title: Institutions with accredited residencies in New York State with an interest in developing new residencies or expanding existing ones.
abstract: OBJECTIVE
  In view of the looming physician shortage, especially in primary care specialties, there have been calls for increasing graduate medical education (GME). However, the capacity for increases of GME in institutions accredited by the Accreditation Council for Graduate Medical Education (ACGME) has not been determined.
  
  
  METHODS
  In 2009, the authors surveyed the 48 designated institutional officials supervising ACGME-accredited residencies in New York State that were eligible for their study, to determine interest in and capacity for development of new core residencies and expansion of existing ones if additional funds were made available at current Medicare rates.
  
  
  RESULTS
  Thirty-six (75%) responded; 39% would add new programs and 47% would expand current programs with additional funding. The major interest in adding new programs was in emergency medicine (35%). Notably, only 11% would add family medicine. The major interest in program expansion was internal medicine (48%), urology (42%), diagnostic radiology (35%), obstetrics-gynecology (26%), and emergency medicine (25%).
  
  
  CONCLUSIONS
  Fewer than 50% of current training institutions are interested in or have the capacity for expansion of core residencies. The interest in establishing or expanding primary care is especially problematic. Because 70% of internal medicine residents become subspecialists, additional funds for GME at current rates would largely encourage the training of additional hospital-based and hospital-intensive specialists, with little impact on those who would practice adult primary care medicine. Significantly increasing the physician training for adult primary care medicine will require more substantial institutional incentives.
authors.affiliation: Stony Brook University, Stony Brook, NY 11794-8036, USA. Norman.Edelman@stonybrookmedicine.edu
authors.forename: Norman H
authors.initials: NH
authors.lastname: Edelman
authors.forename: Raymond L
authors.initials: RL
authors.lastname: Goldsteen
authors.forename: Karen
authors.initials: K
authors.lastname: Goldsteen
authors.forename: Shamuel
authors.initials: S
authors.lastname: Yagudayev
authors.forename: Fabio
authors.initials: F
authors.lastname: Lima
authors.forename: Laura
authors.initials: L
authors.lastname: Chiu
mesh_terms: D003625:Data Collection; D006784:Hospitals, Teaching / Q000458:organization & administration*; D007396:Internship and Residency / Q000191:economics / Q000592:standards; D006278:Medicare / Q000191:economics*; D009518:New York; D058007:Physicians, Primary Care / Q000600:supply & distribution* / Q000639:trends; D014481:United States; D000078329:Workforce