Is GME Snubbing Rural America?
Candice Chen, MD
Theories abound as to why young physicians won't practice in rural areas: less money, horribly long or erratic working hours, massive medical school debts to repay, a lack of cultural diversity and other social chasms with the populations they serve, practicing in isolation, a lack of professional support, and generally poorer schools for their children and fewer career options for spouses, to name a few.
The failures continue despite the efforts and financial incentives by the federal and state governments to encourage medical students and residents to practice in underserved areas both rural and urban. The key reason why young physicians don't take up these obvious and dire needs is a lack of accountability in publicly funded Graduate Medical Education programs, researchers suggest.
Chen and her colleagues studied the career paths of 8,977 physicians who had graduated from 759 medical residency sites from 2006 to 2008. The researchers analyzed data to find out where these new physicians ended up practicing three to five years after graduation. They found that overall only 25.2% of the physicians in this study worked as primary care physicians.
Chen says this number likely too high because it includes hospitalists. The researchers found that 198 of 759 institutions produced no rural physicians during the study period. And 283 institutions graduated no doctors practicing in the Federally Qualified Health Centers that serve low-income or destitute patients in underserved urban and rural areas.
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