New family medicine GME slots answer Academy’s workforce advocacy
Jan. 21, 2026, News Staff — CMS last month awarded 32 new family medicine graduate medical education (GME) Medicare residency slots, spread among 18 programs. The move includes new slots using a five-year GME expansion mandated by the Consolidated Appropriations Acts (CAA) of 2021, policy that answered the Academy’s workforce advocacy.
The slots complement a 2024 win for the Academy’s workforce advocacy: an $11 million investment by HHS and the Health Resources and Services Administration (HRSA) to establish new residency programs in rural communities, including six new programs centered on family medicine residencies with enhanced obstetrical training.
That same year saw the third round of GME slots opened by the 2021 legislation.
The Academy continues to press CMS for robust family medicine representation in Medicare’s GME program as a vital step to improving health care access in rural and underserved communities.
What to know about GME slots available by application
On Jan. 7, HRSA opened applications for residency slots tied to the last round of the GME openings stemming from the 2021 CAA. The Academy encourages eligible family medicine residency programs to apply by the March 31 deadline.
To receive additional full-time-equivalent (FTE) resident cap slots, a hospital must qualify in at least one of four categories:
- operating in a rural area (or recognized as a rural area under the law),
- training more residents than its GME cap,
- operating in a state with new medical schools or branch campuses, or
- serving a health professional shortage area.
At least 10% of the cap slots must go to hospitals in each of those four categories, with no single hospital receiving more than 25 FTE resident cap slots.
Why federally funded GME is important
Medicare has funded residency training since the program’s inception in 1965. However, a cap on GME slots, imposed by the Balanced Budget Act of 1997, has long slowed GME growth, stifling primary care workforce growth as a workforce shortage looms.
The 2021 CAA opened 1,000 FTE resident slots, phased in at a rate of no more than 200 slots a year beginning in fiscal year 2023; the 2023 CAA added 200 additional slots. The Academy lauded these openings as vital to physician training and a boon to public health, especially in health professional shortage areas.
How student loan limits could affect primary care
The Department of Education is expected to propose new rules related to H.R. 1 early this year, including one that addresses a $200,000 lifetime federal loan limit for profession degrees.
The AAFP has cautioned that this cap will worsen physician shortages by making it harder for future doctors to access and repay the financial assistance they need to complete their education. The Academy continues to call on Congress to instead boost the federal student loan borrowing limit and find alternate pathways to lower tuition costs.
Urge Congress to protect the Public Service Loan Forgiveness program
Possible family medicine workforce wins in the continuing resolution
As Congress began to solidify a continuing resolution to fund the federal government the week of Jan. 20, the AAFP identified several legislative elements favorable to primary care, including
- reauthorization and funding for the Teaching Health Center Graduate Medical Education program, a top AAFP priority, through 2029;
- increased funding through 2026 for Community Health Centers and the National Health Service Corps; and
- funding for Area Health Education Centers and Primary Care Training and Enhancement Programs, which were eliminated in the administration’s proposed 2027 budget.
You can support this package by contacting your lawmakers through the Speak Out tool.
Track family medicine legislation
Follow progress on action that could affect our specialty with the Academy's Congressional Bill Tracker.
Other primary care workforce legislation
The AAFP is watching several bills with possible offsets for H.R. 1’s workforce impacts.
- The Resident Education Deferred Interest (REDI) Act (S. 942/H.R. 2028) would allow borrowers to qualify for interest-free deferment on their student loans while serving in a medical or dental internship or residency program.
- The Rural Residency Planning and Development Act (H.R. 6468) would codify HRSA’s Rural Residency Planning and Development (RRPD) program, which provides startup grants to create new rural residency programs. The bill as written would grant the RRPD program $12.7 million a year through 2030.