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Residents Must Pay FICA Tax

AMA Graduate Medical Education (GME) e-Letter
January 2011

Dear Colleagues, 

The U.S. Supreme Court ruled unanimously that medical residents are not exempt from paying employment taxes (PDF) under the Federal Insurance Contributions Act (FICA). 

This ruling in Mayo Foundation for Medical Education and Research v. United States will have a wide-ranging impact on health care and teaching hospitals and involves an estimated $700 million in employment taxes annually. 

"The department certainly did not act irrationally in concluding that these doctors . . . are the kind of workers that Congress intended to both contribute and benefit from the Social Security system," said Chief Justice John Roberts, who wrote the opinion for the court (Associated Press). 

Please send us your input on these or other GME-related issues at

Paul H. Rockey, MD, MPH, Director
AMA Division of Graduate Medical Education

PS: This e-Letter is distributed free each month to more than 13,000 readers. Physicians: Help support this publication. Are you an AMA member? If so, thank you! If not, please join or renew your membership now.

Reminder: Check out our Twitter page for the latest news and updates on medical education. 

Nation needs more physicians--and more residency slots 

AMA President Cecil B. Wilson, MD, in his column in American Medical News, calls for more funding of residency slots, as well as an increase in minority physicians, to help meet the nation's growing health care needs, especially in underserved areas of the country. 

Writing on the AMA's New Horizons in Medical Education forum, Kenneth B. Simons, MD, Chair of the AMA Section on Medical Schools, also makes the case for more GME funding: 

"The 13-year freeze in the support of residency and fellowship training positions by Medicare must end. It is absolutely essential that support for GME positions be increased for our country to address the projected physician shortfall-a ticking time bomb both for our patients and this country." 

With nearly 600 participants in three months, the New Horizons online community has become a great way for physicians, medical school faculty, medical students and residents/fellows to share ideas about advancing medical education and practice. 


Want to join the forum? Send us an e-mail at 

For residents, no clear consensus about possible effects of new duty hour regulations 

The ACGME's new 2011 duty hour standards garner a mixed reception from residents, according to a recent NEJM study, with varying opinions on whether the rules will improve education and trainee quality of life (American Medical News). 

Reflecting this diversity of opinion, an editorial in the Boston Globe support the new regulations but calls for "caution" and raises the issue of continuity of care. 

NEJM: Institutions (and patients) should take steps to keep sleep-deprived surgeons out of the OR 

A perspective in the New England Journal of Medicine calls for more institutional oversight of surgeons' schedules to avoid sleep deprivation. Further, as part of the consent process, patients should be informed of and acknowledge that they understand the possibility of "impairments induced by [surgeons'] sleep deprivation and the increased risk of complications." 

In response, the American College of Surgeons argues that surgeons should be trained to understand their physiological limits and must have "the necessary judgmental latitude" to determine whether they are fit to provide optimal care on a case-by-case basis. 

AMA seeking ACGME RRC nominations in 10 fields 

Get involved! AMA members are sought for nominations to ACGME review committees (PDF) in the following disciplines (as well as the Institutional Review Committee): 


  1. Anesthesiology (two vacancies) 
  2. Dermatology 
  3. Family Medicine 
  4. Internal Medicine 
  5. Otolaryngology 
  6. Pathology (two vacancies) 
  7. Preventive Medicine 
  8. Psychiatry 
  9. Diagnostic Radiology (two vacancies) 
  10. Surgery 
AMA resources for you and your trainees 
  • Order your e-book version of the Graduate Medical Education Directory ("Green Book") 
  • Watch a Youtube video summary of the New Horizons in Medical Education conference 
  • Help your residents master the ACGME general competency requirements 
  • Register now for our patient safety webinar series 
  • Get updated information on medical licensure 
  • Obtain our State-level Data for Accredited Graduate Medical Education Programs in the US: 2009-2010 (PDF) 
  • Get an upated copy of our GME glossary (e-mail with "glossary" in subject line) 
  • Post open residency positions (click on "Residency and Fellowship Vacancy Submission Form") 
For more reading: 

  • AMA medical education and professional ethics Twitter pages 
  • Virtual Mentor (current issue: Ethics and the Role of Guidelines in Medical Practice) 
  • Medical Education Bulletin 
  • American Medical News (also available in a handy mobile edition) 
  • American Medical News vault (10 years' worth of coverage of trends and news in health care) 
  • Health Care Careers e-Letter 
  • Healthy Lifestyles e-Letter 
  • Ending Disparities e-Letter 
  • Physician Health e-Letter 
Medical education in the news 



Reminder: Check out our Twitter pages for the latest news on medical education and professional ethics. Some of our recent posts include the following: 

  • All you need to know about medical school, residency and fellowship--in a cartoon, no less! 
  • A true Patriot: Football club owner offers $20 mill in loan repayment for primary care physicians, nurses. (Boston Globe) 
  • All in the family: New med school model brings students to family, community. 
  • Integrate addiction medicine into primary care residency programs (Annals of Internal Medicine) 
Note: Access the message board of the Association for Hospital Medical Education (AHME) to share ideas and find answers to common GME questions. 


"Houston, we have a solution." What can we learn about patient safety from NASA? 

Over the years, NASA has had well-publicized successes (and failures). By applying these lessons learned from its own experiences as well as those of other high-reliability organizations, NASA has made safety an integral part of its culture. 

Join us on Wednesday, January 19 at 1 p.m. Eastern time for an AMA webinar featuring Gregg Bendrick, MD, MPH, Chief Medical Officer at the NASA Dryden Flight Research Center, located at the Edwards Air Force Base in California. 

Dr. Bendrick's presentation, Patient safety 104: High-Reliability Safety: Applications to Healthcare, will demonstrate how to apply many of the lessons NASA has learned to improve and maintain patient safety. 

Cost is $79 per site for AMA members and $99 per site for nonmembers. 

Accreditation Statement: The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. 

Credit Designation Statement: The American Medical Association designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits(TM). Physicians should only claim credit commensurate with the extent of their participation in the activity. 

Also, check out an archive version of our earlier webinars, "Patient safety 103: Communication: Disclosing Events and Errors to Patients" and "Patient safety 101: It's the system, stupid (or, It's the stupid system)." 

Finally, see "Residents' intentions and actions after patient safety education" in BMC Health Services Research. 

AMA scholarship supports research of issues for female physicians; apply now 

The Joan F. Giambalvo Memorial Scholarship -- an effort by the AMA Women Physicians Congress and the AMA Foundation -- aims to advance the progress of women in medicine and help the AMA identify and address the needs and interests of female physicians and medical students. 

Research proposals (due by Feb. 15) should focus on professional work or practice issues that affect women physicians, such as burnout, re-entry and practice patterns. 

From the American Medical News' vault: "Buy your own lunch" 

Bob Goodman, MD, had been saying for years that physicians needed to stop accepting gifts from drug makers. 

So in 1999 he made some buttons that read, "Just Say No to Drug Reps," and later that year founded the advocacy group No Free Lunch to promote the idea and recruit other like-minded doctors. 

Read this in-depth American Medical News interview with one of the pioneers of the movement--or see other classic stories from the newspaper's recently opened archives. 

Improving medical education to improve health: What should we do? 

In the January issue of Academic Medicine, Steven L. Kanter, MD, editor-in-chief, is inviting responses to his 2011 Question of the Year: 

"What improvements in medical education will lead to better health for individuals and populations?" 

Register now for the AHME Academy, Feb. 7 in Orlando Register now for the 2011 Association for Hospital Medical Education (AHME) Academy, Monday, February 7, in Orlando, Fla. The academy is a one-day primer for those new or returning to GME, covering such topics as:

  • Orientation/onboarding 
  • Integrating the competencies into your program 
  • International medical graduates 
  • Preparing for a site visit 

Also, be sure to check out AHME's Guide to Medical Education in the Teaching Hospital (fourth edition), which covers such topics as osteopathic GME, international medical graduates, and hiring nonphysician medical educators.

Check out video highlights from AMA symposium for IMGs 

Now playing on YouTube: Highlights from an AMA symposium in December for international medical graduates (IMGs). 

In other IMG news, GME program staff who supervise and train IMGs will want to check out a series of webinars from the Acculturation Program of the Educational Commission for Foreign Medical Graduates (ECFMG). 

  • The sessions will focus on strategies for screening IMG applicants and reaching interview decisions. Communication Skills -- Tuesday, January 18, 2011 
  • US Clinical Experience -- Tuesday, February 22, 2011 
  • IMG Survival Guide -- Tuesday, April 12, 2011 
  • Orientation Tools -- Wednesday, May 18, 2011 
All webinars will be held at 9 a.m. and 3 p.m. Eastern time on the days specified. For more information, contact 

The end of the medical school as we know it? 

The Flexnerian revolution began 100 years ago. Is it time for another fundamental change in medical education? 


The external links in this newsletter are provided for informational purposes only and may not necessarily reflect the official positions or policies of the AMA. 

Are you a member of the American Medical Association (AMA)? 

If so, thank you! If not, please join or renew your membership now. 

Give us your story ideas and feedback 

Direct comments to Fred Donini-Lenhoff, (312) 464-4635 


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