Advocacy
Keep updated on the latest AAIM successes and take action on key policy issues affecting academic internal medicine.
The Alliance Signs on to Support Disability-Inclusive Health Care
September 2023 - AAIM joined more than 20 organizations to support a roadmap developed by the Action to Build Clinical Confidence and Culture coalition to improve the health care of 14 million Americans who have intellectual and/or developmental disabilities (IDD). The coalition will work with professional societies, such as AAIM, ACP, and ACGME, to map IDD competencies, create curriculum standards and quality measures, incentivize clinical education, advocate for licensing and certification standards, and promote clinical environments that are supportive of people with IDD.
View the roadmap | See the steering committee
AAIM Urges NASEM to Improve Internal Medicine Representation for Primary Care
August 2023 -- Earlier this week, the Alliance sent a letter to the leadership of the National Academies Standing Committee on Primary Care, urging them to consider increasing the number of representatives to be included in the newly established Standing Committee on Primary Care. Internal medicine is the specialty with the largest number of active physicians specializing in primary care, yet only two internal medicine physicians are listed in the provisional committee appointments. AAIM also recommended considering individuals from community-based teaching hospitals.
Read the letter>
Alliance, Other Stakeholders Send Letter to Congress Urging Appropriate Funding for NDDs
May 2023 -- The Alliance and 760 local, state, and national organizations signed onto and sent a letter calling on Congressional leadership to reject cuts to non-defense discretionary appropriations (NDDs).
Read the letter>
Alliance, Other Stakeholders Sign Letter Supporting the Resident Physician Shortage Reduction Act of 2023
May 2023 -- The Alliance and nearly 80 other organizations signed-on to a letter sent to congressional leaders supporting the Resident Physician Shortage Reduction Act of 2023 (H.R. 2389). This bipartisan legislation is crucial to expanding the physician workforce and ensuring that patients across the country are able to access quality care from providers. The Resident Physician Shortage Reduction Act of 2023 supports a gradual increase of the number of Medicare-funded GME positions by 2,000 per year for seven years, for a total of 14,000 new slots.
Read the letter>
Alliance, Other Stakeholders Sign-on to Letter in Support of the DACA Program and Dreamers
March 2023 -- The Alliance and 77 other organizations signed-on to and sent a letter to congressional leaders urging enactment of legislation that provides permanent protections for Deferred Action for Childhood Arrivals (DACA) recipients. The letter, which was also sent to Sen. Durbin and Sen. Graham, the sponsors of the Dream Act, outlines the invaluable contributions that "Dreamers" provide to the US health and biomedical workforce. Legislation is needed in light of recent court rulings that have left the DACA program in legal limbo.
Read the letter>
Alliance, Other Stakeholders Sign-on to Final Ad Hoc Group Recommendations
March 2023— The Alliance, as one of almost 400 members of the Ad Hoc Group for Medical Research, signed onto the final Ad Hoc Group Recommendations letter sent to House and Senate Appropriations Committee leaders in March 2023. The Ad Hoc Group FY 2024 funding recommendation requests at least $50.924 billion for NIH’s foundational work, a $3.465 billion increase over the comparable FY 2023 program level.
Read the letter>
AAIM Supports Seven Program Signals for 2023-2024 Residency Application
March 2023 — The Alliance has been an integral part of the ERAS Supplemental Application Pilot in FY 2022 and FY 2023. In FY 2024, geographic preferences and the revised experiences section of the pilot will be fully integrated into the application. Program signals are also being fully integrated into the MyERAS application for applicants in 2024, but due to the complexity of program signaling, each interested specialty was asked to explicitly agree to participate in program signals. After careful consideration, the Alliance has indicated that internal medicine will use program signaling in FY 2024; APDIM and CDIM leaders selected seven as the best number of program signals.
Read more>
AAIM Responds to Proposed ACGME Revisions to Subspecialty Program Requirements
February 2023 — The Alliance provided feedback to ACGME about the proposed revisions to the internal medicine subspecialty program requirements. Rather than sharing specific views on individual subspecialities, AAIM comments relate the general requirements that apply to all subspecialties. In particular, the Alliance urged ACGME to acknowledge the broad variability of institutional support available to programs and therefore to be more flexible in requirements related to required rotations, nontraditional settings, and telemedicine. AAIM also urged ACGME to be less prescriptive in the requirements for minimum core faculty and faculty expertise in novel technologies.
Read the feedback>
Alliance, Other Stakeholders Urge Congress to Finalize FY2023 Funding
December 2022— The Alliance, as one of almost 300 members of the Ad Hoc Group for Medical Research, signed onto a November 8 letter sent to House and Senate Appropriations Committee leaders urging the passage of the final FY 2023 funding bills. Specifically, the letter called for passing the $47.5 billion for the NIH base budget that the House Appropriations Committee has already passed. The letter also requested that Congress avoid another continuing resolution (CR) after the current FY 2022 CR ends on December 16, and encourages passage of a final FY2023 spending bill.
Read the letter
AAIM Provides Feedback on Unintended Consequences of New ACGME FTE Requirements
September 2022—Through the work of a cross-council writing group, the Alliance developed a letter summarizing many of the concerns about the new program requirements for core faculty support of internal medicine residency and fellowship programs. Sent September 8, the letter to ACGME acknowledges the shared goal of providing outstanding training and the mutual commitment to prioritizing resources for education. However, the new requirements have raised several financial challenges and potential repercussions for training, compensation, and research that AAIM hopes to ameliorate through cooperation with ACGME and other key stakeholders.
Update: In a September 21 response, ACGME shared that in response to the input from the Alliance and others, the current core faculty member FTE requirements for internal medicine subspecialties will not be enforced in 2023 and that they will be revised as part of the major revision of subspecialty program requirements currently underway.
Read the letter | Read the ACGME response
The Alliance Signs On to GME Advocacy Coalition Letter
July 2022—The Graduate Medical Education Advocacy Coalition--of which AAIM is a member--sent a letter to Senate Majority Leader Chuck Schumer and House Speaker Nancy Pelosi to urge them to build upon historic investment in the health care workforce as they consider upcoming budget reconciliation legislation. Investments to increase the number of physicians are sorely needed; the coalition specifically asked leaders to include policies that would increase Medicare support for GME in the budget reconciliation legislation.
Read the letter
The Alliance Joins More than 75 Organizations in Statement Against Legislative Interference
July 2022—Initially developed by the American College of Obstetricians and Gynecologists and the American Medical Association in response to the June 24 US Supreme Court decision in Dobbs v. Jackson Women’s Health Organization, the statement asserts that “as the US health care system enters a post-Roe era, we, representing dozens of major organizations of health care professionals, oppose all legislative interference in the patient–clinician relationship. Our patients need to be able to access—and our clinicians need to be able to provide—the evidence-based care that is right for them, including abortion, without arbitrary limitations, without threats, and without harm.”
Read the full statement
The Alliance Calls for Policymakers to Support Gun Safety Legislation
May 2022—The Alliance is saddened and horrified by the most recent spate of mass shootings in the United States. More than two years ago, AAIM joined 40 other leading organizations to call for policies to help reduce firearm related injury and death in the United States. Today, the Alliance calls for policymakers to represent the interests of the public—which includes our patients, learners, and faculty and staff—and support legislation to mandate background checks, enact “red flag” laws, ban access to assault weapons, and increase federal support for research on gun violence as a public health issue.
Read the full statement
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.
Read letter
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.
Read letter
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.
Read comments
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.
Learn more
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.
Read letter
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