The WRIGHT Center for Graduate Medical Education

The WRIGHT Center for Graduate Medical Education (TWCGME) and its primary affiliated entity, The WRIGHT Center for Community Health (TWCCH), share a mission to improve the health and welfare of our communities through responsive whole person health services for all and the sustainable renewal of an inspired and competent workforce that is privileged to serve. TWCGME'S passionate purpose is to demonstrate an "Achievable by All" Graduate Medical Education Safety-Net Consortium (GME-SNC) Teaching Health Center model that CO-creates transformational health care teams of leaders who empower people, families, and communities to own and optimize their health, health care delivery system, and their interprofessional health care workforce development. With full engagement of TWCGME stakeholders, the GME-SNC aspires to optimize its collective impact framework to effectively address America's primary care workforce shortage and mis-distribution, and related health, health care, and health care career access needs and challenges. As a GME-SNC, TWCGME partners with a network of safety-net health services providers and integrates GME federal resources directly from the U.S. Health Resources and Services Administration's (HRSA) THCGME program and the Department of Veteran Affairs' GME, as well as through its affiliation agreements with CMS GME-funded partnering hospitals and Inpatient Rehabilitation Facilities. Notably, TWCGME became a pioneering THCGME consortium grantee in 2011 when HRSA launched the THCGME program. Since then, THCGME grantees, including TWCGME, have been developing and expanding community-based clinical learning environments in community health centers (CHCs) and partnering hospitals and specialty stakeholders across our nation to train primary care resident and fellow physicians to offer nondiscriminatory health services while serving historically marginalized populations in medically underserved settings. Evidence demonstrates that physicians who train at CHCs are more likely to work in a CHC or other underserved settings after graduation, as validated by HRSA's Teaching Health Center GME program's undeniable Graduate outcomes fifteen years after its inception. This vital response to the primary care shortage most effectively trains and retains primary care physicians in communities where they are most needed, with 86%, 62%, and 31% of THCGME graduates remaining in primary care practice, serving underserved and rural communities, as compared to 23%, 26%, and 5% of traditional GME graduates respectively. With a notably higher-than-national-average complement of primary care physicians selecting careers in historically underserved settings, including in FQHCs and rural communities, after graduation, HRSA's THCGME program and TWCGME GME-SNC's historical Graduate practice pattern outcomes demonstrate logical, delivered solutions to resolve America's primary care crises. Yet this pioneering program's funding remains vulnerable and egregiously discordant and far below its value and impact to our country. This unfortunately unresolved inadequate funding debacle at the federal level continues to leave this notably impactful THC GME-SNC solution under-resourced, nonsensically undermining its national community benefit impact, despite escalating primary care shortages across our country. This bizarre tragedy of the commons reality is illuminated by the just released 2025 National Residency Match Program outcomes that revealed unfilled match positions in primary care disciplines. This repeated reality highlights persistent shortcomings in our historical, national Graduate Medical Education (GME) system championed by traditional academic Medical centers controlling isolated CMS centric GME systems. Graduate Medical Education (GME) expansion limited solely to the Centers for Medicare & Medicaid Services (CMS) program clearly will not fix primary care workforce development for America. In essence, relying solely on CMS for GME expansion may perpetuate the existing national GME system's limitations in supporting primary care, while targeted programs like THCGME have shown more promising outcomes with less investment. Our national primary care crises underscores the urgent need for deliberate solutions like HRSA's THCGME program and TWCGME's GME-SNC that affordably deliver high integrity, responsible primary care workforce development that is responsive to the health care needs of the American people. TWCGME believes that the existing GME system is not adequately structured to incentivize or support primary care training. There are gaps in national strategies for developing a primary care workforce that aligns with national health care needs and addressing these gaps is the shared responsibility of all health care stakeholders, including our federal government, the ACGME's single Medical Education accreditation system, CODA's single dental Education accreditation system, and GME Sponsoring Institutions. America's rapidly evolving health care landscape and the specific needs of underserved populations will not be adequately addressed without transformational, deliberately designed, and intentionally resourced national GME reform. According to data published by the Association of American Medical Colleges (AAMC) in March 2024 shows that the nation will face a physician shortage of up to 86,000 physicians by 2036. This continuing crisis compounds the physician and provider burnout challenges exacerbated by the 2020 global pandemic. TWCGME's GME-SNC physician training model, inspired by Teaching Health Center frameworks and Community Health Academic Medical Partnerships (CHAMPs), is designed to mitigate the health, health care, and health care career access barriers resulting from and further propagating this national shortage, while generating unprecedented collaboration and collective action strategies at the local community level for advancement of the Quintuple Aim, adapted from the Institute for Healthcare Improvement's Triple Aim, of improving health outcomes, and the access, quality, affordability, and experience of health care services delivery for all stakeholders.