UNDER THE ROTUNDA
After a proposed infusion of nearly $50 million into the latest draft of the Texas Senate’s budget for 2022-23, medicine has new hope for the state giving graduate medical education (GME) the financial support it deserves to keep the physician pipeline open.
Without enough GME positions at Texas schools, not enough medical school graduates will stick around to practice in the Lone Star State – a point the Texas Medical Association has pressed to lawmakers for years. And those GME slots won’t exist without robust funding for the state’s GME grant program.
TMA received word last week from the Senate Finance Committee that it was bumping up its latest allocation for the GME expansion grant program from the original $150 million to about $199 million. That’s how much state authorities say the program needs to sustain itself – meaning to both create new GME positions and refill ones already available. The target ratio – which Texas reached in the past few years – is 1.1 first-year residency slots per medical school graduate.
The Finance Committee’s latest on-paper funding is great news for the future of medicine – because without more funding, Texas’ hold on that ratio is tenuous, according to a recent report by TMA’s Council on Medical Education.
“Unless the state’s GME capacity continues to grow incrementally, the state will fall short of the target 1.1 to 1 ratio and even a 1 to 1 ratio,” the council wrote in its report. “Texas needs to create 250 additional first-year GME positions by 2024 to maintain the 1.1 to 1 ratio; 300 by 2025; 400 by 2026; and 475 by 2027. Without additional GME growth, there will not be enough first-year GME positions to retain Texas graduates beginning in 2024 and Texas will lose graduates to other states. Given the state’s investment in the education of these physicians and the ongoing physician workforce shortage in the state, this would be a tremendous loss for Texas.”
Several members of the Finance Committee were instrumental in giving GME its due in the latest Senate budget draft, including Sen. Jane Nelson (R-Flower Mound), chair of the committee; Sen. Brandon Creighton (R-Conroe), chair of the workgroup on the education budget; Sen. Dawn Buckingham, MD (R-Lakeway); Sen. Paul Bettencourt (R-Houston); and Sen. Royce West (D-Dallas).
But budget discussions are fluid, and TMA lobbyist Michelle Romero says it’s now crucial for physicians to let lawmakers know how important it is to maintain the Senate’s proposed funding level. The House’s version of the budget still allocates just $150 million for the GME grant program.
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