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Graduate Medical Education Safety-Net Consortium (GME-SNC) Model

A New Approach to
Graduate Medical Education

Academic Health Centers’ (AHCs) hospital-based, specialty-intense spirit of research, discovery, education and patient care delivered humbling medical advances during the Flexner era, yet progress from discovery to care continuum has been notably slow, with escalating health disparities and increasing workforce shortages and misdistribution.

Large-scale industrial changes are disorienting and chaotic; physician burnout is at an all-time high. Despite being an intensely change-averse industry, healthcare is becoming decentralized by capitalistic forces.1, generating innovative solutions for high performance and solvency.

The Wright Center for Graduate Medical Education is a proud disruptor of the historically pedantic healthcare industry.

Through the organization’s stewardship of federal and local resources, our team has optimized and expanded the reach of stakeholders’ investments and begun to reinvigorate the rural regions most affected by our nation’s physician shortage. The Graduate Medical Education Safety-Net Consortium (GME-SNC) model advances local healthcare workforce and delivery solutions while addressing foundational issues of access and affordability.

Graduate Medical Education Safety-Net Consortium (GME-SNC) Model

Responds to Community Health Needs
The GME-SNC is inspired by Health Resources and Services Administration’s (HRSA) Teaching Health Center program (THCGME). Built on a framework similar to Nasca et al’s proposed Community Health-Academic Medical Partnerships (CHAMPS)2, the GME-SNC immerses trainees in community settings where they’re most needed and increases likelihood of graduates working in such settings.3

Upholds Public Trust
The GME-SNC promotes value-based payment reform strategies that often redirect hospital utilization to more appropriate, affordable community-based venues. Transparency is ensured by standardized reporting methodologies that harness evolving health information and educational technologies to develop and demonstrate workforce competencies, ensure stewardship of public GME funds to meet highest federal reporting standards and to monitor and improve population health outcomes.

Leverages Learning
Physician-led teams’ value-driven workflow redesign in a scholarly culture leverages learners as clinical system improvers. Empowered patients and families make meaningful contributions to enhance care delivery and development of comprehensive workforce skills. The GME-SNC demonstrates administrative and operational efficiency with consortium scheduling and time tracking across cost centers and a robust quality improvement management system stimulating learner-driven improvements.

Optimizes Educational Capacity
GME payment methodologies vary substantially between Veterans Affairs (VA), Centers for Medicare and Medicaid Services (CMS) and HRSA. The GME-SNC deliberately converges VA, CMS and HRSA GME resources within one centralized sponsoring institution to fund cohesive educational operations, clarifying clinical and non-clinical faculty time and trainees’ integration into patient care delivery.

The GME-SNC nurtures an enriched community network of learning venues to improve care coordination and public health while well-preparing an inter-professional workforce. AHCs’ self-directed transformation, through engagement in GME-SNCs as backbone organizations, can lead a fix for America’s healthcare. The GME-SNC can inspire high integrity academic frameworks to build comprehensive networks of inclusive stakeholders aligned around shared purpose and mutually reinforcing action plans. Utilizing Institute for Healthcare Improvement’s seven leverage points and high impact leadership models, the GME-SNC catalyzes large-scale healthcare transformation to address national healthcare workforce needs, to actuate the Triple Aim and to refuel meaningful professional practice.4

1. Christianson CM, Bohmer R, Kenagy J. Will disruptive innovations cure health care? Harvard Business Review, Sept-Oct 2000: 103-111.
2. Mullan F, Chen C, Petterson S, Kolsky G, Spagnola M. The social mission of medical education: ranking the schools. Ann Intern Med. 2010;152:804-11 [PMID:20547907]
3. Rieselbach RE, Feldstein DA, Lee PT, Nasca TJ, Rockey PH, Steinmann AF, et al. Ambulatory training for primary care general internists: innovation with the affordable care act in mind. J Grad Med Educ. 2014;6(2):395–398
4. Ruddy MP, Thomas-Hemak L, Meade L. Practice transformation: professional development is personal. Acad Med. 2015 Dec 29.

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