Graduate Medical Education


When students graduate with a DO or MD degree at an American medical school, they must then enter a residency program in their chosen specialty. The duration of this training varies from three years for Family Medicine, Internal Medicine, and Pediatrics, to five years for Surgery, Orthopedics, and Obstetrics and Gynecology. Upon completion of residency, a physician is eligible to become Board Certified in that field and may elect to continue training in a subspecialty fellowship.

Graduate Medical Education, or GME,  is the term that encompasses these residency and fellowship programs. UIWSOM graduates spend much of their fourth year as medical students interviewing and auditioning for GME programs. They enter a process known as "The Match" where they rank their GME preferences and are "Matched" to programs that have also ranked them. Residents and Fellows are physicians and have a training license that allows them to practice medicine but only under the supervision of a fully licensed physician. Residents and Fellows are required to perform the duties of direct patient care, but they are also held accountable for increasingly difficult academic responsibilities.

Physicians must successfully complete their residency to become Board Certified in their specialty. While some states allow a physician to receive a license after only one or two years of GME training, it is very difficult for physicians trained in the 21st Century to practice medicine without being residency trained and board certified.


GME programs are located throughout the country in every state and nearly every major metropolitan area. Programs may be located at a large academic medical center associated with an existing medical school or they may be at community-based hospitals. The US Military sponsors GME programs as do VA hospitals and Community Health Centers and Rural Health Centers.

Medical students are not guaranteed a residency position following graduation - they have to compete with all other students interested in that location and that specialty program.

Unfortunately, there are a limited number of GME positions across the country and an increasing number of medical school graduates from the US and abroad competing for these positions. Most GME programs are funded by the federal government through the Medicare program, but funding for existing programs was capped in 1998 and therefore cannot expand beyond current capacity.

There is a shortage of GME positions in the state of Texas. The Texas Higher Education Coordinating Board (THECB) released a report on the GME deficit in December 2014 recommending additional state funding for GME expansion. The Texas State Legislature responded by appropriating over $60 million in grant funding to assist with new GME development.


UIWSOM feels strongly that in order to serve the population of South Texas, new residency training programs must be created. Physicians tend to settle within 100 miles of where they completed their residency so the creation of new residency programs in the region is imperative to UIWSOM's mission.

GME Development is a time consuming process which requires years of careful due diligence to ensure the highest quality educational experience for the trainee while preserving the highest quality of care for each and every patient. Hospitals and clinics must be fiscally responsible and clinical faculty must be engaged in the teaching process.

For this reason, the UIWSOM Office of Graduate Medical Education was established in 2014 with the intent of identifying opportunities for GME growth and development. In 2015, UIWSOM helped to establish the Texas Institute for Graduate Medical Education and Research, or TIGMER. This is a 501c3 nonprofit GME consortium that provides expertise, shared resources, and academic oversight to new and developing residency programs. TIGMER holds initial accreditation as a Sponsoring Institution by the Accreditation Council on Graduate Medical Education (ACGME).

Thomas Mohr, D.O., the Associate Dean for GME and his team are working to build relationships with clinical partners. Several new programs already have obtained accreditation. When these programs launch, they will be open to osteopathic graduates from any osteopathic medical school. Once they have obtained ACGME accreditation, any MD or DO student will be able to apply.

For more information about GME Development in South Texas, please see the TIGMER web page at:

Thomas Mohr, D.O., FACOI
Associate Dean for Graduate Medical Education
Professor of Internal Medicine
Marsha Sellner
Director of Graduate Medical Education