Robert C. Bowman, M.D.
Population: Students graduating from US medical schools since 1965
School comparisons over time
Steady declines from 60% in 1980 to 38% in the most recent classes. Replacements are out of state born students and the 16% born outside of the United States. Those with the most connections to a state and to rural practice and family medicine are replaced by those with the most connections to opportunity, subspecialty, and major medical centers.
Medical students born instate have a 17% choice of FP
Medical students not born instate have an 11% choice of FP
US medical schools have had a 17% decline in admissions of instate born medical students in the past 20 years.
During the managed care "panic" students born in the same state had a marked increase in choice of FP. Students born outside the state did not increase much in choice of FP (higher social status perhaps?) When looking at urban vs rural instate, rural instate students had 15% increase and urban instate had 30% increase in FP choice during this time.
If admissions committees gave greater priority to kids born in their state, would we have more family docs and perhaps more rural docs? Those that tend to have a higher instate ratio also tend to graduate more family physicians. Geography is a contributor through barriers. NY, MI, CA, TX, and OH have higher instate choices of medical school and residency both because of large populations and numerous schools or residencies in the selection pool. Several of the consistent FP producers are listed below.
|
|
Number of FPs from School that were born in state |
Percentage with birth state and medical school state the same |
|
U of PR Geography |
49 |
76.6% |
|
Ponce |
36 |
75.0% |
|
U C del Caribe |
21 |
72.4% |
|
SUNY Syracuse Large pop |
107 |
69.5% |
|
Southern Illinois |
90 |
68.7% |
|
LSU Shreveport |
79 |
66.4% |
|
Mercer top 10% |
63 |
66.3% |
|
Wayne State top 10% |
200 |
65.4% |
|
U MN Duluth top FP producer 50% |
116 |
65.2% |
|
NEOUCOM |
83 |
62.9% |
|
U Mississippi |
73 |
62.4% |
|
SUNY Buffalo Large pop |
71 |
61.7% |
|
Indiana |
249 |
61.5% |
|
Missouri KC |
70 |
61.4% |
|
U of Michigan Large pop |
86 |
61.0% |
|
U of Iowa |
203 |
60.4% |
|
Wright State Large pop |
110 |
60.1% |
|
U of Wisconsin |
117 |
60.0% |
|
Mich St Allo |
133 |
59.9% |
|
U of MN |
188 |
59.9% |
|
U of Louisville |
91 |
59.9% |
|
U NE Med Ctr |
104 |
59.8% |
|
LSU New Orl |
91 |
58.7% |
|
Ohio State Large pop |
175 |
58.1% |
|
U of Arkansas |
154 |
57.7% |
Instate admissions may be a marker of lower socioeconomic status. Students in urban areas often have similar acceptance rate for instate and out of state.
Logistic Regressions: Location
Instate Born and Choice of Family Medicine
Instate Born and Rural Practice
Urban-Rural Location, Per Capita Income, and Choice of Family Medicine
Family Physicians Are Different