Best Urban Underserved Distributions
Robert C. Bowman, M.D. 7/15/2007
For Recent Graduates Known to be In United States Locations and Classified in a Primary Practice Activity (not still in residency or not classified), Ranked By Percentage Found in Urban Underserved Locations, the National Urban Underserved Average is 3.0%
|
FP = family physician MS = Medical School Grad Urban Influence Codes are 1993 coding |
Total |
Urban Under-served |
Urban Bottom Income Quartile Practice |
Major Medical Center |
Practice Location County Median Family Income over $60,000 |
All Under-served |
|
Foreign Born Puerto Rican MS |
274 |
16.4% |
2.2% |
30.7% |
12.5% |
21.5% |
|
Puerto Rican Male FP |
56 |
14.3% |
1.8% |
33.9% |
8.7% |
21.4% |
|
Other Hispanic Male FP |
171 |
14.0% |
2.9% |
52.6% |
20.0% |
18.1% |
|
Mexican American Female FP |
244 |
13.5% |
3.7% |
57.0% |
30.9% |
17.6% |
|
Mexican American Male FP |
356 |
13.5% |
5.6% |
45.5% |
14.5% |
22.5% |
|
African American Male FP |
393 |
12.2% |
4.6% |
48.6% |
21.7% |
20.9% |
|
African American Female FP |
709 |
11.4% |
2.7% |
56.1% |
25.7% |
17.9% |
|
Puerto Rican Female FP |
62 |
11.3% |
8.1% |
37.1% |
36.4% |
16.1% |
|
Central American MS |
2796 |
9.9% |
11.8% |
55.5% |
21.7% |
14.3% |
|
Other Hispanic Female FP |
103 |
9.7% |
2.9% |
53.4% |
27.8% |
14.6% |
|
Nigerian Medical School |
757 |
9.0% |
12.7% |
60.2% |
26.4% |
14.0% |
|
Inner City FP Res Grad |
2703 |
8.5% |
6.2% |
57.9% |
33.6% |
13.0% |
|
Birth Whole County Short FP |
325 |
8.3% |
7.7% |
39.1% |
11.2% |
26.8% |
|
Office Pediatric IMG |
2656 |
8.0% |
10.0% |
59.2% |
31.4% |
14.2% |
|
Puerto Rican Medical School |
2459 |
7.8% |
7.8% |
51.0% |
15.2% |
10.4% |
|
Puerto Rican Birth |
2564 |
7.5% |
8.0% |
53.4% |
20.5% |
10.2% |
|
Philippines Medical School |
2582 |
7.5% |
11.3% |
54.9% |
23.4% |
16.3% |
|
Historically Black Med School |
2191 |
7.4% |
10.3% |
65.4% |
31.9% |
10.8% |
|
Foreign Born US MD FP |
1779 |
6.6% |
5.5% |
56.8% |
31.5% |
10.5% |
|
All Foreign Born FP |
2893 |
6.5% |
7.7% |
55.5% |
31.2% |
11.0% |
|
Military Born FP |
170 |
6.5% |
6.5% |
51.2% |
22.6% |
12.4% |
|
Inclusive Primary Care IMG |
18428 |
6.2% |
8.4% |
58.4% |
29.0% |
12.8% |
|
Office Internal Med IMG |
5769 |
5.9% |
8.8% |
60.0% |
29.0% |
12.6% |
|
Asian Male FP |
1113 |
5.7% |
6.9% |
54.7% |
33.2% |
9.4% |
|
Foreign Born IMG FP |
1832 |
5.6% |
10.5% |
53.3% |
0.0% |
11.8% |
|
Internal Medicine IMG |
22144 |
5.3% |
8.5% |
67.2% |
27.0% |
10.5% |
|
Foreign Born IMG |
21943 |
5.2% |
8.6% |
67.6% |
27.0% |
10.4% |
|
Urban Born FP |
11428 |
5.1% |
8.0% |
49.7% |
28.2% |
11.1% |
|
Birth MS City/County FP |
8273 |
5.1% |
8.0% |
50.9% |
30.2% |
10.6% |
|
Born Metro Urban Inf 1 and FP |
14571 |
5.1% |
9.3% |
51.8% |
32.0% |
10.4% |
|
All International Med Grads |
35278 |
5.0% |
8.2% |
66.7% |
28.0% |
10.1% |
|
Born Urban Inf 4 and FP |
120 |
5.0% |
18.3% |
40.8% |
15.0% |
19.2% |
|
Native American Male FP |
40 |
5.0% |
12.5% |
40.0% |
17.5% |
27.5% |
|
Asian Female FP |
1147 |
5.0% |
6.5% |
60.3% |
40.6% |
8.3% |
|
Pakistan Medical School |
2857 |
4.9% |
10.2% |
61.7% |
22.8% |
15.0% |
|
Instate Born FP |
7152 |
4.8% |
9.0% |
46.4% |
24.3% |
12.2% |
|
Born Metro Urban Inf 2 and FP |
9207 |
4.7% |
15.0% |
47.8% |
22.1% |
11.8% |
|
Unknown Birth IMG |
9297 |
4.6% |
7.6% |
66.0% |
28.3% |
10.2% |
|
Distant International |
12086 |
4.6% |
6.7% |
72.1% |
27.0% |
8.8% |
|
India Medical School |
7724 |
4.4% |
8.0% |
68.0% |
31.6% |
9.3% |
|
West Coast Distributional |
6228 |
4.2% |
2.7% |
77.5% |
37.6% |
6.5% |
|
China Medical School |
518 |
4.1% |
5.0% |
76.4% |
33.5% |
5.0% |
|
Allo MCAT 8.5-9.25 MS |
18877 |
4.0% |
18.0% |
67.4% |
16.7% |
9.5% |
|
All Inclusive Primary Care US |
82474 |
4.0% |
9.4% |
62.4% |
31.1% |
8.2% |
|
Born NonMetro Urb Inf 9 FP |
325 |
4.0% |
7.4% |
31.7% |
14.6% |
18.5% |
|
Born NonMetro Urb Inf 3 FP |
336 |
3.9% |
11.9% |
42.6% |
21.4% |
12.5% |
|
White Male FP |
7172 |
3.8% |
10.7% |
44.4% |
22.5% |
12.2% |
|
Foreign Born US School |
27399 |
3.7% |
6.2% |
76.0% |
34.1% |
5.2% |
|
Isolated Rural Born FP |
358 |
3.6% |
13.1% |
37.7% |
18.7% |
15.6% |
|
Office Pediatrics US MS |
15476 |
3.6% |
9.1% |
71.6% |
36.7% |
5.5% |
|
Native American Female |
28 |
3.6% |
3.6% |
60.7% |
11.1% |
25.0% |
|
Small Rural Born FP |
991 |
3.5% |
11.9% |
33.9% |
14.6% |
20.2% |
|
Rural Located FP Res Grad |
201 |
3.5% |
10.4% |
45.3% |
22.9% |
14.4% |
|
Caribbean MS with US |
3777 |
3.5% |
7.9% |
63.8% |
33.0% |
7.0% |
|
Born NonMetro Urban Inf 5 FP |
1058 |
3.4% |
12.1% |
42.4% |
18.2% |
13.8% |
|
Osteopathic Lower MCAT |
8396 |
3.4% |
8.9% |
58.8% |
24.1% |
8.8% |
|
Born NonMetro Urban Inf 6 FP |
792 |
3.4% |
13.1% |
35.9% |
17.3% |
16.0% |
|
Allo MCAT 9.25-9.5 MS |
25077 |
3.4% |
15.0% |
71.2% |
24.9% |
7.1% |
|
Born NonMetro Urban Inf 5 FP |
1058 |
3.4% |
12.1% |
42.4% |
18.2% |
13.8% |
|
Osteopathic Higher MCAT |
13023 |
3.3% |
8.2% |
58.9% |
29.6% |
7.3% |
|
White Female FP |
5296 |
3.3% |
9.5% |
50.1% |
30.2% |
9.4% |
|
All Physicians |
245875 |
3.2% |
9.1% |
71.6% |
30.5% |
6.2% |
|
Not Born County/City w/ MS |
67263 |
3.2% |
12.3% |
67.9% |
25.1% |
7.3% |
|
US Born Office Internal Med |
23962 |
3.1% |
7.7% |
72.3% |
32.9% |
6.2% |
|
Large Rural Born FP |
1563 |
3.1% |
13.2% |
43.2% |
20.0% |
12.6% |
|
Born NonMetro Urban Inf 8 FP |
1173 |
3.0% |
12.2% |
36.9% |
13.5% |
19.6% |
|
Born in County/City with MS |
146843 |
2.9% |
8.0% |
74.6% |
33.3% |
5.1% |
|
Military Birth |
2181 |
2.9% |
16.6% |
69.5% |
26.5% |
6.3% |
|
Born NonMetro Urban Inf 7 FP |
1556 |
2.8% |
12.8% |
42.7% |
17.6% |
14.6% |
|
Isolated Rural Birth |
2595 |
2.7% |
11.7% |
61.2% |
20.8% |
10.0% |
|
Urban/Urban Focused |
148140 |
2.7% |
9.3% |
73.9% |
32.1% |
4.9% |
|
Small Rural Birth |
7412 |
2.6% |
13.5% |
62.0% |
21.0% |
9.8% |
|
Allo MCAT 9.5-10 MS |
55642 |
2.6% |
8.3% |
73.2% |
30.5% |
4.9% |
|
Canadian Medical School |
2181 |
2.6% |
6.1% |
72.2% |
31.0% |
6.4% |
|
Born Metro Urban Inf 2 Not FP |
39117 |
2.5% |
12.9% |
76.4% |
26.4% |
4.6% |
|
Large Rural Birth |
13630 |
2.5% |
12.4% |
66.2% |
22.8% |
7.7% |
|
Born NonMetro Urb Inf 7 NotFP |
5011 |
2.5% |
13.0% |
73.1% |
21.9% |
6.5% |
|
Born NonMetro Urb Inf 5 NotFP |
3477 |
2.5% |
12.8% |
73.2% |
25.5% |
6.2% |
|
Born NonMetro Urb Inf 8 NotFP |
2720 |
2.4% |
13.7% |
70.8% |
21.5% |
7.2% |
|
Born NonMetro Urb Inf 9 NotFP |
668 |
2.4% |
9.7% |
70.7% |
21.3% |
8.2% |
|
Born NonMetro Urb Inf 3 NotFP |
1130 |
2.3% |
12.0% |
73.7% |
25.0% |
5.7% |
|
Allo MCAT 10-10.5 MS |
39665 |
2.2% |
6.4% |
75.5% |
38.5% |
3.7% |
|
Born Metro Urb Inf 1 Not FP |
87984 |
2.2% |
7.1% |
78.9% |
35.6% |
3.5% |
|
Allo MCAT 10.5-12 MS |
34823 |
2.1% |
5.9% |
82.3% |
36.9% |
3.3% |
|
Early Admit KC, NE OH |
2296 |
2.1% |
9.8% |
73.0% |
26.2% |
4.1% |
|
Born NonMetro Urb Inf 6 NotFP |
2159 |
2.0% |
15.1% |
74.5% |
23.0% |
6.1% |
|
Uniformed Services MS |
1920 |
2.0% |
27.8% |
36.9% |
29.5% |
4.1% |
|
Born NonMetro Urb Inf 4 NotFP |
366 |
1.9% |
11.7% |
71.6% |
23.0% |
6.6% |
Distributional origins are associated with greater levels of distribution. Those most socially and geographically different and distant and those shaped by obligations have greater levels of distribution. Declining admissions of the above and declining obligations (J-1 Visa) and declining choice of family medicine will all impair rural underserved distribution.
Family medicine choice consistently multiplies distribution. Even family physicians with lower levels of distribution have double the rural and underserved distribution rates compared to allopathic public US MD Grads. Family physician distribution levels remain steady even when including the 1987 – 1993 class years when levels of family medicine choice were at low levels and health policy was less supportive of primary care.
General pediatrics and general internal medicine remain predominantly in major medical centers. This limits urban underserved contributions to average levels and reduces rural and underserved levels below national averages. Medicine pediatric physicians have slightly better distribution levels beyond major medical centers, but 80% of medicine pediatric physicians are lost in the first ten years after the match.
Family medicine residency graduates of 1997 – 2003 are found still in family medicine at a stable 98% (no greater deterioration for earlier class years), family physicians remain in office based primary care at 90%, and underserved distributions are multiplied compared to other physician forms of primary care.
Major Medical Centers for definitions of locations