Last Batch of New Residency Spots Doled Out by CMS

As the Centers for Medicare & Medicaid Services (CMS) doled out the final 200 of an additional 1,000 residency positions created by Congress 5 years ago, medical groups called for more federally funded spots to mitigate workforce shortages.
“While this final distribution represents a meaningful step forward, our country remains in desperate need of additional, permanent residency positions to help alleviate the persistent physician workforce shortage,” David Skorton, MD, president and CEO of the Association of American Medical Colleges (AAMC), said in a statement.
In 2021, Congress passed the Consolidated Appropriations Act, which provided federal funding for 1,000 additional residency programs across the country. It was the first time federal funding for residency slots had been expanded since 1997.
These positions were meant to be awarded to hospitals fitting one of four criteria: being in a rural area, training residents in excess of their current graduate medical education (GME) caps, being in states with new medical schools or branch campuses, or serving areas designated to be in shortage of healthcare professionals.
The first 200 positions were awarded in 2022, and have been rolled out each year since. A second piece of legislation in 2023 created an additional 200 positions, which were awarded in 2025.
In total, 99 hospitals in 31 states received new residency positions, according to AAMC. About 42% of those positions went to primary care and psychiatry residency programs.
Kisha Davis, MD, MPH, president of the American Academy of Family Physicians (AAFP), applauded the additional slots for primary care positions.
“We know that more primary care physicians in underserved communities means better access to care and better health outcomes,” Davis said in a statement emailed to MedPage Today. “The AAFP appreciates that CMS awarded 18 new family medicine residency slots in high-need areas” in this latest distribution.
However, while Davis called this “important progress,” she added that “we can’t lose sight of the fact that our nation does not have enough primary care physicians to meet patients’ needs.”
“We need concrete policy changes to ensure that more people go into primary care and can practice, and stay, in communities that need it the most,” she noted.
AAFP said it is supporting legislation focused on residencies in primary care and rural and high-need areas, as well as funding for graduate programs that can help train primary care physicians to work in community-based settings.

AAMC called on Congress to pass the Resident Physician Shortage Reduction Act of 2025, which would gradually increase the number of Medicare-supported GME positions.
Bryan Carmody, MD, MPH, of Eastern Virginia Medical School in Norfolk, who runs a popular blog on medical education, noted an important caveat — that hospitals can add residency positions even without federal funding, as long as they meet certain educational standards.
Indeed, hospitals have continued to add residency positions since the 1997 cap, “even without Congress subsidizing the cost,” he told MedPage Today in an email.
Carmody said he’s not sure that expanding federally funded positions will curb any alleged physician shortage; he also questions whether one exists. Instead, he argued that shortages are “distributional” and the “natural result of the incentives in our system.”
“I’m not convinced that subsidizing positions in this way is going to do much of anything to address those problems,” he added, noting that there’s “no requirement that these newly trained residents will practice in a way that improves access for patients.”

They may end up in primary care, or “they might work as a sub-specialist in the affluent suburbs,” Carmody said. What they choose is more dictated by the incentives in the current system, he suggested, “and I don’t see how those incentives are changed in the least by whether or not the hospital received extra public money to train them or not.”