The layers of systems affecting patient care, including that of clinic and hospital policy as well as state and federal laws, are the topic of one of the Accreditation Council for Graduate Medical Education's six Core Competencies. Health policy, a key aspect of Systems Based Practice, often receives limited exposure in graduate medical education (GME). Evidence A 15-point framework for teaching health policy in undergraduate medical education was published earlier this decade. At the GME level, several programs-both institutional and specialty-specific-have described their experience teaching health policy to their own learners. We therefore expand on the previously described framework adapting it for the development of a GME curriculum focused on U.S. domestic health policy. In addition, we analyze how well the currently employed Milestones address important health policy concepts. Implications Review of the Milestones of across all specialties reveal that four components-health insurance, history and consequences of major health care legislation, health disparities, and U.S. healthcare system, financing, and payment-remain underrepresented in the current approach to teaching health policy in graduate medical education. We recommend a centralized approach from institutional GME programs to address shared curricular needs in health policy supplemented by tailored content designed to solidify these concepts with a specialty-specific focus.

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