Iowa Graduate Medical Education (GME) supports the development, expansion, and sustainability of residency and fellowship programs across the state. Our work strengthens Iowa’s healthcare workforce, enhances access to care, and promotes high‑quality training environments for future physicians. This coordinated statewide training and workforce system ensures Iowa’s rural and underserved communities have consistent access to physicians trained in Iowa, supported primarily by sustainable Medicaid and Medicare funding and strengthened through rural-focused residency models.
Iowa GME works to unify efforts across Iowa HHS, medical schools, hospitals, rural facilities, state workforce programs, Medicaid financing, and federal GME pathways to develop a sustainable, data-driven approach to addressing rural provider shortages.
Iowa hosts a diverse network of residency and fellowship programs across multiple specialties. These programs deliver the clinical training necessary for physicians entering practice and play a key role in retaining physicians within the state.
Medicare Graduate Medical Education (GME) is a cornerstone of Iowa’s long‑term strategy to expand and sustain physician training, particularly in rural communities. Across the state, hospitals differ in their ability to leverage Medicare GME depending on whether they have already established a Medicare GME cap. Larger, long‑standing teaching hospitals have an existing cap that limits the number of residents Medicare will support, which means they cannot expand training capacity without identifying alternative funding sources. In contrast, many rural hospitals and “never‑claimer” facilities have no established cap, giving them a valuable opportunity to set one by launching new residency programs or rural training tracks, an action that creates a stable, nondiscretionary funding stream through Medicare’s Direct and Indirect GME payments. This distinction shapes Iowa’s rural workforce strategy: uncapped hospitals can use new program development to secure long‑term financial sustainability, while capped hospitals must more heavily rely on state Medicaid GME supplemental payments, private investment, or other funding mechanisms to support program growth.
Iowa hospitals have benefited from the Grassley‑led expansion of rural residency slots under the Consolidated Appropriations Act (CAA) Section 126, which allocates 1,000 new Medicare-funded GME positions nationally—at least 10% designated specifically for rural hospitals. To date, Iowa has received approximately 14.4 permanent additional slots across multiple rounds, including emergency medicine positions at Iowa Methodist Medical Center and family medicine slots at MercyOne Waterloo Medical Center, with further positions awarded at MercyOne Des Moines in cardiovascular disease. This injection of federal funding supports Iowa's efforts to build and sustain residency programs in underserved and rural areas, aligning with the state’s broader GME
Iowa has 644 Medicare-supported GME slots, meaning these residency positions receive funding through Medicare Direct GME, out of a total of 963 residents in training statewide. These slots are distributed among the state's teaching hospitals, providing essential federal support for physician training in both urban and rural settings.
Iowa’s State Medicaid GME Supplemental Payments help support the cost of training medical residents by updating how hospitals are reimbursed for both direct and indirect graduate medical education expenses. Under State Plan Amendment IA250014, qualifying state‑owned and teaching hospitals receive supplemental Medicaid GME payments based on existing cost‑reporting criteria, including their number of FTE interns and residents. These payments are intended to stabilize the state’s physician‑training infrastructure and can also serve as a core component of long‑term sustainability plans for new rural residency programs developed under federal RRPD grants, as Medicaid GME is an allowable non‑Medicare funding source.
ShepsGME Technical Assistance Center supports creation and sustainability of graduate medical education and graduate dental education in rural and underserved settings through technical assistance, research, and policy analysis.
Rural Medical Training Collaborative: Helps sustain health professions in rural communities through education, training, networking, mutual encouragement, and peer learning.
ACGME Home: Find information about accreditation and recognition, including for applications, site visits, and review and comment
GME Track | AAMC: A resident database and tracking system that was introduced in March 2000 to assist GME administrators and program directors in the collection and management of GME data.
Iowa Board of Medicine ensures that medical professionals in Iowa are qualified, adhere to professional standards, and practice safely to protect public health. Issues and renews licenses for physicians.
List items for GME Professional Organizations that Support
Des Moines Area Medical Education Consortium (DMAEC): A nonprofit partnered with the University of Iowa Carver College of Medicine, facilitating clinical rotations, coordinating ACGME-approved residency programs across four Des Moines hospitals, and supporting nine residency programs.
University of Iowa Health Care – Graduate Medical Education Office: Manages 32 residency and 110 fellowship programs (totaling nearly 1,000 trainees). Offers well-being initiatives, house staff council, leadership programs, educational innovation funds, and malpractice/stipend support.
Iowa Medical Society (IMS): Supports GME expansion advocacy and statewide healthcare workforce recruitment programs.
Iowa Academy of Family Physicians (IAFP): Includes residents in its structures (Resident Council and board representation) and supports member engagement, advocacy training, and promotion of family medicine residencies statewide.
Physician Support Line: Psychiatrists helping physicians and medical student colleagues navigate the many intersections of their personal and professional lives.
