Robert C. Bowman, M.D.
Longer term studies of all family medicine residency graduates, using current locations and applying the same RUCA coding methods, reveals that each graduation year from 1985 - 1995 contributed a fairly consistent rural workforce in 2003 with about 115 graduates currently in isolated rural locations, 213 in rural locations, and 240 in large rural locations. The rural contributions of the more recent residents graduating from 1996 - 2001 are 30% higher in each group; averaging 160 in isolated rural, 320 in rural, and 328 in large rural locations (thanks to Ed Fryer and Graham Center). These higher numbers are consistent with the additional 30% graduating or 800 more total FP graduates a year during this time period. For this latter group, the numbers retained or recycled are as yet unknown.
This steady state stands in contrast to the expectations of many that rural physicians are moving in a one way direction away from rural practice over time. There appears to be more of an equilibrium between rural and urban FP locations. Long term studies of a cohort of primary care graduates over a 12 year period in Nebraska revealed an equilibrium between rural and urban locations with 33% choosing rural primary care initially, 33 % in rural practice at the end of 12 years, and 50% in rural practice at some point of time (Practice Mobility in a Cohort of Primary Care Physicians, Bowman,Wigton,). Between various states there are differences in the percentages of rural and urban, but this has more to do with the rural practice locations in the state or the percentage of the rural population of the state. This also means that first practice location is a good marker for studies at a later point in time.
Comparing Medical Students By Class Year
Physician Distribution in the US