Health Care Reform and Graduate Medical Education

For almost three decades, the federal government has provided billions of dollars annually to support graduate medical education without regard to the number and balance of generalists and specialists produced by the nation's teaching hospitals. Now, believing that the increasing ratio of specialists to generalists has deleterious effects on the cost1,2 and quality of health care and concerned about a surfeit of physicians, President Bill Clinton has recommended that residency positions be allocated and funded through a centralized regulatory process sponsored by the federal government. Although Clinton's call for nationally coordinated planning of the physician work force is an . . .