Birth Origin and Ethnicity of Family Medicine Graduates

Robert C. Bowman, M.D.

Newer file at Ethnicity Gender and Rural Practice Choice

	Underserved excluding MMC	Underserved All	Poverty Level Zip at 20%	CHC Zip	Rural Practice Zip	Poverty Level Zip at 18%	Military Zip	Core Metro Born	Lesser Metro Born	NonMetro Born	Residency to practice Less than 60 miles	Residency to Practice over 500 miles
White Female	12.9%	21.7%	23.7%	17.1%	23.7%	27.7%	4.0%	43.3%	35.3%	21.4%	54.9%	26.5%
White Male	14.5%	21.6%	20.9%	13.7%	28.3%	24.7%	8.4%	33.8%	38.6%	27.6%	47.7%	29.6%
Black Female	24.8%	41.1%	30.3%	14.0%	10.0%	36.0%	2.8%	61.1%	29.6%	9.3%	60.7%	26.1%
Black Male	25.1%	40.1%	32.5%	16.9%	11.7%	38.6%	7.1%	57.8%	32.8%	9.4%	57.5%	28.2%
Mexican Am Female	25.4%	41.0%	46.4%	31.8%	9.3%	49.6%	2.5%	64.9%	28.9%	6.2%	65.5%	23.3%
Mexican Am Male	29.7%	41.3%	37.3%	27.6%	14.6%	40.8%	3.7%	59.2%	28.2%	12.6%	59.3%	21.6%
Asian Female	13.6%	24.5%	27.7%	20.0%	7.7%	31.4%	2.6%	69.8%	22.9%	7.3%	58.5%	29.9%
Asian Male	13.4%	25.0%	25.4%	17.9%	7.6%	28.8%	6.8%	70.6%	21.8%	7.5%	54.4%	31.6%
PR Female	11.5%	13.1%	43.4%	7.1%	8.2%	48.0%	6.8%	62.5%	25.0%	12.5%	67.4%	26.1%
PR Male	15.1%	15.1%	51.0%	5.9%	9.4%	53.1%	5.7%	28.6%	52.4%	19.0%	60.0%	31.4%
Other Hisp Female	17.1%	34.2%	29.3%	21.1%	13.2%	30.1%	0.0%	64.9%	23.0%	12.2%	57.4%	23.5%
Other Hisp Male	22.7%	34.5%	33.0%	18.4%	9.2%	34.0%	2.8%	59.4%	29.2%	11.5%	47.2%	37.1%
Native Female	40.0%	53.3%	44.8%	18.5%	46.7%	48.3%	0.0%	33.3%	25.9%	40.7%	42.9%	17.9%
Native Male	29.5%	40.9%	47.6%	30.2%	36.4%	50.0%	4.5%	31.4%	37.1%	31.4%	45.7%	28.6%
Other Female	16.6%	29.1%	30.5%	19.9%	17.6%	34.6%	3.6%	51.7%	32.0%	16.3%	58.4%	25.7%
Other Male	18.4%	28.5%	28.8%	18.2%	25.3%	32.6%	6.5%	35.4%	38.6%	26.0%	51.6%	28.2%
Total	15.5%	24.8%	24.9%	16.4%	22.4%	28.8%	5.9%	43.9%	34.8%	21.3%	52.9%	28.0%

When reviewing the following it is important to remember that urban origins are far more common in non-white as compared to white. Also there is great variation in socioeconomic status that seems to have more to do with FP choice Medicine, Education, and Social Status, although rural locations are a concern as well.

FP Grads 2000 - 2003	Rural	Urban	Number	% of All FP
White	19.9%	80.1%	5289	73.9%
Asian	3.9%	96.1%	671	9.4%
Black	9.9%	90.1%	516	7.2%
Mexican American	43.5%	56.5%	69	1.0%
Native	35.5%	64.5%	31	0.4%
Other Hispanic	12.0%	88.0%	75	1.0%
Other	3.8%	96.3%	80	1.1%
Puerto Rico	15.6%	84.4%	45	0.6%
Unknown	11.6%	88.4%	379	5.3%
All totaled	17.2%	82.8%	7155	100.0%

Includes only those with birth city and ethnicity in AMA Masterfile, basically US citizens graduating from US and International Medical Schools and choosing FP

Bolded items note the tendency for those born in certain types of communities to return to similar communities. This is a confirmation of Wigton's work involving surveys of medical students and primary care residents.

Non-white FP graduates had more urban birth origins and distributed to rural areas at half the rate. Other studies note the contributions of non-white graduates to inner city and underserved populations. More rural born minority graduates would be a great boost to areas in most need of health access.

Rural location rates for FP graduates were beginning to decrease in the 2002 and 2003 graduates, the post managed care era group.

NonWhite

FP Grad

Who were

Born urban

Born Large

Rural

Born Medium Rural

Born Isolated Rural

Chose These Locations

n =

1550

Urban

1480

89.4%

75.4%

68.0%

54.5%

Large Rural

5.2%

10.8%

10.0%

4.5%

Medium Rural

3.6%

10.8%

12.0%

22.7%

Isolated Rural

1.8%

3.1%