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    States take novel steps to address work force shortage

    Based on a partnership with Urology Times, articles from the American Association of Clinical Urologists (AACU) provide updates on legislative processes and issues affecting urologists. We welcome your comments and suggestions. Contact the AACU government affairs office at 847-517-1050 or [email protected] for more information.

    American Association of Clinical Urologists logo

    As policymakers learn about the burgeoning bottleneck between medical school graduation and graduate medical education (GME), a number of novel approaches to physician training have launched from Sacramento to Jefferson City to Tallahassee. Not surprisingly, many of these solutions pit providers against one another amid concerns about patient safety and the dilution of professional standards.

    The most common of these new approaches is direct funding of residency positions (see related infographic). Oklahoma's most recent state budget appropriated $13 million to support GME programs affiliated with the Oklahoma State University Medical Center and/or OSU Center for Health Sciences, while legislators in Idaho increased the number of state-supported students in a regional medical education network (WWAMI) and allocated $200,000 for a new family practice residency program. Florida Gov. Rick Scott (R), stung by the legislature's rejection of his plan to expand Medicaid and facing a tough re-election contest, toured the state promoting an $80 million Statewide Residency Program. An official statement from Scott’s office asserted, "For the first time, hospitals are receiving a supplemental payment specifically for graduate medical education."

    A more controversial plan to tackle the med school-residency bottleneck was signed July 10 by Missouri Gov. Jay Nixon (D). The first-of-its-kind law allows medical school graduates who have passed licensing exams—but not completed residencies—to practice primary care and prescribe drugs in rural and underserved areas of the state. They would be overseen by licensed physicians, who would have to be physically present with them for a portion of their tenure. The proposal was endorsed by the Missouri State Medical Association, but the American Medical Association and organizations of physician assistants strongly opposed the creation of a new category of medical licensee: assistant physicians. The American Academy of Physician Assistants, for one, expressed concern that patients may be confused when "assistant physicians" call themselves doctors.

    Next: CA law allows students to become docs in 3 years instead of 4

    More Legislative Updates from the AACU

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