsible for training 690 primary care residents across the District of Columbia and 27 states, the study authors wrote. Forty-two of the programs are newly launched using THC funds, while 17 used the program to expand existing initiatives supported by Medicare.

The program was funded $150,000 per resident for the first five years, which demonstrated an understanding of the need for stable funding for community residency programs, the NEJM study authors wrote. “Our findings suggest that $150,000 per resident per year is reasonably reflective of the true current cost of a resident to a community-based sponsor,” they added. After last year's budget cuts, the funding was reduced to $95,000 a year for each resident's training.

The new study throws the challenges the program faces into stark relief and has prompted bipartisan calls from members of Congress to make an effort to save the program.

"I believe strongly that patients and families should be able to get the care they need when and where they need it,” Sen. Patty Murray (D-Wash.) said in a statement. “Teaching Health Centers are critical to reaching this goal. I look forward to working with all of my colleagues on sustainable funding to support and expand this important program for families in Washington state and nationwide."

Rep. Doug LaMalfa (R-Calif.) similarly called for action, noting that the THCGME program is vital for resolving lack of primary care access for patients in rural or underserved areas. The latest data, he added, will help allocate funds in the most efficient possible way.

- read the study
- here’s the statement