The education of residents (doctors who have finished medical school and are receiving further training) has been a basic part of Medicare spending since the program began in 1965, with money going to teaching hospitals to help pay for the training programs. Teaching hospitals in 2009 received $9.5 billion from Medicare and more than $3 billion from state Medicaid programs. The money is used to educate about 100,000 doctors in training each year.
About 900 of the residency positions go unfilled, and the Affordable Care Act (ACA) will transfer them from their current hospitals to teaching hospitals in underserved areas of the country, including sections of some southern and western states. Most of the unused slots will be reserved for residents training in primary care or general surgery.
The ACA provides new funding — $230 million during the next five years — to train medical students in sites away from teaching hospitals, such as local community health centers, clinics and mental health centers. The goal is to increase students’ skills in providing primary care in community settings.
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