Graduate Medical Education in Alaska: Federal Funding - Part 1

Alaska has a shortage of medical doctors (“physicians”).1,2,3,4,5,6 The shortage is not new or unique to Alaska.  Increasing graduate medical education in Alaska has been recommended by stakeholders.3,5,6,7 Graduate medical education (GME) is the training of medical school graduates after medical school.  Increasing the number of medical students in the WWAMI School of Medical Education will not directly increase the number of physicians working in Alaska because WWAMI medical students are in undergraduate medical education, not graduate medical education.  All new medical school graduates, even WWAMI medical students, must participate in GME before providing medical care without supervision.8 

Alaska has one independent GME program, the Alaska Family Medicine Residency (AFMR);9 and two University of Washington Alaska tracks, the Pediatric Track and the Internal Medicine Track.  Alaska has not launched another independent GME program despite the efforts of federal, state, Alaska Native, and not-for-profit stakeholders.

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Graduate Medical Education in Alaska - Part 2

This is the second of two articles about graduate medical education (GME) in Alaska. GME is the structured training of medical school graduates.  This article summarizes issues other than funding and expands on recommendations to increase GME in Alaska.

Compared to all other states, Alaska has the fewest number of GME programs, the fewest number of GME trainees (medical residents), and the lowest GME trainee to state population ratio.1 Eighty-five percent (85%) of GME funding comes through Medicare and Medicaid.2 In 2021 Medicare GME was $13.4 billion.3 Medicare GME funding in Alaska was third from lowest per state population and third from lowest per state Medicare population.  In 2022, Medicaid GME was $7.3 billion.4 Alaska does not use Medicaid to support GME.4 The Department of Veterans Affairs (VA), the Health Resources and Services Administration (HRSA), and the Department of Defense (DOD) do not support GME in Alaska.5,6

Distinguishing Graduate Medical Education (GME) from Undergraduate Medical Education (UME)
Undergraduate medical education (UME) occurs in medical school.  During the first two years medical students are primarily in the classroom.  During the second two years medical students are in hospitals and clinics applying to patient care what was learned in the classroom.  Medical students pay tuition, receive grants, or may have post-training service obligations.  Medical students receive a medical doctor (MD) or doctor of osteopathy (DO) degree when graduating.  New medical school graduates are not ready to provide patient care without supervision.  All states require two-three years of GME prior to medical licensure.7 Alaska requires two years of GME prior to medical licensure.8

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