Keep updated on the latest AAIM successes and take action on key policy issues affecting academic internal medicine.
Alliance Continues Advocacy for Formal DIO Evaluation Process
April 2022— Because the support of a DIO is critical to a successful education mission, the Alliance has again asked ACGME to strongly consider developing and implementing an assessment tool to objectively assess the performance of the DIO. To be beneficial to the program, institution, and ACGME, this tool should be anonymous, administered on a 360-degree basis (including all key stakeholders), and include feedback from all program directors within the institution. The Alliance also asked ACGME to consider a formal DIO evaluation process in March 2021 in consideration of the challenges posed to institutions by the COVID-19 pandemic.
Read the April 2022 letter to ACGME | Read the March 2021 letter to ACGME
Alliance, Other Stakeholders Urge Swift Passage of FY 2022 Federal Spending Bills
November 2021—The Ad Hoc Group for Medical Research sent a letter November 15 to Congressional leadership urging the timely passage of FY 2022 bills to invest robustly in agencies and programs that will improve the nation’s health and well-being. Noting that HR 4502 and Senate draft Labor-HHS-Education spending bills already include strong increases, the letter encourages lawmakers to provide at least $46.4 billion for NIH’s base, supplement the work with separate new investment in the proposed Advanced Research Projects Agency for Health, and avoid additional continuing resolutions past December. AAIM is a member of the Ad Hoc Group for Medical Research.
Read the letter
Alliance Comments on ACGME Focused Revisions to Program Requirements
October 2021—At the end of July 2021, ACGME opened a 45-day comment period for the focused revisions to program requirements related to program director and coordinator support. While generally in support of the revisions, the Alliance emphasized the timeline needed to effect significant changes in staffing as well as past positions shared with ACGME about administrator FTE needs and program support.
Review AAIM comments
AAIM Joins GME Advocacy Coalition in Advocating for Additional Medicare-Supported GME Slots
September 2021— The Graduate Medical Education (GME) Advocacy Coalition has called on Congress to include additional GME slots in the budget reconciliation legislation they are drafting. This would build upon the 1,000 GME slots that Congress provided at the end of last year in the Consolidated Appropriations Act of 2021.
Coalition Comments on Safety Event Reporting
July 2021—The Coalition to Improve Diagnosis commends AHRQ on the release of the Common Format for Event Reporting–Diagnostic Safety Version 0.1. Despite the complexity and variability associated with diagnosis, the proposal begins to address the need for consistent approaches to diagnostic safety event reporting.
Coalition Encourages CMS to Broaden Distribution Criteria for New Positions
July 2021—The GME Advocacy Coalition—of which AAIM is a member—sent a letter June 28 to CMS about the proposed distribution of the 1,000 newly created Medicare-supported residency positions provided for in the 2021 Consolidated Appropriations Act. The coalition urged CMS to finalize the alternative 2 methodology in the FY 2022 Inpatient Prospective Payment System proposed rule (with modifications) and increase the number of FTE slots awarded per hospital for FY 2023 and all succeeding years, decisions that will allow CMS to distribute the positions in a way that ensures teaching hospitals can make meaningful increases in residency programs to produce more physicians.
Read the letter
UPDATE: Alliance Comments on CoPA UME-GME Transition Recommendations
May 2021—AAIM provided feedback on the preliminary recommendations from the Coalition for Physician Accountability UME–GME Review Committee to improve transition. Understanding that that CoPA does not intend to make “substantive changes to the preliminary recommendations,” the Alliance provided insights to operationalize the recommendations related to faculty development, minimizing bias, and examining resource and financial implications as well as the application process, virtual interviews, structured evaluative letters, and student advising.
Alliance Urges Federal Support for Physician Training
May 2021—The Graduate Medical Education Advocacy Coalition, of which the Alliance is a long-time member, sent a letter May 18 to President Joseph R. Biden and key congressional leaders to encourage support for the Resident Physician Shortage Reduction Act of 2021 (S 834/HR 2256). This bipartisan legislation would take steps to alleviate the physician shortage by gradually providing 14,000 new Medicare-supported GME positions and commission a report to specifically look at ways to create a more diverse clinical workforce.
Read the letter
NASEM Releases Report on Implementing Primary Care
May 2021—The National Academies of Science, Engineering, and Medicine (NASEM) recently released Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care, putting forward an evidence-based plan with actionable objectives via an implementation plan that balances national needs for scalable solutions while allowing adaptations to meet local needs. The Alliance is a study sponsor and provided public testimony at the study kickoff in January 2020.
Read AAIM testimony (January 2020)
COPA Releases UME-GME Transition Recommendations
April 2021—The Coalition for Physician Accountability recently released its recommendations developed by its Undergraduate Medical Education to Graduate Medical Education Review Committee. Convened in summer 2020, this committee was charged to recommend solutions to identified challenges in the UME-GME transition. The 42 recommendations are grouped into 12 themes, and are open for public comment until May 26.
AAIM has re-engaged the joint committee-council writing group that developed a preliminary Alliance statement (linked to below) in response to a December 2020 request from COPA seeking organizational input on the “ideal state” of UME-GME transition. The Alliance's comments will appear in the May 27 issue of AAIM Connection.
Read the COPA recommendations
Alliance Submits Comments on Proposed ACGME Section II CPR Revisions
April 2021—In response to a public comment period issued by ACGME, AAIM commented on the draft focused revisions to Section II of the Common Program Requirements relating to dedicated time for program directors, assistant/associate program directors, program coordinators, and core faculty members. The AAIM feedback was developed by a subset of the task force that generated the Alliance testimony for ACGME's program support congress in fall 2020: Paul B. Aronowitz, MD, MACP, Steven R. Barczi, MD, Anne B. Curtis, MD, MACP, FACC, FHRS, FAHA, Susan Lane, MD, FACP, Diane L. Levine, MD, FACP, and Bethany Millar, C-TAGME.
Essentially, GME program leaders need time and flexibility to carry out their responsibilities. AAIM recommends reinstating the 20% minimum FTE on non-clinical time dedicated to program administration; restoring the 50% FTE for program coordinators; and asking departments that share a single coordinator across multiple smaller programs to describe their process for augmenting administrative support, specifically during busier times.
Read the comments
AAIM Urges Administration to Support RISE Act
March 2021—The Alliance for Academic Internal Medicine (AAIM) joined Research!America and other organizations to urge the Biden Administration to support the Research Investment to Spark the Economy (RISE) Act.
AAIM Supports Increase in GME Positions
March 2021—The Alliance for Academic Internal Medicine (AAIM) has signed on to an effort by organizations representing America’s medical schools, teaching hospitals, and their physician partners to urge Congress to take steps to increase the supply of physicians in the United States.
Letter to U.S. House | Letter to U.S. Senate
Alliance Advocates for Formal DIO Evaluation Process
March 2021—The challenges of the COVID pandemic have exacerbated many struggles in medical education; the 2020 APDIM Fall Program Directors Survey revealed that up to one-third of internal medicine program directors in community- and university-based settings feel less than "highly supported" by GME leadership; 9.7% and 8.1% of program directors felt not at all supported by their hospital and GME leadership, respectively. Because the support of a DIO is critical to a successful education mission, the Alliance asked ACGME to strongly consider developing and implementing an assessment tool to objectively assess the performance of the DIO.
Read the letter to ACGME
GME Advocacy Coalition Thanks Congress for GME Support
February 2021—More than 80 organizations of the GME Advocacy Coalition, including AAIM, sent a letter to Congressional leaders January 27 to thank them for adding 1,000 new Medicare-supported GME positions in the Consolidated Appropriations Act, 2021. Federal support for GME has been effectively frozen since 1997; these new slots will alleviate some of the pressure teaching hospitals have been facing and allow them to increase training. The residency positions supported by the Consolidated Appropriations Act, 2021 are a needed first step to train enough physicians to treat a growing and aging population.
Read the letter
AAIM Comments on Ideal State of UME-GME Transition for COPA
January 2021—In response to a December 8 request from the Coalition for Physician Accountability UME-to-GME Review Committee seeking organizational input on the “ideal state” of UME-GME transition, an Alliance joint committee-council writing group developed a statement that emphasized the necessity for collaboratively developed assessment and transition tools, a commitment to transparency at the program and applicant levels, support for holistic review and for international medical graduates, and the importance of professional identity formation. AAIM thanks the writing group for its efforts: Richard L. Alweis, MD, Stefanie R. Brown, MD, FACP, FAAP, Chayan Chakraborti, MD, FACP, SFHM, Shobhina G. Chheda, MD, MPH, Aashish K. Didwania, MD, Matthew M. Fitz, MD, Susan Lane, MD, FACP, Amy Shaheen, MD, MSc, FACP, and Patricia Vassallo, MD, FACC, FASE.
Update April 2021: The Coalition for Physician Accountability recommendations to improve the UME-GME transition will be released for comment April 26. AAIM will reactivate the work group that provided feedback about "ideal transition" to prepare the response.
Read AAIM comments
Alliance Joins Coalition Letter to Advise Biden on Biomedical Research
December 2020—AAIM joined 348 member organizations in the Ad Hoc Group for Medical Research to commend US President-Elect Joseph R. Biden for his support of growth for NIH as part of $300 billion in new research and development investments in his Build Back Better plan. In the months and years ahead, the coalition urges attention to:
- Foundational principles that promote both a thriving scientific enterprise and public trust in science.
- Emergency supplemental funding to allow NIH to continue to make progress against COVID-19 and to resume pre-pandemic research.
- Sustained, robust growth for NIH’s base budget across scientific disciplines and disease areas.
Read the letter
Alliance Testifies to ACGME Congress on Program Support
November 2020—AAIM was invited to testify during the November 16 ACGME Congress on Program Support, which was convened by an ACGME Board of Directors Task Force to examine common and specialty-specific program requirements relating to duties, functions, dedicated time, and support for program directors, assistant/associate program directors, program coordinators, and core faculty members. The Alliance was ably represented by APDIM President-Elect Susan Lane, MD, FACP, ASP Councilor Steven Barczi, MD, and APDIM Program Administrators Advisory Council Past Chair Bethany Millar, C-TAGME; their comments reiterated and emphasized Alliance positions about protected time for program directors, ratios for program administrator support, salary support for core faculty, streamlining data and standardizing documentation, and program autonomy.
Review the testimony
AAIM Joins ECFMG Call to Speak Out Against Visa Duration Status Proposed Rule
October 2020— The Alliance commented October 23 on a proposed visa rule change from US Immigration and Customs Enforcement (ICE), an agency of the US Department of Homeland Security, that aims to change the process for certain nonimmigrant visa holders to extend their period of authorized stay in the United States. One of the visa classifications targeted by the change is the J-1. AAIM noted in its comments that the J-1 physicians affected by the proposed change are already carefully monitored, making such a rules change unnecessary. Additionally, the Alliance noted that patients in underserved and rural areas, and those in critical access points in large urban areas, would be most impacted by the rules change.
View the letter
Alliance Provides Feedback on the Future of the USMLE Step 2 CS Exam
August 2020—In the interest of identifying and developing an optimal approach to assess clinical skills for licensure, on July 10 NBME invited Alliance constituent organizations to share perspectives on the prior USMLE Step 2 CS exam and how clinical skills would ideally be assessed for licensure going forward.
Read AAIM comments
AAIM Supports the LGBTQ+ Community
June 2020—In recognition of Pride Month and the recent ruling by the US Supreme Court that the Civil Rights Act of 1964 confirming workplace discrimination protections extend to gay and transgender workers, the Alliance for Academic Internal Medicine (AAIM) speaks out in support of all LGBTQ+ faculty, administrators, learners, and patients, and their right to be treated equitably in all professional, personal, and health care environments.
Read the statement
AAIM Statement on Racial Injustice
June 2020—AAIM expresses its horror and sadness in agreement with the rest of the world at the death of George Floyd at the hands of police. For our African-American colleagues, this is a predictable fact of life reflecting several hundred years of history of unchecked police power and judicial authority. We are witnessing a tragic failure of a democratic society wherein African-Americans are continually and systematically treated unfairly, with overt discrimination, and must fear for their very existence.
Read the full statement
ABIM Clarifies Procedural Competence Expectations for Residents and Fellows
ABIM has released a letter clarifying how residents and fellows can demonstrat competence in the performance of invasive procedures.
Download the ABIM letter (PDF) | Review previous ABIM messages
Change to Pass/fail Score Reporting for Step 1
February 2020—USMLE announced today that score reporting for Step 1 will move from a three-digit numeric score to reporting only a pass/fail outcome. A numeric score will continue to be reported for Step 2 Clinical Knowledge and Step 3. Step 2 Clinical Skills (CS) will continue to be reported as pass/fail. This policy will take effect no earlier than January 1, 2022.
Learn more | AAIM Response (PDF)
AAIM Joins Ad Hoc Group's Call for Increased NIH Funding
October 2019—The Alliance joined 305 organizations, institutions, and businesses in signing a letter urging appropriators to work quickly to agree to provide a robust increase in funding for NIH in FY 2020.
Read the letter
Alliance Recommends PA FTE Minimum Requirement to RC-IM
October 2019—At the request of the RC-IM, AAIM submitted language recommending required program administrator FTE equivalents in residency programs. The recommendation—developed by the APDIM Program Administrators Advisory Council—suggests a minimum of one FTE coordinator for programs with 24 or fewer residents and a minimum of 0.5 FTE additional personnel per every additional 14 residents.
Read the language and rationale | Read the invitation letter
AAIM Comments on ACGME IM2035 Paradigm Shift Scenarios
September 2019—In June 2019, the ACGME Review Committee for Internal Medicine invited stakeholders to comment on three proposed paradigm shifts that were developed as part of the ACGME IM2035 scenario planning exercise. Through the intense work of a cross-council-committee work group, AAIM shared its feedback on the strengths, weaknesses, opportunities, and limitations of the preamble and the three paradigm shifts (implementing competency-based medical education, more widespread adoption of the AIRE innovation mechanism, and shifting to a data-based learning accreditation system).
Read the Alliance comments
AAIM Responds to InCUS Recommendations
July 2019—The Alliance has submitted its unified response to the recommendations from the Invitational Conference on USMLE Scoring. While allowing discussion of different perspectives of groups within the Alliance, the response emphasizes that the discipline’s most important priority is to train the best physicians possible to care for patients, which requires better tools to assess readiness and knowledge as well as a comprehensive plan to improve the UME-GME transition.
Learn more | AAIM Statement to NBME and FSMB on USMLE Scoring: February 2019
Alliance Supports Dream Act Legislation
July 2019—Through the auspices of the AAMC GME Coalition, AAIM signed on to a letter urging Congress to pass either the American Dream and Promise Act of 2019 or the Dream Act of 2019. The coalition letter maintains that either piece of pending legislation would ensure that members of the health care workforce approved for DACA and other undocumented individuals are able to continue their employment, education, training, and research.
Read the letter
AAIM Signs on to Support Opioid Workforce Act of 2019
June 2019—AAIM recently signed on to support the Opioid Workforce Act of 2019 (H.R. 3414).
AAIM Responds to ABIM Pulmonary Disease and Critical Care Med Boards
April 2019—The ABIM Pulmonary and Critical Care Medicine Boards proposed changes to the policies for dual certification in Pulmonary Disease and Critical Care Medicine.
Read the AAIM response
Alliance Comments on Administrator Ratios
April 2019—AAIM provided support for ACGME's proposed program requirements on administrator ratios as part of the comments on focused program requirement revisions.
Alliance Supports ABIM Procedural Competency Recommendations
April 2019—The Alliance agrees with the ABIM Internal Medicine Board’s four recommendations that would remove the requirement for a common set of procedures to be performed by all residents for certification eligibility.
AAIM Signs on to Support Resident Physician Shortage Reduction Act
April 2019—AAIM is part of the GME Coalition, which recently sent a letter to encourage Congressional leaders to cosponsor the “The Resident Physician Shortage Reduction Act of 2019” (S. 348, H.R. 1763). This bipartisan legislation would provide a responsible increase in Medicare support for GME to address the impending national physician workforce shortage. The letter notes the projected shortfall of physicians by 2030 and the impact on already vulnerable populations in rural and underserved areas.
Read the letter
AAIM Supports Added Pathway to Gastroenterology , Transplant Hepatology Certification
March 2019—AAIM offered recommendations to the ABIM Gastroenterology Board on approving a pilot program as an added pathway to Gastroenterology and Transplant Hepatology Certification.