Via Research Recognition Day 2024 VCOM-Carolinas

Educational Reports

The Characterization and Analysis of Medical Students, Residents, and Fellows to the Physician Workforce in South Carolina Callaham Brock, OMS-III, Forrest Bohler, MS-II, Kristine Lombardozzi, MD, Heather Bendyk, MBA VCOM-Carolinas, Spartanburg, SC 29303 Co-authorship should be given to collaborators such as a Statistician, who have made intellectual contribution in terms of writing, research design, study implementation, and data analysis and interpretation. Abstract Results Conclusions

Background: South Carolina ranks in the bottom half of states in physicians per capita due in part to its relatively high proportion of rural areas. While there are various factors that determine physician practice location, the location in which an aspiring physician attends medical school and receives their residency training has been shown to be a strong correlative predictor. In order to address South Carolina’s shortage, two new in -state medical schools have been opened in the past decade and a half, in effort to increase the state’s supply of medical students, yet the state’s supply of practicing physicians remains relatively low. Objective: This 2023 study investigates the characteristics of South Carolina medical students, residents, fellows, and physicians to provide insight into the factors that influence physician retention and recruitment efforts. Methods: This study statistically analyzes the Association of American Medical Colleges State Physician Workforce Data Reports produced biennially since 2007, to provide insight into the factors that influence physician retention and recruitment efforts. Results: Findings from this study reveal that South Carolina has a relatively high proportion of medical students (UME), the amount of graduate medical education (GME) positions remains low and is likely to blame for the decreasing levels of practicing physicians. Conclusion: This study underscores the need for additional GME positions within South Carolina in order to actualize the full potential of the state’s relatively strong metrics in UME. These findings may prove useful to legislators in states struggling to retain physician workforces and could guide policy efforts to address physician shortages. Keywords: South Carolina, Physician workforce, chronic health workforce shortage The study utilized the State Physician Workforce Data Report, produced biennially by the Association of American Medical Colleges (AAMC), along with individual state reports for South Carolina from 2007 to 2021. The data was extracted from the reports to analyze trends and relationships in the physician workforce. The key steps include: 1.Data Collection: • Downloaded AAMC reports from 2007 to 2021, focusing on physician supply, undergraduate medical education (UME), graduate medical education (GME), and retention. • Extracted data on active physicians, medical students, residents, and fellows, as well as retention metrics for South Carolina. 2.Variables Extracted: • Extracted various measures, such as active physicians per 100,000, UME students per 100,000, GME residents and fellows per 100,000, and retention rates. • Created ratios comparing UME students to physicians and GME residents/fellows to physicians. 3.Data Presentation: • Graphed measures chronologically to visually represent trends over time. 4.Statistical Analysis: • Conducted Pearson product-moment correlation and linear regression analyses to assess relationships between different population measures: • UME student population to total physicians. • GME resident and fellow population to total physicians. • Retention of physicians from UME and GME to relevant student and resident populations. 5.Ethical Considerations: • Institutional Review Board exempt based on institutional policy, as the study used publicly available data with no involvement of human subjects. Overall, the study aimed to provide a comprehensive characterization of the physician workforce in South Carolina, analyzing key metrics and relationships over the specified time period. Introduction or Methods

• The analysis conducted in South Carolina reveals significant increases in the Undergraduate Medical Education (UME) and Graduate Medical Education (GME) populations when compared to the overall physician population. • The rate of increase in UME is disproportionate to that of GME in the state. • The study identifies a statistically significant negative correlation between the retention of physicians from UME and the total number of UME students, as well as a similar negative correlation with GME residents and fellows. • Despite having 239.9 active physicians per 100,000 population in 2020, South Carolina ranks 36th in the United States for physicians per capita. • The state has experienced an overall decrease in physician retention despite consistently ranking 10th or better in the nation for combined UME and GME retention. • The low physician retention rate in a rural state like South Carolina, despite solid UME and GME program retention, raises concerns about the delivery of quality healthcare. • The study suggests that the state's rural physician program, established in 1998, has had limited effectiveness. • By examining approaches taken by states such as Michigan and Florida, the study suggests adopting initiatives akin to Michigan's loan repayment program and Florida's "Slots for Doctors Program" as potential solutions for addressing physician shortages. These programs could be instrumental in tackling shortages, particularly in areas with underserved specialties or regions, and enhancing healthcare accessibility for vulnerable populations. • Sustained efforts are needed to increase the physician supply in South Carolina, focusing on expanding GME residency and fellowship programs to enhance the overall retention of physicians in the state.

Table 1. . Data extracted from AAMC Workforce Data Reports between 2007-2021.

Graph 1 . UME and GME to Physician Population (per 100k population) in South Carolina between 2006 and 2020.

References

Use QR Code or go to: https://docs.google.com/document/d/1T3vIOycXgL eK_hWhmC9u7j4dWPtzxUnwfc4FfJSzXs0/edit?us p=sharing Author Contact Information:

Table 2 . Pearson Product Moment Correlation (r), Linear Regression (r 2 ), and p-value of Workforce Data Statistics between 2006-2020.

Callaham A. Brock cbrock@vcom.edu (864) 993-3698

This project would not have been possible without the exceptional support of Dr. Lombardozzi and Heather Bendyk. Thank you to Christopher Lombardozzi, MD for your exceptional editing recommendations. Thank you to the AAMC for making this data publicly available, where research can identify gaps within our profession.

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2024 Research Recognition Day