Each year, California’s eight, non-profit, free-standing children’s hospitals train approximately 50% of the state’s pediatric residents (medical school graduates who are training to be pediatricians) and over 10% of all fellows (pediatricians who have completed their residency and are training to become specialists). They also provide pediatric training rotations for hundreds of family medicine, emergency medicine, and obstetrics and gynecology residents annually.
CCHA Hospitals Train the Pediatric Workforce of Tomorrow
CCHA: 486 (47% of total)
CA Total: 1,027
CCHA: 731 (6.8% of total)
CA Total: 10,706
CCHA: 195 (12.1% of total)
CA Total: 1,611
The costs to operate these Graduate Medical Education (GME) training programs are substantial and state and federal programs that subsidize the training of physicians disadvantage training programs operated by children’s hospitals. In part, this is because Medicare provides the bulk of federal GME funding, and children’s hospitals do not typically treat Medicare patients – Medicare funds services for the elderly, not children. Instead, children’s hospitals receive federal GME from a smaller, Children’s Hospital Graduate Medical Education (CHGME) program. But CHGME only provides about half as much support to train pediatricians as Medicare GME provides to train other types of doctors. Specifically, CHGME provides about $75,000 per year for each pediatrician in training while Medicare GME provides about $153,000 per year.
Given the lack of support at both the state and federal level, it is not surprising that there are fewer pediatric residency programs in California than other types of residency programs. For example, there are 67 family medicine residency programs in California and 44 internal medicine programs, but only 17 pediatric residency programs, even though children make up almost one quarter of California’s population.
At the federal level, CCHA along with the Children’s Hospital Association (CHA) are advocating for increased funding for CHGME that is equal to the GME program. In fiscal year 2022, total federal funds for the GME program were $718.8 million. In contrast, CHGME received only $375 million in fiscal year 2022, and $350 million in fiscal year 2021. Currently, the House and Senate are proposing $385 million in GME funding for Fiscal Year 2023 but to date, no votes have been cast on this issue. CCHA and CHA will continue to push for increased funding for this critical program.
With more sustainable funding, children’s hospitals have the infrastructure in place to be able to train additional providers and help address California’s pediatric behavioral health workforce shortages.
To learn more about pediatric residency training in California, download our White Paper.