Last week, the Institute of Medicine (IOM) published a long-awaited report on graduate medical education (GME) that calls for transitioning the current GME system to a transparent, performance-based system over the next 10 years.

Overall, the report proposes overhauling the GME payment system, but does not define what a performance-based system will include, leaving this work to be developed by activities supported by a Transformation Fund.  It also fails to address the role of other payers, including private payers, local communities and other stakeholders but maintains Medicare as the primary source for GME funding.  The report also contains some troubling conclusions, including a statement that it found no “credible evidence” to support claims of a looming physician shortage despite the growing demand for physicians due to newly insured patients and an aging population.

Read a brief summary of the report’s recommendations and the AMA’s statement on it.