Robert C. Bowman, M.D.
Various types of students have different levels of rural and underserved distribution. A key factor in distribution is choice of family medicine. In the following table the types of distribution by student characteristics are listed, with or without choice of family medicine.
|
Total Doctor / Rural Doctor Per Cent |
Rural Choices for 203,000 most recent US MD Grads of 1987 – 1999 in 2005 equilibrium cross section locations |
Rural Career Choices |
Multiplier of Birth Core Metro NonFP With / Without FM |
% of Allopathic Physicians |
|
|
With / Without Family Medicine |
Underserved With / Without FM |
Major Med Center With / Without FM |
|||
|
14.4/ 8.0% |
Foreign Born |
5.5%/12.8% |
0.74/1.73 |
5.5%/12.9% |
76%/52% |
|
49.3/38.8% |
Born Core Metro over 1 million |
7.4%/19.6% |
1.00/2.65 |
4.6%/11.5% |
76%/48% |
|
55.5/46.4% |
Born out of state in any urban area |
7.8%/21.1% |
1.05/2.85 |
5.2%/13.1% |
75%/48% |
|
34.8/30.7% |
Born instate in any urban area |
8.2%/20.4% |
1.11/2.76 |
5.5%/11.9% |
75%/46% |
|
19.9/22.3% |
Older and born in any urban area |
10.4%/24.1% |
1.41/3.26 |
6.7%/15.2% |
72%/45% |
|
11.7/14.8% |
Born in lower income urban area |
11.9%/25.9% |
1.61/3.50 |
7.9%/18.9% |
72%/42% |
|
22.2/26.6% |
Born urban and less than 1 million |
11.1%/25.4% |
1.50/3.43 |
6.2%/13.6% |
72%/43% |
|
5.0/ 8.2% |
Born out of state in a rural area |
14.6%/35.9% |
1.97/4.85 |
7.2%/15.3% |
70%/39% |
|
12.0/30% |
Born in a rural area |
18.7%/44.7% |
2.53/6.04 |
8.4%/16.4% |
68%/34% |
|
8.8/20% |
Born in lower income rural area |
19.7%/46.0% |
2.66/6.22 |
9.2%/17.8% |
66%/31% |
|
2.8/ 6.6% |
Older and born in a rural area |
20.4%/43.3% |
2.76/5.85 |
9.4%/18.7% |
65%/34% |
|
6.2/16.1% |
Born instate in a rural area |
22.2%/49.4% |
3.00/6.68 |
9.5%/17.0% |
66%/31% |
Top row - 14.4% of all allopathic US MD grads are foreign born and this group is 8% of rural physicians. Foreign born US MD grads choose rural locations at 5.5% for non family physicians and 12.8% for foreign born USMD grad family physicians. This is lower than the 1.0 Core metro birth marker so the multiplier is 0.74 for non FP and 1.73 for family physicians who are foreign born. The same percentages and ratios apply to underserved locations outside of major medical centers. About 76% of nonFP foreign born physicians are found in Major medical centers and only 52% of foreign born US MD family physicians are found in major medical centers with 75 or more physicians at a zip code.
Rows in red indicate the most likely additions during an expansion. Those not in red have been declining in admissions in past decades.
The most numerous medical students are urban born and dominate admissions. For example over 55% were born out of state in an urban area and this group was also nearly half of rural physicians at 46.4%. All urban origin sources of US MD physicians including core metro born, foreign born, and those born in metro areas of less than 1 million are a group comprising 90% of US MD physicians and 70% of US MD rural physicians. Because they are more numerous, they dominate distribution numbers, but not percentages.
There are several implications regarding student factors and distribution: