Patterns of Rural Workforce

Robert C. Bowman, M.D.

Education is a key factor in preparing the students most likely to choose family medicine and rural practice Medicine, Education, and Social Status. However there are ways that states can compensate by recruitment efforts.

Family Medicine Physician Distribution basics of US FP distribution with graphics

Physician Workforce Studies file with links and data

Patterns of Migration for FPs - 5 patterns of migration

The Impact of Recruitment Investment by 2 states

From my studies of recent FP grads, I can tell you that NC continues to do well. All states medical schools, and residencies donate to meet NC needs. This is the result of a superb and mature statewide multilevel effort. Visits to Virginia also revealed that those faculty most interested in outreach had been taught the value of such efforts by even short times working with this AHEC system. NC and WI and IA also have arguably the best coordinated efforts to recruit and retain FPs, as seen in the NC pattern below, and in Iowa with the highest concentration of FPs.

The universe of this study is all FP graduates 1997-2003 with contact in NC

1 = Birth state of NC for all grads 2.=Medical school in NC for all FP grads

3 = FP residency in NC 4 = Choose NC locations for practice

The pattern of MS, TN noted above, losing graduates to other states is similar in the midwest and other states with less rapid growth and less investment in recruitment.

Note that North Carolina is in the lowest group regarding admissions of rural born medical students. Probability of admission tables

High Growth State Patterns

- see NC above, similar patterns in NV, CA, VA, etc.

State Table for 1997 - 2003 FP Residency Graduates At Various Points in Time

	Birth State	Med School	FP Residency	Practice	Gain from Birth to Practice	Gain from Residency to Practice
AK	37	0	31	117	80	86
AL	222	245	363	297	75	-66
AR	208	267	327	322	114	-5
AZ	130	125	318	361	231	43
CA	1602	1404	2257	2441	839	184
CO	216	183	456	463	247	7
CT	187	88	123	114	-73	-9
DC	159	302	15	73	-86	58
DE	52	0	107	79	27	-28
FL	311	403	855	870	559	15
GA	347	429	565	606	259	41
HI	99	87	82	114	15	32
IA	399	694	405	376	-23	-29
ID	82	0	93	129	47	36
IL	1020	1284	1283	1056	36	-227
IN	465	404	609	599	134	-10
KS	254	305	326	329	75	3
KY	261	251	230	288	27	58
LA	282	355	298	361	79	63
MA	353	334	288	351	-2	63
MD	236	423	287	302	66	15
ME	68	156	202	195	127	-7
MI	803	792	979	786	-17	-193
MN	491	542	645	632	141	-13
MO	415	914	429	432	17	3
MS	161	113	94	176	15	82
MT	97	0	31	92	-5	61
NC	261	451	648	800	539	152
ND	104	119	137	110	6	-27
NE	227	345	277	203	-24	-74
NH	37	77	49	104	67	55
NJ	447	311	542	446	-1	-96
NM	115	136	128	201	86	73
NV	43	84	68	137	94	69
NY	1283	1066	1260	1003	-280	-257
OH	994	1215	1057	918	-76	-139
OK	222	316	309	302	80	-7
OR	150	138	118	285	135	167
PA	969	1304	1450	1016	47	-434
PR	168	140	147	130	-38	-17
RI	56	55	90	78	22	-12
SC	178	259	469	399	221	-70
SD	115	126	97	105	-10	8
TN	268	407	452	419	151	-33
TX	1034	1521	1545	1650	616	105
UT	216	148	176	215	-1	39
VA	325	514	555	571	246	16
VT	32	92	41	60	28	19
WA	223	307	593	654	431	61
WI	387	447	611	638	251	27
WV	192	294	272	177	-15	-95
WY	51	1174	92	78	27	-14

Education access can impact birth. Admissions varies by state and medical school and state medical education investment. States also vary in support of family medicine residency programs. Health policy support in the various states also is a consideration. Managed Care Comparison Table

Family Medicine Physician Distribution basics of US FP distribution with graphics

Rural Workforce and Health Policy in the United States

Origins and Locations of Recent Family Medicine Residency Graduates