Addressing physician shortage in medically underserved rural and tribal communities through residency program...

Area of Science:

• Medical Education
• Health Workforce Research
• Rural Health

Background:

• The United States faces a significant physician shortage, disproportionately affecting rural and tribal areas.
• Oklahoma ranks low in primary care provider availability, with severe shortages in its rural and tribal communities.
• Indian Health Service (IHS) facilities report high physician vacancy rates, impacting healthcare access.

Purpose of the Study:

• To assess the geographic distribution and practice patterns of family medicine residency graduates from Oklahoma tribal programs.
• To determine the impact of these programs on addressing physician shortages in rural and underserved areas.

Main Methods:

• A retrospective cohort analysis of 87 graduates from three ACGME-accredited family medicine residency programs in tribal healthcare systems (2013-2024).
• Verification of practice locations using National Provider Identification (NPI) and Federation of State Medical Boards (FSMB) data.
• Classification of practice sites by Medically Underserved Area/Population (MUA/P) status, Health Professional Shortage Area (HPSA) score, and rural designation.

Main Results:

• 66.7% of graduates stayed in Oklahoma, with 79.3% practicing in Primary Care HPSAs and 65.5% in rural areas.
• Graduates from Oklahoma State University College of Osteopathic Medicine (OSU-COM) were more likely to practice in Oklahoma (78.6%) and tribal healthcare systems (55.4%).
• Over half of the graduates initially practiced in Medically Underserved Areas (MUAs).

Conclusions:

• Rural tribal residency programs are effective in retaining physicians in underserved and rural locations.
• These programs contribute to balanced physician distribution, especially within tribal healthcare settings.
• The model offers a replicable strategy for graduate medical education (GME) to address national physician workforce disparities.