The Children's Hospitals Graduate Medical Education (CHGME) program is the only federal program devoted to the training of pediatricians and pediatric subspecialists. The program is intended to compensate for the disparity in the level of federal graduate medical education funding (GME) for pediatric teaching hospitals versus other types of hospitals.
Defining CHGME Hospitals
There are 59 hospitals across the U.S. that receive CHGME funding. While adult-focused teaching hospitals may offer pediatric training, they are not eligible for these funds because they receive Medicare GME. Organizations identified as CHGME hospitals:
- Primarily serve children under 18.
- Have an accredited pediatric training program.
- Make up 1% of all hospitals but provide close to one third of inpatient hospital care received by children on Medicaid.
CHGME hospitals train civilian and some military providers, including:
- Pediatricians and pediatric specialists, as well as child and adolescent psychiatrists, pediatric dentists and podiatrists.
- Family medicine and other adult specialists for their pediatric rotations.
- Most physicians in some fields, like pediatric rehabilitation, receive their training at CHGME hospitals.
Funding and Managing the Program
The Bureau of Health Workforce (BHW) and Health Resources and Services Administration (HRSA) administer the program, which accounts for only 2.5% of total federal spending on GME. The program is funded based on annual appropriations and reauthorized every five years, meaning that 2023 is a reauthorization year. It's a discretionary grant program so the overall funds are capped.
CHGME hospitals receive two types of payments:
- Direct Medical Education (DME) payments cover the direct cost of GME, such as stipends and fringe benefits for residents, and salaries and fringe benefits for faculty.
- Indirect Medical Education (IME) payments cover expenditures such as the cost of treating more severely ill patients and processing diagnostic tests because of the training of residents.