Graduate medical education (GME), the training of resident physicians, is funded by GME payments to hospitals and health systems, largely from Medicare and Medicaid. The number, specialty, and practice locations1 of future physicians is heavily dependent on how GME positions are determined and placed. In 2015, Medicare alone provided $12.5 billion in GME payments to teaching hospitals. Yet, shortages persist in select specialties, such as primary care, and in rural and underserved areas.