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President's Budget Proposal Eliminates Pediatric Medical Education Funding

Washington, DC – Children’s National, which trains hundreds of pediatricians each year, issued the following statement in response to cuts to Children’s Hospitals Graduate Medical Education (CHGME) program proposed by the Obama Administration.

President Obama, in his fiscal year 2012 budget, proposes to eliminate funding for the Children's Hospitals Graduate Medical Education (CHGME) program, which provides critical support to 56 freestanding children's hospitals in 30 states – including Children's National Medical Center – to support the training of pediatricians and other medical residents.

In explaining elimination of the program, the White House said it prefers to focus instead on targeted investments to increase the primary care workforce. Although they represent 1 percent of all hospitals, freestanding children’s hospitals train more than 40 percent of general pediatricians – the primary care workforce for children.

Pediatricians trained in children’s teaching hospitals benefit from the high volume of cases presented at a hospital and exposure to a wide range of conditions they otherwise might not see in other teaching settings. This robust, hospital-based experience positively impacts pediatric practice and outcomes in all settings.

Children’s National is the largest center for pediatric training in the greater mid-Atlantic region. Each year, Children's trains 90 pediatric residents, 140 fellows, and 500 visiting residents in adult care doing their pediatric rotations. These are medical doctors securing additional and required training in pediatrics, who contribute their energy, insights, and expertise to the care of patients and families at the Children’s hospital, clinics, and primary care health centers. Additionally, Children's National makes its training available to physician assistants and nurse practitioners, further amplifying the value of the program.

The CHGME program was enacted in 2000 with the goal of providing freestanding children’s hospitals with the same federal graduate medical education funding that adult teaching hospitals receive through Medicare.

If the proposed CHGME cuts go through, Children's National will sustain a $14 million cut – nearly the entirety of the hospital’s annual budget for training pediatricians and pediatric specialists. When taken in concert with the millions of dollars in Medicaid cuts the hospital faces in Maryland and the District of Columbia, this vital aspect of Children’s education mission – training the nation’s pediatric workforce – is in jeopardy.

These proposed cuts come at a time when many communities across the country face a persistent shortage of general and specialty pediatricians. Children's National commissioned original research from RAND, to assess the pediatric health needs of children in the metro area. This study, published in 2009, clearly documents glaring gaps in access to pediatricians. The shortages are most acutely related to dental health, mental health, substance abuse, and developmental delays.

In addition to training in general pediatrics and subspecialty programs, Children's National offers a community based pediatrician training program. The community health track is specifically tailored to address disparities by placing residents in historically underserved communities and training them in the cultural and economic realities of community pediatrics. Last year, 12 residents participated in this program, and the June 2011 class includes 8 additional placement opportunities. This program would not be possible without CHGME funding.

In addition to the impact on pediatrician training, elimination of CHGME dollars will have a devastating impact on the training of medical students in pediatrics. Pediatric residents serve an essential role in teaching medical students. These proposed cuts will essentially gut the pipeline for training doctors to care for our nation’s children.

Overcoming disparities in pediatric care was the focus of President Obama's visit to Children's National in July 2009, which marked a high point in the national dialogue around health care reform and children. Children’s National is disappointed in the Administration’s failure to recognize freestanding children’s hospitals’ role in training the nation’s pediatric health care workforce, including primary care pediatricians. Children's National is working with members of the regional Congressional delegation and the National Association of Children's Hospitals (N.A.C.H.) to ensure the viability of the nation's pediatric health care workforce.

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For media inquiries, contact Children’s National Public Relations: Paula Darte or Jennifer Stinebiser, 202-476-4500.

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