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Graduate Medical Education
Traditionally, the goals of most graduate medical education (GME) programs have
been to provide high-quality education and training as well as to meet accreditation
requirements and other educational objectives. While quality and accreditation will
remain paramount, many hospitals, medical schools, and academic medical centers (AMCs)
are now asking how residency programs impact their strategy and organizational performance.
As AMCs develop new strategies and undertake new initiatives, often focused on clinical
service lines, they are questioning what assets can be used to support strategic initiatives.
GME programs should be considered such an asset. The challenge is how to develop and implement
GME strategies and structure GME programs appropriately to support organizational goals.
ECG is uniquely positioned to help hospitals, schools of medicine, and AMCs with this
challenge. We have more than 30 years of experience with healthcare organizations and a deep
understanding of GME requirements. This experience coupled with our expertise in strategic
and business planning allows us to work with AMCs to not only ensure that the GME programs are
meeting accreditation requirements but also to make certain that those programs are best
supporting the AMC’s clinical strategies and operational goals.
ECG works with AMCs to:
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Develop GME Strategies – Whether it is expanding GME
programs or restructuring them to address clinical and other strategies, ECG works with our clients to
ensure that GME is positioned as a strategic asset, driving both academic excellence and organizational
performance.
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Review and Improve the Structure of
Existing GME Programs and Provide Interim Management – We
help hospitals and medical schools to review the medical and administrative leadership structures of
their existing GME programs to ensure that they are designed to support the strategic, clinical, and
educational goals. In addition, we provide interim management of GME, including institutional functions
as well as program-specific management functions to assure high-quality and successful accreditation outcomes.
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Assess the Composition of Existing Programs, then Plan and Implement Changes in Those Programs – In
accordance with the recent redistribution of residency slots and other program sizing concerns, we assist
AMCs to align their residency programs with their clinical strategy, including identifying those areas in
which the AMC would most benefit from making changes in current program complement, composition, and strategies.
Whether a question of strategy, structure, operations, financing, sizing, or how the residency program
can better promote an organization’s long-term strategy, ECG can help to ensure that the GME program is considered
a strategic asset, provides a strong educational experience, achieves financial goals, and supports the AMC’s
overall strategic objectives. As we work on these projects, we incorporate all regulatory/accreditation
requirements into our analysis, planning, and recommendations.
Following are examples of our work and our clients’ results in this area:
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Selected Projects
- Develop a GME strategic plan.
ECG assisted a large, independent AMC
in devising a strategy for the academic enterprise including 35 GME programs with approximately 250 residents.
Tasks completed for this project included (1) defining objectives for the AMC’s academic mission, (2) reviewing
the performance and financial impact of research and education programs, (3) establishing recommended accountabilities
and performance expectations for these activities, (4) developing a revised funds flow/physician compensation model
for academic activities, and (5) modifying the organizational structure for academic affairs.
- Provide interim management of GME administration.
ECG provided interim management of the
office of medical education, resulting in favorable accreditation results for several programs, improved processes
and efficiencies, and enhanced service to residents, program directors, and faculty.
- Evaluate and enhance the financial performance of GME.
ECG was engaged by a large teaching hospital
to evaluate the financial performance and other attributes of the academic enterprise at the hospital. Our work
resulted in the development of a general strategy for the aggregate size and composition of GME programs, as well
as the design of a framework to guide future decisions with respect to altering the resident/fellow complement.
- Integrate GME planning with organization-wide strategic planning.
As a component of an organization-wide strategic
planning project, ECG helped a multihospital system to devise specific strategies and improvement plans for its four
GME programs with approximately 100 residents. The organization had embraced a specific strategy to strengthen the
private medical staff, and GME was seen as an essential component of this objective. Our project resulted in specific
recommendations to expand and enhance the programs and to develop a new faculty model to foster opportunities for the
private medical staff to participate in GME activities.
- Devise a GME strategy and evaluation tool.
The objective of this engagement was to assist
a large AMC in the development of a GME strategy by devising a rational approach for determining the size, specialty
composition, and direction for GME programs. Our
approach included developing financial,
operational, academic, and mission-related
criteria upon which the appropriateness of individual GME programs could be evaluated, as well as
assessing the impact of major external forces on GME strategy, including Medicare reimbursement changes, managed care
penetration, and physician workforce planning issues. This process of exploring and identifying priorities relative to
GME enabled the organization to define and clearly articulate a GME strategy. Our work also provided the client with
a flexible planning tool with which GME programs could be periodically evaluated.
- Assess the financial impact of GME.
The objective of this engagement was to conduct a
strategic assessment of an AMC’s GME programs, including analyzing the financial impact of residency programs and
evaluating them according to strategic, financial, and academic criteria. Our work resulted in a comprehensive
assessment of the contribution of GME programs to the AMC’s academic and clinical service missions. This assessment
provided our client with the analytical tools required to evaluate program performance in subsequent academic years.
In addition, the organization received specific action plans that offer alternative approaches to make residency
sizing/composition decisions in recognition of program performance in an environment of declining reimbursement.
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