Bill Overview
Title: FAIR Act
Description: This bill requires hospitals to certify that they accept residency applications from both osteopathic and allopathic medical schools and to disclose the number of applicants and acceptances from each type of program in order to receive graduate medical education payments under Medicare.
Sponsors: Rep. Harshbarger, Diana [R-TN-1]
Target Audience
Population: Medical school graduates seeking residency positions
Estimated Size: 33000
- The bill addresses medical residency applications, which is a part of the medical education system.
- Residency programs in hospitals train medical school graduates, usually within the United States.
- Both osteopathic (D.O.) and allopathic (M.D.) graduates are mentioned, so those are the target groups involved.
- Medical school graduates actively seeking residency positions will be directly impacted.
- Osteopathic schools graduate fewer students than allopathic schools each year, but both contribute significantly to the physician workforce.
- There are approximately 28,000 allopathic graduates in the U.S. each year and about 7,000 osteopathic graduates, meaning around 35,000 medical graduates seek residencies annually.
- The bill's policies focus on hospitals that receive Medicare funding for graduate medical education, important for residency training.
Reasoning
- The FAIR Act specifically targets the process hospitals use to accept residency applications, which particularly concerns medical school graduates (osteopathic and allopathic).
- Osteopathic graduates, who often experience barriers due to a preference for allopathic applicants in some institutions, may benefit more from the FAIR Act.
- The estimated population target is about 33,000 American medical graduates per year, seeking residency positions in the U.S., although international graduates may also find indirect benefits.
- Budget limitations suggest the policy must be efficiently implemented, possibly affecting initial awareness and reach.
- The policy does not affect those outside the medical education system, thus interviews focus on recent graduates or those in residency application phases.
- Wellbeing is assessed based on security and fairness perceptions in the residency application process.
Simulated Interviews
Recent medical school graduate (New York, NY)
Age: 27 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 2.0 years
Commonness: 10/20
Statement of Opinion:
- I believe the FAIR Act will make it a fairer process for osteopathic graduates like me.
- Currently, it feels like we have fewer opportunities compared to our allopathic counterparts.
- Increased transparency might push hospitals to reconsider any implicit biases.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
Current resident (Chicago, IL)
Age: 29 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 1.0 years
Commonness: 12/20
Statement of Opinion:
- As an allopathic graduate already in residency, I'm not directly affected.
- However, I support the fairness in opportunities across educational backgrounds.
- It's beneficial for my mentees from diverse medical schools.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 7 | 7 |
Recent medical school graduate (Los Angeles, CA)
Age: 26 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 1.0 years
Commonness: 15/20
Statement of Opinion:
- The policy won't change much for me since I'm an allopathic graduate.
- It's good to know there's a push for equality.
- Residency application stress remains high regardless of policy.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 6 |
International medical graduate (Dallas, TX)
Age: 32 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 1.0 years
Commonness: 5/20
Statement of Opinion:
- FAIR Act might not help an international grad like me directly but transparency is appreciated.
- Understanding the acceptance rates could guide my application strategy better.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 5 | 4 |
| Year 5 | 4 | 3 |
| Year 10 | 3 | 3 |
| Year 20 | 3 | 3 |
Hospital administrator (Seattle, WA)
Age: 40 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 8/20
Statement of Opinion:
- We already consider applications from both types of schools, but transparency is key.
- Ensuring compliance with FAIR Act while managing financial constraints is a challenge.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 5 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Recent medical school graduate (Houston, TX)
Age: 25 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 9/20
Statement of Opinion:
- This act is very important for osteopathic graduates.
- I've always felt there was a hidden curriculum where allopathic schools had an upper hand.
- Transparent and fair application processes are motivating.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 6 | 5 |
Resident advisor (Phoenix, AZ)
Age: 28 | Gender: other
Wellbeing Before Policy: 7
Duration of Impact: 2.0 years
Commonness: 14/20
Statement of Opinion:
- I've seen firsthand the challenges osteopathic students face.
- A policy like the FAIR Act should level the playing field.
- The requirement for disclosure can only improve the system's transparency.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 6 |
Recent medical school graduate (Atlanta, GA)
Age: 31 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 1.0 years
Commonness: 6/20
Statement of Opinion:
- As an IMG, the competition is tough and slots are limited.
- The FAIR Act's transparency might shed light on my options better than current methods.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 5 | 5 |
| Year 3 | 5 | 5 |
| Year 5 | 5 | 4 |
| Year 10 | 4 | 4 |
| Year 20 | 4 | 4 |
Recent medical school graduate (Boston, MA)
Age: 26 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 5.0 years
Commonness: 16/20
Statement of Opinion:
- I've noticed disparities in how osteopathic and allopathic applications are perceived.
- The FAIR Act should create a more merit-based selection.
- I'm curious how transparency will change future application cycles.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 9 | 8 |
| Year 3 | 9 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 7 | 8 |
Policy analyst (Washington, D.C.)
Age: 39 | Gender: female
Wellbeing Before Policy: 9
Duration of Impact: 10.0 years
Commonness: 1/20
Statement of Opinion:
- Efforts like the FAIR Act are necessary in today's diverse medical education landscape.
- This policy is a step in creating equity among different medical education paths.
- The long-term effects of such policies must be diligently monitored.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 9 | 9 |
| Year 2 | 9 | 9 |
| Year 3 | 9 | 9 |
| Year 5 | 9 | 8 |
| Year 10 | 9 | 8 |
| Year 20 | 9 | 8 |
Cost Estimates
Year 1: $20000000 (Low: $15000000, High: $30000000)
Year 2: $20000000 (Low: $15000000, High: $30000000)
Year 3: $20000000 (Low: $15000000, High: $30000000)
Year 5: $20000000 (Low: $15000000, High: $30000000)
Year 10: $20000000 (Low: $15000000, High: $30000000)
Year 100: $20000000 (Low: $15000000, High: $30000000)
Key Considerations
- Ensuring that the necessary administrative adjustments by hospitals do not unduly burden smaller institutions.
- Monitoring to ensure allopathic and osteopathic graduates have equitable access to residencies.
- Ensuring compliance to maintain Medicare funding without excessive administrative costs.