The Teaching Health Center Graduate Medical Education (THCGME) program supports primary care medical and dental residency programs.
How is our program different?
Other residency programs base training out of hospitals. Our programs train in outpatient settings in the community, such as Federally Qualified Health Centers (FQHCs).
On which areas of primary care do we focus?
- Family Medicine
- Internal Medicine
- Internal Medicine: Pediatrics
- Obstetrics and Gynecology
- General Dentistry
- Pediatric Dentistry
How does resident training help communities?
We create opportunities for residents. This means more primary care workers for people and places with the most need.
What’s the cost of training?
Through a contract we awarded, the George Washington University collected and analyzed information from THCs on their expenses and revenues associated with resident training.
The university developed a costing instrument to collect this information. They put it into the field in April 2015 among THC programs with residents enrolled in Academic Year (AY) 2013-2014. Of the 43 THCs surveyed, 26 submitted complete data for analysis.
- THC clinics see a largely low-income, Medicaid-covered population. About two-thirds of patient revenues are from Medicaid, regardless of the THC’s organizational model.
- In AY 2013-2014, residents in the 26 THCs provided 269,773 visits precepted by faculty. This included 203,924 outpatient visits at clinics and 65,849 inpatient visits at hospital training sites.
- THC clinics provided 126,839 uninsured/uncompensated care clinic visits during AY 2013-2014. Residents participated in 24% of these patient visits.
- Nearly three-fourths (74%) of THC residency revenues are derived through precepted visits in the outpatient setting. The median per resident revenue in AY 2013-2014 was $46,535. THCs with residents in all training years had median per resident revenues of $99,391, compared to $25,584 in programs with only first post-graduate year residents.
- Resident compensation including salary and fringe benefits accounts for 26% of all expenses. Faculty compensation for training residents, including salary and benefits associated with residency administration, precepting outpatient and inpatient service, clinic administration time, as well as any precepting contracts paid by the residency, accounts for 30%.
- Resident clinical service administrative and operational expenses, including all inpatient and outpatient operational costs allocated to the residents’ patient visits accounts for 19%. Other educational costs, including residency personnel costs, occupancy and other costs for residency overhead, make up 17% of total THC expenses.
- In-kind expenses, which include all other educational costs borne by partners and hospital precepting contracts, represent an additional 9 percent of total expenses.
- There was variation in the cost of training between THCs. New, small, and rural programs appear to have higher costs of training.
- After taking into account patient service revenue/costs and residency training costs, they estimated the median overall cost of training a resident in a THC in FY 2017 to be $157,602.
Review the 2019 Report to Congress: THCGME Direct and Indirect Training Expenses Report (PDF - 583 KB) .
Whom do we serve?
We focus on people in rural and high-need areas.
Most Teaching Health Centers are in Federally Qualified Health Centers (FQHCs), Rural Health Clinics, and tribal health centers. All prioritize care for high-need communities and vulnerable people.
Over half (59%) of THCGME program training sites are in Medically Underserved Communities (MUCs). Training in these communities increases health care services and adds more primary care workers.
What impact do we have?
In academic year (AY) 2020-2021, our funds train 769 residents in 60 primary care residency programs, across 25 states.
- Family medicine (65%) is the top discipline.
- In AY 2018-2019, nearly all residents received training in a primary care setting. Eighty percent of residents trained in an MUC or rural community.
- Since 2011, the THCGME program has supported the training of over 1,148 new primary care physicians and dentists.
What have our grantees accomplished?
Review the accomplishments for Academic Year 2018-2019 (PDF - 157 KB) .
Who received awards in 2020-2021?
We awarded seven new Teaching Health Centers (THCs) in Academic Year 2020-2021.
Why is our work important?
In the National and Regional Projections of Supply and Demand for Primary Care Practitioners: 2013-2025 (PDF - 295 KB) , the National Center for Health Workforce Analysis projects the total demand for primary care physicians will grow by 38,320 full-time equivalents (FTEs) between 2013 and 2025.
They estimate a shortage of 23,640 primary care physician FTEs by 2025.
The THCGME program is a vital supply line to meet this demand.
How to contact us