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Comparing GME Office Structures: Considerations and Strategies for Rightsizing

Comparing Graduate Medical Education Office Structures Web

The graduate medical education (GME) office for an academic medical center (AMC) or teaching hospital is responsible for maintaining ACGME accreditation of its residency and fellowship programs. Beyond compliance-related issues, the office may fulfill a wide variety of functions and responsibilities. These responsibilities range from tactical and operational activities, such as reporting and communication, to strategic activities like portfolio alignment and linking GME programs to physician workforce planning initiatives. Table 1 provides a high-level overview of the services a GME office provides.

Table 1: Functions of a GME Office

GME Office Size and Scope

As part of an assessment to help a leading health system reorganize its GME office for two of the nation’s most prestigious teaching institutions, ECG’s academic healthcare team conducted a comparative analysis of peer organizations’ GME office structures. Our consultants reviewed seven large AMCs to summarize their office resources.

Given the variation in the functions fulfilled by each GME office, there was substantial variability in the staff head count and associated FTEs within the office.

  • Most offices staffed positions supporting accreditation and evaluations, finance and administration, data analysis and IT, and communications.
  • Head count ranged from 5 to 16 individuals (or approximately 5 to 12 FTEs).
  • Offices supported between 85 and 290 programs each, which is a ratio of approximately 8 to 20 programs and 70 to 240 filled (accredited) positions per staff member (head count).
  • Some offices received additional support from other departments within the health system and/or at the medical school (e.g., finance, data analytics, communications), which affects the overall size of the office.
  • AMCs that have a close relationship and are more integrated with a medical school have smaller GME offices because there are additional business support FTEs for the residency and fellowship programs within the medical school.

Reviewing and Revising GME Office Structure

As the GME portfolio of a health system changes through mergers, acquisitions, and program expansion, it is helpful to occasionally review and revise the organizational structure of the GME office. For example, as offices are required to complete more external reporting for their GME programs, they have to address the lack of adequate information systems and data analysis resources. Performance can be improved by realigning job responsibilities, removing roles that are no longer effective, and creating new roles and partnerships to address any unmet needs of the GME enterprise of the future.

Our team used the results of this analysis to develop recommendations for our client that would streamline the work of the GME office and position the GME programs for future success. The recommendations included updating organizational reporting structure, providing clarity around roles and responsibilities, and expanding office functions to include new expertise in information systems and communications. We also recommended that the GME office assign teams pairing physician leaders with accreditation specialists according to their specialty/program to encourage team building, professional development capabilities, and employee engagement.

Are your GME programs set up for success?

Read our article, Solving the GME Planning Puzzle and Aligning Academic Priorities with System Priorities

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