AMA takes on medical student, resident issues

Chicago -- The American Medical Association at its Annual Meeting here in June adopted a string of policies aimed at improving medical student education and resident training.

The financial health of the medical education system and finding ways to ease students' growing debt burden led the agenda. The AMA reiterated the need for adequate, stable funding for graduate medical education, and delegates voted to pursue federal legislation to create an all-payer trust fund that would include contributions from private health insurers.

Delegates supported efforts to gain Medicare funds for training in nonhospital settings, such as preventive medicine programs, which are typically not eligible for Medicare payments. They also asked for the reinstatement of Title VII money to 2005 levels of $300 million to sustain the training of doctors in underserved communities.

Delegates also took action on items related to medical education, voting to encourage schools to teach about pharmaceutical marketing and its impact on research, prescribing and the physician-patient relationship. They also voted to support efforts to encourage training on how to take a patient's sexual history in a nonjudgmental manner.

When schools teach about cultural competency, the AMA asked that lesbian, gay, bisexual and transgender health issues be included.

In response to the banning of a lesbian, gay, bisexual and transgender group at a New York medical school, delegates voted to support the right of medical students and residents to form groups and meet on campus without regard to their sexual orientation, gender, age, race, ethnicity, nationality, religion or disability.

Delegates asked the Liaison Committee on Medical Education to create standards on professional behavior for schools to teach in tandem with standards for assessing students' skills in this area. Several delegates voiced disappointment about the adoption of the U.S. Clinical Skills Exam and wanted to ensure professionalism testing remain in the domain of individual schools.

Delegates voted to support the creation of a standardized fellowship application process. They also sought salary increases for residents, but stopped short of indicating who they thought should foot that bill. They voted in favor of having breast-pumping rooms for lactating students, residents and faculty at all medical schools and teaching hospitals.