Background and Objectives: Medicare provides the majority
of funding to support graduate medical education (GME).
Following the flow of these funds from hospitals to
training programs is an important step in accounting for
Methods: Using a national survey of 453 family practice
residency programs and Medicare hospital cost reports, we
assessed residency programs' knowledge of their federal
GME funding and compared their responses with the actual
amounts paid to the sponsoring hospitals by Medicare.
Results: A total of 328 (72%) programs responded; 168
programs (51%) reported that they did not know how much
federal GME funding they received. Programs that were the
only residency in the hospital (61% versus 36%) and those
that were community hospital-based programs (53% versus
22%) were more likely to know their GME allocation.
Programs in hospitals with other residencies received
less of their designated direct medical education payment
than programs that were the only residency in the
sponsoring hospital (-45% versus +19%).
Conclusions: More than half of family practice training
programs do not know how much GME they receive. These
findings call for improved accountability in the use of
Medicare payments that are designated for medical