Proposed performance-based metrics for the future funding of graduate medical education: Starting the conversation

Kelly J. Caverzagie, Susan W. Lane, Niraj Sharma, John Donnelly, Jeffrey R. Jaeger, Heather Laird-Fick, John P. Moriarty, Darilyn V. Moyer, Sara L. Wallach, Richard M. Wardrop, Alwin F. Steinmann

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Graduate medical education (GME) in the United States is financed by contributions from both federal and state entities that total over $15 billion annually. Within institutions, these funds are distributed with limited transparency to achieve ill-defined outcomes. To address this, the Institute of Medicine convened a committee on the governance and financing of GME to recommend finance reform that would promote a physician training system that meets society's current and future needs. The resulting report provided several recommendations regarding the oversight and mechanisms of GME funding, including implementation of performance-based GME payments, but did not provide specific details about the content and development of metrics for these payments. To initiate a national conversation about performance-based GME funding, the authors asked: What should GME be held accountable for in exchange for public funding? In answer to this question, the authors propose 17 potential performance-based metrics for GME funding that could inform future funding decisions. Eight of the metrics are described as exemplars to add context and to help readers obtain a deeper understanding of the inherent complexities of performance-based GME funding. The authors also describe considerations and precautions for metric implementation.

Original languageEnglish (US)
Pages (from-to)1002-1013
Number of pages12
JournalAcademic Medicine
Issue number7
StatePublished - Jul 1 2018

ASJC Scopus subject areas

  • Education


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