A Novel Program to Increase the Number of Women Patients Seen by Residents in a VA Hospital

A recent requirement from the Accreditation Council for Graduate Medical Education that internal medicine residents must provide care for a minimum of 25% of female patients in their longitudinal clinics has posed difficulties for Internal Medicine programs that utilize Department of Veterans Affairs (VA) hospitals for outpatient training. The authors report an innovative program developed at a Connecticut VA hospital for internal medicine residents at the Yale University School of Medicine. Residents participate in the clinic at the VA Women's Health Center every fourth week instead of attending their usual VA primary care clinic. To increase the numbers of patients being seen by residents, the "Sharing Program" was initiated in 2001 so that wives of veterans could be seen in the VA women's clinic. Sharing Program patients are billed for their care by the Yale University Medical Group and the VA is reimbursed by the University Medical Group for the cost of providing care to these patients. As a result of the Sharing Program, the mean proportion of female patients assigned to residents has reached 25%. Surveys showed high levels of patient and resident satisfaction, and that residents perceived an improvement in their education in the outpatient care of women.