Most students who graduate from Arizona medical schools train out of state, and physicians are more likely to establish careers where they complete their residency training during those pivotal years after medical school. One key reason that medical-school graduates leave Arizona is that the state does not have enough residency slots at hospitals or community health centers that allow doctors to train and practice their craft after graduating. The shortage has been made worse by a federal limit on Medicare-funded slots, state funding cuts to graduate medical education and some hospitals' reluctance to start or expand training programs.