The Veterans Access, Choice, and Accountability Act of 2014: Examining Graduate Medical Education Enhancement in the Department of Veterans Affairs.

From 2006 to 2011, the Department of Veterans Affairs (VA) introduced the Graduate Medical Education (GME) Enhancement initiative to increase residency positions at VA training sites. VA once again has an opportunity to fund new residency positions through the Veterans Access, Choice, and Accountability Act of 2014 (VACAA). Congressional requirements under VACAA give priority to positions in primary care, mental health, and other specialties that the Secretary of Veterans Affairs deems appropriate. Moreover, facilities meeting the following criteria will be awarded priority for expansion: no prior GME activities, a shortage of physicians, rural locations, areas with a "high concentration of veterans," or located in Health Professional Shortage Areas as defined by the Health Resources and Services Administration. The authors of this Commentary discuss the implications of the new legislation, reviewing the past VA GME Enhancement efforts to examine the potential impact of further expansion of VA GME positions. Understanding the intent of the legislation and its provisions will allow qualified existing and potentially new affiliates to successfully pursue new residency positions during the five-year period of VA GME expansion under VACAA.