Federal Flu for Health Professions Education

Congress slashes funds for programs aimed at training doctors in geriatrics and other fields and diversifying work force.
January 16, 2006

Lots of college groups are unhappy with how they've fared in the latest round of spending and other bills passed in the penurious environment by a Congress set on cutting the federal budget. But proportionally, perhaps no set of institutions has taken a bigger hit than schools that educate doctors, nurses and other health professionals.
"Just let me know when you''ve heard enough bad news, and I'll try to make something up," Erica Froyd told a group of health professions financial aid officers at a meeting last week sponsored by the Association of American Medical Colleges. Froyd, senior legislative analyst for the medical college association, outlined the severe cuts that Congress made to programs aimed at training doctors and other health professionals in a spending bill for the Health and Human Services and other departments in late January.

The programs, which fall under Title VII of the Public Health Service Act, have been targeted for reduction if not elimination in many recent years, forced to fight a perception -- mistaken, medical school and other officials insist -- that they are not effective. Last summer, the House of Representatives approved a plan to cut from its 2006 spending plan about $250 million of the $300 million that the government provided for the programs in 2005. The AAMC and a coalition of other groups launched a campaign to restore the funds, arguing that many of the areas targeted for cuts -- in fields such as geriatrics and rural health -- were key priorities right now.

The Senate Appropriations Committee voted in July to restore almost all of the funds. But the programs fell victim to the federal axe in the final days of the legislative year, when Congress approved a compromise spending bill for the Departments of Labor, Health and Human Services, and Education that cut 2006 funds for the programs about in half, to $145.2 million from $299.6 million in 2005.

The programs taking the biggest hit were the Health Opportunity Careers Program, which is designed to bring more students from underrepresented groups into medical fields, and a geriatric training program, as shown by the following table:

Program 2005 (in millions) 2006 (in millions) % change
Primary care medicine and dentistry $88.8 $40.9 -54%
Area Health Education Centers 29.0 28.7 -1%
Health Education Training Centers 3.8 0 -100%
Allied health training 11.8 4.0 -66
Geriatric training 31.6 0 -100%
Rural training 6.1 0 -100%
Public health, preventive medicine 9.1 7.9 -100%
Health administration 1.1 0 -100%
Workforce information and analysis .7 0 -100%
Diversity programs      
--Centers of Excellence 33.6 11.9 -65%
--Health Careers Opportunity Program 35.6 4.0 -89%
--Faculty Loan Repayment 1.3 1.29 -1%
--Scholarships for Disadvantaged Students 47.1 46.7 -1%

Source: Association of American Medical Colleges

The 2006 spending bill also contained a provision that will require institutions, for the second straight year, to repay to the federal government about $40 million in unspent funds provided in 2005 to two loan programs for health professions and nursing students.

Froyd, who is also director of the Health Professions and Nursing Education Coalition, bemoaned the steady "chipping away" of funds for health profession education. "We need to stop this," she said, to nods from the dozens of financial aid directors on the receiving end of her report.


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