April 30 - May 1, 2007, Rockville, Maryland
The Council of Graduate Medical Education (COGME) convened in the Hilton Washington D.C. Rockville Executive Meeting Center at 8:30 am both April 30 and May 1, 2007.
Russell G. Robertson, M.D., Chair
Denise Cora-Bramble, M.D., M.B.A, Member
Joseph Hobbs, M.D., Member
Mark A. Kelly, M.D., Member
Rebecca M. Minter, M.D., Member
Angela D. Nossett, M.S., Member
Robert L. Phillips, Jr., M.D., M.S.P.H., Vice Chair
Earl J. Reisdorff, M.D., Member
Vicki L. Seltzer, M.D., Member
Jason C. Shu, M.D., Member
William L. Thomas, M.D., F.A.C.P., Member
Leana S. Wen, M.S., B.S., Member
Barbara J, Chang, M.D., M.A., Designee of the Department of Veterans Affairs
Renate Rockwell representing Tzvi M. Hefter, Designee of the Administrator, Centers for
Medicare and Medicaid Services, DHHS
Anand Parekh, Designee of the Assistant Secretary for Health, DHHS
Thomas J. Nasca, M.D., M.A.C.P., Member
Kendall Reed, D.O., F.A.C.S., Member
Dennis Williams, Deputy Administrator, Health Resources and Services Administration (HRSA)
Michelle Snyder, Director, Bureau of Health Professions (BHPr)
Marilyn Biviano, Ph.D., Director, Division of Medicine and Dentistry, BHPr
Jerald M. Katzoff, Executive Secretary
Dr. Robertson, Chair, welcomed the COGME members. He introduced Anand Parekh, M.D., Designee of the Assistant Secretary for Health, DHHS
Dennis Williams, Deputy Administrator, Health Resources and Services Administration, and Michelle Snyder, Director, Bureau of Health Professions, each gave welcoming remarks. Both noted the importance of the Council’s recent work and the emerging recommendations of the two reports under development. In describing current activities of both HRSA and BHPr, both Dr. Williams and Ms. Snyder noted how the Council’s work has complemented the Agency’s and Bureau’s activities and goals over the past several years. Ms. Snyder noted recent changes in senior management at the Bureau. Of direct impact on the Council is the recent appointment of Dr. Marilyn Biviano to head the Bureau’s Division of Medicine and Dentistry, which, among its activities, provides oversight to COGME and two other advisory committees.
Executive Secretary’s Report
Mr. Katzoff discussed the COGME letter that was sent to the Secretary and Congress in March 2007 concerning proposed Medicare changes in definitions for GME reimbursement and asked Dr. Robert Phillips to elaborate on the issue. Mr. Katzoff then discussed the solicitation process for appointing new members to the Council. He indicated that four members of the Council will be ending their terms on September 30, 2007. Mr. Katzoff noted that the Council’s charter permits all retiring members to continue in their posts after their terms have expired, until a new member has officially been appointed to the Council.
Presentations to the Council on its Two Emerging Reports
From mid morning until noon, Dr. Barbara Chang, chair of COGME’s writing group on Enhancing GME Flexibility, led the discussions and review on each of the draft recommendations and accompanying narrative of the emerging report. Following lunch, Dr. Earl Reisdorff, Chair of COGME’s writing group on New Paradigms for Physician Training in Improving Access to Healthcare, led the discussions and review on each of the draft recommendations and accompanying narrative of that emerging report.
The first day’s plenary session ended at 3 pm.
Breakout of Council Members into Two Writing Groups
At 3:15 PM , the two writing groups convened to further revise each of their two reports in light of the discussions held earlier that day.
Report to Council on Draft Recommendations of the Two Reports
In the morning of the second day of the plenary session, the chairs of each writing group reported to the plenary meeting the new revised wording of each of the draft recommendations produced as a result of the previous day’s activities.
(Note that what follows are the revised draft recommendations contained in the most recent versions of the two draft reports dated mid-June 2007).
New Paradigms for Physician Training Writing Group
Graduate Medical Education Flexibility Writing Group
Recommendation 1: Align GME with future healthcare needs
Recommendation 2: Broaden the definition of “training venue” (beyond traditional training sites)
Recommendation 3: Remove regulatory barriers to executing flexible GME training programs and expanding training venues
Recommendation 4: Make accountability for the public’s health the driving force for graduate medical education (GME)
Next Steps for Producing the Reports
In afternoon discussions, COGME members endorsed sending the two draft reports to about 15 organizations for review and comment prior to the reports’ transmittal to the Secretary, Congress, and the general public. The 15 organizations that COGME identified were thought to have strong expertise and interest in the issues and draft recommendations included in the two reports. The Council also endorsed inviting a small, select group of these organizations to present their comments to COGME on the first day of its two day plenary session scheduled for September 18-19, 2007.
Components of September Agenda
In discussions concerning the recommendations for enhancing GME flexibility, COGME expressed interest in learning the extent of state and regional engagement in GME and physician workforce planning. It therefore endorsed inviting selected states to discuss this issue at the September meeting, with the possibility that this issue will from the basis of the4 next report and /or a conference to be sponsored by COGME on state physician workforce/GME advisory panel activities.
In addition, the members agreed to send to Mr. Katzoff by early August their ideas for possible new topics as candidates for a new report. These items would then be discussed in the September meeting.
In public comments given on both days, Ms. Sunny Yoder of the Association of American Medical Colleges, Dr. Steven Shannon of the Association of American Colleges of Osteopathic Medicine, and Dr. Paul Rockey of the American Medical Association each welcomed COGME efforts in taking up the issues embedded in its two emerging reports.
The Council adjourned May 1, at 11 A.M.