VA plans to expand resident training for academic year beginning July 2007

The number of patients the VA treated grew 22% between 2001 and 2005.

By Myrle Croasdale — Posted June 5, 2006

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In response to a physician shortage within its system, the Dept. of Veterans Affairs intends to add 1,500 to 2,000 medical residents to its work force over the next few years.

The VA has a budget of $50 million to add 300 to 400 new residents for the academic year beginning in July 2007 and to cover other education expansion costs for fiscal year 2007. If Congress keeps the funding coming, similar increases will be seen until the VA grows from 8,500 residents to 10,000 to 10,500. (See correction)

Medical and surgical subspecialists are especially in demand, but more primary care physicians also are needed, said Malcolm Cox, MD, chief academic affiliations officer for the Veterans Health Administration.

"There's a general lack, and residents are a major component of delivering health care in the VA. When their numbers diminish, there really is a problem keeping up," he said.

The number of patients the VA treats grew 22% over a four-year period, from 4.1 million in 2001 to more than 5.3 million in 2005. As of April, 30,475 new veteran enrollees were waiting for their first appointment.

Dr. Cox expects the VA to have selected which hospitals and residency programs will get new residency positions by October. Priority will be given to requests from:

  • Facilities short on subspecialists.
  • Community-based outpatient clinics and facilities unaffiliated with academic medical centers.
  • Facilities in geographic areas that have been historically understaffed, such as the Southeast and Southwest.
  • Facilities piloting innovative training models.

The VA's residencies are funded directly by Congress and are not subject to the cap on Medicare graduate medical education payments, the major funder of GME outside the VA system. In fiscal year 2006, the VA's budget for GME was $450 million, which will climb to $500 million in 2007 to pay for the first round of expansion. (See correction)

Historically, the VA has had 10% to 11% of total residency positions under its jurisdiction. But with the incremental growth in residency slots over the past decade to roughly 103,000, the VA's 8,500 residents brings its share down to 8%.

"At 8%, the VA wasn't contributing its fair share to the [physician] work force," Dr. Cox said. "Given the shortage of physicians, that didn't seem to be a good idea."

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This story originally contained incorrect information on the Dept. of Veterans Affairs graduate medical education budget. American Medical News regrets the error.

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