Should Private Equity Firms Own Residency Slots?

Private equity (PE) margin maximization and profit-making strategies focus on acquisition, short-term ownership, and sale of health care entities, including residency program opportunities. PE ownership durations generally have 3 purposes: reduce staff, sell assets, and refinance debt. The purpose of graduate medical education (GME), however, is to provide learning and training opportunities in a variety of clinical, academic, technical, and research domains. This article offers examples of PE involvement in residency training and argues that PE and GME purposes not only conflict but add instability to graduate medical education learning environments. This article also suggests reasons why PE investment in GME, including residency "slot" ownership, undermines academic health centers' ethical and educational obligations to trainees in their GME programs.