Graduate Medical Education
The ob-gyn workforce faces compounding challenges that pose serious threats to patient access to care. Physicians continue to experience record levels of burnout, mounting student loan debt, legislative interference in the practice of reproductive health care, and unpredictable cuts to payments that already fall well short of costs.
The retirement rate among doctors exceeds the replacement rate, and there are already too few ob-gyns to meet the country’s rising demand. In a 2021 report, the U.S. Department of Health and Human Services projects a shortage of 5,000 ob-gyns by 2030. National Center for Health Workforce Analysis at the Health Resources and Services Administration (HRSA) projects an overall shortage of nearly 140,000 physicians in 2036 with nonmetro areas experiencing the worst deficits. Currently, an estimated 36% of U.S. counties are considered “maternity care deserts,” or counties that do not have a hospital or birth center offering obstetric care or any obstetric providers.Although medical school enrollment has increased by over 25% since 2012, the 1997 cap in Medicare support for graduate medical education (GME) has hindered proportionate increases in residency training. ACOG is committed to improving access for all women to timely, high quality health care.
Our Position
At the federal level, ACOG advocates for:
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Federal support for residency training through legislation that increases the number of Medicare-supported GME residency positions by 14,000 over a seven-year period
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Increased support for new residency programs in rural areas and ensure rural hospitals have the resources to bring on additional residents
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The expansion of and investment in the development of new rural residency programs and rural track programs in obstetrics and gynecology
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Programs that bolster the primary care workforce, recruit residents to train in rural areas and care deserts, and improve workforce diversity
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Payment methodologies that provide ob–gyns with the necessary resources to offer individualized, patient-centered care
ACOG also supports the Teaching Health Center Graduate Medical Education program within the Health Resources and Services Administration, as an investment in increasing access to care for rural and underserved communities, and advocates for sustainable federal funding of the program.