Advisory committee for family medicine residencies grapples with cuts

posted 06.02.11

The Family Practice Residency Advisory Committee to the Texas Higher Education Coordinating Board met Wed., June 1, to determine its recommendations for dividing state support for training family physicians among Texas’ 29 family medicine residency programs. The meeting occurred just days after the Legislature passed a budget that stripped almost 74 percent of the programs’ state funding from 2010-2011 levels.

Committee chair Roland Goertz, M.D., M.B.A., led the meeting in a somber mood as he described the drastic loss of support. The residency programs often cobble together operating budgets from a variety of funding streams, and some are more precarious than others. The programs report that they depend on the state funds for between 4 percent and 18 percent of their operating budgets, leading many on the committee and in the audience to predict that the new funding levels could cause some of the training programs to close.

“I think we’ll see a series of cascading issues happen now that we know the end game,” Goertz said.

The Legislature began appropriating funds for family medicine residency training in 1977, and since that time, the program has provided support for more than 8,000 family physicians. In 2010-2011, the Legislature appropriated $21.2 million to the Family Practice Residency Program budget line item. The recently passed budget cuts that to $5.6 million.

Two other line items supporting residency training through THECB were eliminated, a cut totaling $5.59 million.

The committee also bemoaned the elimination of funding for the Statewide Primary Care Preceptorship Program, which began in 1978 and has placed medical students in month-long rotations with primary care physicians ever since. The program has shown consistent success in increasing the likelihood that medical students will choose careers in primary care.

The cuts also spell the end of the Faculty Development Center, which has provided training for family medicine faculty in residency programs since 1978. The committee will recommend that THECB consider creative ideas to continue both the preceptorship program and the FDC in some form without funding, but prospects—especially for the FDC—are dim.

The Legislature passed a bill that directs THECB to conduct an interim study on the state’s capacity for graduate medical education to determine if there are enough available residency positions for the number of medical students graduating from Texas medical schools, and if the proportion of slots offered is properly aligned to produce the physician workforce the state needs. In light of the state’s withdrawal of support for GME across the board, the results of the study should be interesting, to say the least.