September 13-14, 2005, Bethesda, Maryland
The Council on Graduate Medical Education (COGME) convened in the Washington Room in the Holiday Inn Select, 8120 Wisconsin Avenue, Bethesda, Maryland, at 8:30 am. on September 13-14, 2005.
Robert L. Johnson, M.D., Vice Chair
Rebecca M. Minter, M.D., Member
Angela Dee Nossett, M.D., Member
Earl J. Reisdorff, M.D., Member
Russell G. Robertson, M.D., Member
Jerry Alan Royer, M.D., Member
Humphrey Taylor, Member
Tzvi M. Hefter, Designee of the Administrator, Centers for Medicare and Medicaid Services
Barbara K. Chang, M.D., M.A., Representative of the Department of Veterans Affairs
Retired Members Present:
Carl J. Getto, M.D.
William Ching, M.D., Ph.D.
Lucy Montalvo, M.D., M.P.H.
Howard Zucker, M.D., Designee of the Acting Assistant Secretary for Health
Tanya Pagan Raggio, M.D., M.P.H., F.A.A.P., Executive Secretary
Jerald M. Katzoff, Deputy Executive Secretary
Howard Davis, Ph.D.
Jaime Nguyen, M.D., M.P.H.
Welcome and Announcements
Dr. Raggio, acting as interim chair, welcomed COGME members. She expressed regret that Bureau Management Staff were not able to attend because of the exigencies resulting from hurricane Katrina and noted that many HRSA personnel, especially commission corps officers, were assisting the victims of Katrina.
Dr. Raggio presided over the election of chair and vice-chair. COGME members elected Dr. Robert L Johnson as chair and Dr. Russell G. Robertson as vice-chair.
Dr. Raggio, as COGME Executive Secretary, gave her report. She explained the process that would govern the production of future COGME reports. Current resource limitations will preclude the use of contractors to develop reports. Limited resources will be available to pay honorariums for presentations on the topic by experts and for these experts to develop papers related to the material they presented. These papers will serve as the resource material that will be used to compose the final report. COGME members, with the help of staff, will need to assume the responsibility to develop final reports,
incorporating materials provided by the presenters and providing their own expertise. .
Dr. Raggio recognized retiring members for their invaluable sustaining service to COGME. Each retiring member received a plaque inscribed with a dedication and noting the length of service.
Discussion of Potential Report Topics
COGME membership broke into three discussion groups (workforce, graduate medical education, and GME financing) to consider potential report topics. The groups reported to the plenary session as to the topics considered. The following topics were considered by COGME membership to be among the most critical facing the nation’s physician workforce and health care system. The plenary session then prioritized these topics and selected the following as viable potential report topics. The topics were categorized as to the length of time their completion would be expected to take. Short/brief reports, expected to take less than a year are indicated by SR, and long reports, expected to take 18 months or more, by LR.
1. National Service: SR
2. Emergency Preparedness: SR
3. Flexibility in Training and GME: LR
4. Osteopathic Medicine: SR
5. Technology: SR
6. Forecasting Models: LR
After some deliberation, COGME members chose the first and third topic issues (National Service and Flexibility in Training and GME) on which to develop its next two reports.
Other related issues the Council addressed were:
Presentation on Physician Re-entry
The Wednesday morning session began with a presentation by Saralyn Mark, M.D., Senior Medical Advisor, U.S. Department of Health and Human Services, Office on Women’s Health. Dr. Mark discussed the issue of reentry of physicians after an interruption of practice for reasons related to family responsibility, health, alternative career choices, and other reasons not related to disciplinary actions. She noted that although initially considered an issue mostly relevant to women physicians, information obtained indicated substantial interest among male physicians who wished to resume active practice after a period of interruption. A major issue for physicians wishing to resume active practice after a period of interruption is to assure that such physicians possess those competencies currently needed in their respective specialties. A major question concerns the structure necessary to provide the training required for this assurance.
The Council concurred that this topic is important and will plan to address it more thoroughly at future meetings.
Tentative plans are that COGME will reconvene in April and September, 2006. The April agenda is expected to include presenters on both topics selected for reports after which Council members will begin the effort to compose these reports.
Two individuals responded to a call for public comment:
Holly J. Mulvey, M.A., Director, Division of Graduate Medical Education & Pediatric Workforce, stated the concern of the American Academy of Pediatrics that suitable measures be implemented to provide an adequate and well trained pediatrician workforce composed of appropriate numbers pediatric subspecialties to meet the health needs of the country’s children and young adults. She expressed concern, however, with COGME’s recent recommendation to expand the total physician workforce.
Konrad C. Miskowicz-Retz, Ph.D., Director, Department of Accreditation, American Osteopathic Association, expressed concern about certain misapprehensions related to the governing structure of Osteopathic Schools of Medicine. He also spoke to the curricula and training processes used to produce Doctors of Osteopathic medicine.
The meeting on the second day adjourned at 10:00 a.m.