Medicare GME Expansion Residency Programs: The Complete, Essential List for 2026

Medicare GME expansion residency programs overview showing where training capacity increased and which U.S. hospitals gained new residency funding for 2026.

The Medicare GME expansion residency programs represent one of the most significant federal investments in U.S. physician training in recent years. Through Round 4 awards and Section 4122 funding, Medicare expanded Graduate Medical Education (GME) support for hospitals across the country This article provides a clean, residency-only analysis of Medicare GME expansion programs, using CMS-accurate language, strict ACGME definitions, and transparent explanations, so readers understand what was funded, what was not, and why it matters..

What Is Medicare GME Expansion?

Medicare funds physician training through Graduate Medical Education (GME). Historically, hospitals were limited by a Medicare GME cap, which restricted how many residents Medicare would support financially.

Recent federal policy changes allowed CMS to expand those caps, enabling hospitals to receive funding for additional resident training time. This expansion was implemented in multiple phases, including Round 4 awards and Section 4122 awards.

How Medicare Uses GME Expansion to Shape the Physician Workforce

Medicare GME expansion is not random. It is a policy instrument designed to influence where and how physicians are trained in the United States.

Through cap expansions, CMS can:

• Encourage growth in shortage specialties
• Strengthen training capacity at safety-net hospitals
• Support workforce development in underserved regions
• Stabilize teaching hospitals facing rising care complexity

Rather than creating overnight changes, GME expansion works incrementally, allowing hospitals to scale training in a controlled and sustainable manner.

Components of Medicare GME Funding

The Medicare GME funding has two components:

• DGME (Direct Graduate Medical Education)
  Covers direct costs such as resident salaries, benefits, faculty teaching time, and educational infrastructure.
• IME (Indirect Medical Education)
  Compensates teaching hospitals for higher patient-care costs associated with training residents.

These two components are combined and awarded as Full-Time Equivalents (FTEs).

Understanding the Role of FTEs in Residency Growth

All Medicare GME expansion awards are expressed as Full-Time Equivalents (FTEs). This approach gives hospitals flexibility while maintaining fiscal oversight.

In practice, FTE-based funding allows hospitals to:

• Phase in residency expansion gradually
• Support residents across multiple training years
• Allocate funding across different rotations or tracks
• Align growth with faculty, case volume, and accreditation readiness

This is why GME expansion should be interpreted as a capacity signal, not an instant change in Match numbers.

Why These Tables Focus Only on Residency Training

To make this analysis useful and actionable, the tables in this article focus exclusively on residency programs—that is, programs that represent entry points into U.S. graduate medical education.

This approach ensures:

• Relevance for medical students and IMGs
• Accurate workforce interpretation
• Clear separation between entry-level training and subspecialization

By narrowing the scope to residency programs only, the tables reflect training pipelines, not downstream specialization.

How to Read the Tables Correctly

Each table in this article uses standardized, CMS-aligned headings:

• Hospital Name
• Residency Program
• Total GME FTE Awarded (DGME + IME)
• ACGME Accreditation Number
• State

Interpreting the Numbers

• 1.00 FTE ≈ one full-time resident supported for one year
• Less than 1.00 FTE = partial-year or shared funding
• More than 1.00 FTE = long-term capacity to support multiple residents

Hospitals often consolidate FTEs across time before increasing intake.

Round 4 Medicare GME Expansion Residency Programs

The Round 4 expansion phase emphasized core residency specialties, particularly in hospitals serving high-need or underserved populations.

Common patterns in Round 4 include:

• Strong representation of Psychiatry and Internal Medicine
• Expansion of Family Medicine and Emergency Medicine
• Inclusion of integrated surgical residencies
• Geographic diversity across multiple states

Round 4 Medicare GME Expansion Residency Programs List

Section 4122 Medicare GME Expansion Residency Programs

Section 4122 awards built upon earlier expansion efforts, often providing larger FTE allocations to institutions positioned for sustained growth.

Notable characteristics include:

• Concentrated expansion at select hospitals
• Continued prioritization of mental health training
• Reinforcement of primary care capacity
• Support for large academic and safety-net centers

Section 4122 GME Expansion Residency Programs List

What This Means for Medical Students and IMGs

For applicants navigating the U.S. residency landscape, Medicare GME expansion is best understood as a forward-looking indicator.

Hospitals receiving expansion funding are more likely to:

• Increase residency intake in future cycles
• Develop new tracks or preliminary years
• Maintain long-term training stability
• Remain open to diverse applicant pools, including IMGs

Historically, many programs operationalize expansion one to three years after funding approval, once infrastructure and accreditation alignment are complete.

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