Over $15bn a year is spent on medical training in the United States, but more needs to be done to see where the money is going and what it is being spent on. That’s the view from a new report by the Institute of Medicine, which says greater accountability is needed to understand the quality of training being offered and whether the doctors graduating from these programs are competent enough to practice.

Over 25 million uninsured Americans will be eligible to receive treatment under the Affordable Care Act in the next few years, presenting huge challenges to the country’s healthcare system. Gail Wilensky, who chaired the reports’s panel, said: “It’s time to modernize how graduate medical education is financed so that physicians are trained to meet today’s needs for high-quality, patient-centered, affordable health care.”