Family Medicine Residencies: How Rural Training Exposure in GME Is Associated With Subsequent Rural Practice.

Area of Science:

• Medical Education
• Rural Health
• Physician Workforce Distribution

Background:

• Rural US populations experience physician shortages and lower life expectancy compared to urban areas.
• A critical need exists to encourage residency graduates to practice in rural settings.
• Understanding factors influencing rural practice is essential for improving healthcare access.

Purpose of the Study:

• To quantify the association between the duration of rural training during family medicine residencies and the likelihood of subsequent rural practice.
• To identify the impact of rural exposure in graduate medical education (GME) on physician practice location.
• To inform strategies for increasing the number of physicians practicing in rural communities.

Main Methods:

• Merged data from multiple sources: AMA Masterfile, AMA GME supplement, ABFM certification, ACGME, and CMS hospital costs.
• Utilized multiple logistic regression to analyze associations between rural training and practice location (rural/urban) in 2018.
• Included 12,162 physicians who completed US FM residencies (2008-2012), adjusting for confounders like age, sex, program size, and location.

Main Results:

• Only 14% of physicians practiced rurally in 2018; 80% of these had no prior rural training.
• Physicians with no rural training constituted the majority of those practicing rurally.
• Spending over half of residency training in rural areas was strongly associated with increased odds of rural practice (OR 5.3-6.3).
• Few residents (4%) and programs (5%) had substantial rural training exposure.

Conclusions:

• A clear linear relationship exists between the extent of rural training exposure during FM GME and subsequent rural practice.
• Increasing rural training components in residency programs can effectively promote rural physician workforce development.
• Targeted GME interventions focusing on rural exposure are vital for addressing rural healthcare disparities.