Medical Education Debt a Top Priority at AMA-RFS Meeting

Resident & Staff Physician®January 2008 Vol 54 No 1
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Dear Colleague,

The American Medical AssociationResident and Fellow Section(AMA-RFS) hosted its 31st InterimAssembly Meeting in November2007 in beautiful Honolulu, Hawaii.More than 180 residents and fellowsfrom across the United States gatheredto carve out a new policy anddiscuss major AMA initiatives.

At the forefront of discussionwas HR 2669, the College Cost Accessand Reduction Act, whicheliminated the 20/220 pathway foreconomic hardship deferment startingOctober 1, 2007. The 20/220pathway had enabled many residentphysicians to qualify for economichardship deferment andhold off payment for 3 years, withoutaccruing interest on subsidizedloans. Residents qualified if theirdebt burden was greater than 20%of their income, and if their incomeminus their debt burden was notgreater than 220% of the federalpoverty level.

Through the AMA?s lobbying efforts,the 20/220 pathway has beentemporarily reinstated by the Departmentof Education until the fallof 2008. This temporary fix givesthe AMA, and other interested organizations,the necessary time toobtain a more permanent legislativesolution. In fact, the S. 2303bill has already been introduced,with the goal of fully reinstating the20/220 pathway. Congress can alsoreinstate the pathway through theHigher Education ReauthorizationAct. You can continue to help theAMA with this effort by visiting theAMA-RFS online at, and, using our telephonescript, talking points, and Capwiz,contact Congress members andurge them to take action on this importantissue.

In addition, the assembled residentsand fellows from diverse backgroundsdiscussed and adopted resolutionson topics such as:

  • Removing barriers of care to transgender patients
  • Loss of status after qualified family medical leave during residency
  • Telemedicine and licensure
  • Monitoring of at-home call implementation by residency programs.

The intricacies of at-home callwere discussed at length, with someresidents noting that the potential forabuse existed. The RFS and theHouse of Delegates adopted a resolutioncalling for the AMA to studythe impact of at-home call on residentwell-being and patient safety.

Fellow and AMA Trustee SamanthaL. Rosman, MD, updated theRFS Assembly on the AMA?s campaign,'Voice for the Uninsured."This is a 3-year, multimillion dollarcampaign to raise awareness of theproblem and obtain coverage for theuninsured. The campaign spots,which are now blanketing the primaryand were played for attendees,state that "1 out of 7 uninsuredAmericans is 47 million too many."Dr Rosman has spoken with thepresidential candidates of both partiesand continues to raise awarenessof this issue among voters. Check theevent spots and photos at

What else can you do about theseissues? Lobby, lobby, lobby. You canlobby on these and other issues importantto resident and fellow physiciansat the National AdvocacyConference/Lobby Day in Washington,DC, on March 31, 2008. Residents,fellows, and medical studentswill converge on Capitol Hill to discusswith legislators and their staffissues important to physicians intraining and the future of medicine.Resident and Fellow/Medical StudentLobby Day is also an excellentopportunity to increase your awarenessof legislative issues affectingmedicine, to foster relationshipswith legislators through political involvement,and to gain real-life educationin the practical aspects ofphysician advocacy.

Kimberly Ruscher, MD

Delegate, AMA House of Delegates

Resident and Fellow Section

Governing Council

Michelle Powers, MD, MBA

Alternate Delegate, AMA Houseof Delegates

Resident and Fellow Section

Governing Council

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