Evaluates Medicare's policy regarding graduate medical education (GME) & addresses concerns about federal budget spending. Provides an overview of the changing physician work force & the effects of Medicare's GME policy on residency training & teaching hospitals at which such training is based. Presents various options for GME policy & explores their implications. Charts & tables.

This document reports testimony presented on Medicare financing of graduate medical education, as proposed by the Balanced Budget Act of 1995. Witnesses included: (1) Timothy M. Golddfarb, Director, Healthcare Systems (Oregon), who noted the importance of graduate medical education funding to teaching hospitals; (2) Leo P. Brideau of Strong Memorial Hospital (Rochester, New York) who was concerned with protecting the program's viability; (3) Larry Wickless of the American Osteopathic Association, who hoped for increased support for graduate osteopathic programs; (4) Spencer Foreman, who spoke on behalf of the Greater New York Hospital Association concerning the importance of international medical graduates to institutions serving poor populations; (5) William E. Jacott, who spoke for the American Medical Association, which supports changes in the graduate medical education program; (6) Patrick B. Harr, who spoke for the American Academy of Family Physicians, about the physician surplus; (7) Leslie S. Cutler, University of Connecticut Health Center, who suggested establishment of medical education consortiums; (8) Anthony M. Marlon and Jerry Reeves of Sierra Health Services (Las Vegas, Nevada), who described a private-public pilot program to fund education of medical residents; (9) Mary O. Mundlnger, Columbia School of Nursing (New York), who sought funds for graduate nursing education; and (10) Lynn E. Caton, representing the American Academy of Physician Assistants, who sought to make physician assistant programs eligible for such funding. In addition to the testimony, discussions between witnesses and the committee members are also transcribed. (CH)

This hearing presents testimony on Medicare support for graduate medical education in light of Clinton Administration and other reform proposals to reduce the number of specialized residencies in teaching hospitals. The testimony includes opening statements by Senator William V. Roth, Jr., chair of the Senate Committee on Finance, and Senator Phil Gramm. Bruce Vladeck, administrator of the Health Care Financing Administration offered a statement as administration witness. Statements by public witnesses included those of: Robert Crittenden of the University of Washington School of Medicine; Don E. Detmer, on behalf of the Association of Academic Health Centers; Spencer Foreman, on behalf of the Greater New York Hospital Association of Academic Health; and Ralph W. Muller, on behalf of the Association of American Medical Colleges. Appended are prepared statements by the witnesses and communications regarding graduate medical education reform from the Alaska Family Practice Residency, American Association of Colleges of Nursing, American Association of Colleges of Osteopathic Medicine, American Association of Dental Schools, American College of Preventive Medicine, American Hospital Association, National Association of Children's Hospitals, National Association of Public Hospitals and Health Systems, and National League for Nursing. (MDM)