A Dilemma for Medical Education Reform: Form versus Content

Mullan and his colleagues (1994) provide a striking picture of the major transformation that may be looming for graduate medical education (GME) in the United States. Many health policy makers believe that a relative shortage of generalist physicians, combined with an excess of specialists, has contributed substantially to problems of limited access and high costs for health care in the United States (Franks, Nutting, and Clancy 1993). Market forces embodied in the expansion of managed care have the potential to dampen significantly the demand for subspecialists in the coming decade (Wennberg et al. 1993; Weiner 1994). Because GME is heavily subsidized by the federal government, Congress established the Council on Graduate Medical Education (COGME) in 1986 to provide guidance on GME and issues related to the physician workforce.

Author(s): John Z. Ayanian

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Volume 72, Issue 4 (pages 705–712)
Published in 1994