H.R. 4731: Resident Physician Shortage Reduction Act of 2025

Medicare pays for most of the residency positions that turn medical school graduates into practicing doctors. The number it funds has been capped for decades. H.R. 4731 raises that cap by 2,000 funded positions in each year from 2026 through 2032.

That adds up to 14,000 new training slots. If hospitals don't claim them all in a given year, the leftovers roll into the next year, and if the seven years end short of 14,000, HHS keeps running rounds until the full number is distributed.

The slots aren't handed out evenly. One-third of each year's positions are set aside for hospitals already training more residents than Medicare pays for — but only if they're at least 10 over their limit and put a quarter of their residents into primary care and general surgery. Of the remaining slots, at least 10% each must go to rural hospitals, to hospitals in federally designated shortage areas, and to a few other priority groups. Hospitals tied to one of six historically Black medical schools get priority within the shortage-area pool.

No hospital can take more than 75 of these positions over the whole period, which spreads the expansion rather than letting the largest teaching hospitals absorb it. The bill also orders the Government Accountability Office to study how to bring more doctors out of rural, lower-income, and underrepresented communities, with a report due to Congress within two years.

What the bill doesn't settle is the price tag. Medicare's graduate medical education spending already runs into the billions a year, and 14,000 more funded residents adds to that — the bill leaves the cost to play out through the existing Medicare formula rather than naming a number. It also doesn't touch the other bottlenecks: medical school capacity, or the specialties and regions new doctors actually choose.