Via Research Recognition Day Program VCOM-Carolinas 2025

Clinical Educational Research

The Characterization of Medical Students, Residents, and Fellows to the Physician Workforce in the United States Nadira Javid, OMS-II, Callaham A. Brock, OMS-IV, David Redden, PhD 1 , Kristine Lombardozzi, MD 2

1. Edward Via College of Osteopathic Medicine, Dept. of Biomedical Research, Auburn, Alabama 2. Edward Via College of Osteopathic Medicine, Dept. of Surgery, Spartanburg, South Carolina

Discussion

Results

Introduction

This longitudinal study uses data collected from the AAMC Physician Workforce Reports 4 published between 2007 2021. Data on key metrics including physician supply, UME and GME, and physician retention was collected and organized for each state. The states were grouped into six regions, listed in the key of Figure 1, and the data was then analyzed to determine growth trends of each measure and whether a region effect existed between different outcomes. P-values were generated from Generalized Estimating Equations (GEE) for analysis. This method was chosen to account for correlations within regions and to provide better estimates of the relationship between UME and GME growth and physician retention. Graphs were generated to visualize trends in metrics over time for each region as well. trends in UME and GME on physician retention and workforce supply. The study aims to determine whether regions that have experienced growth in UME and GME exhibit correspondingly higher physician retention and workforce supply. Additionally, the study aims to assess whether a statistically significant correlation exists between educational program data and regional differences. Methods The United States faces a critical physician shortage, with projections from the Association of American Medical Colleges (AAMC) indicating a shortfall of up to 86,000 physicians by 2036 1 .Although we are seeing an increasing number of undergraduate medical education (UME) graduates, many of these students are unable to complete their education because they cannot obtain a residency position 2 . The disparity between the number of UME graduates and the inability to find graduate medical education (GME) opportunities may be a contributing factor to the physician shortage. The differences in UME and GME can be observed in all regions of the country and addressing this imbalance is critical to improving the physician supply. The inequity in physician distribution geographically 3 must also become a priority to develop physician shortage solutions. This study explores the impact of regional growth

Statistical analysis using GEEs in Table 1 highlights several key findings. For student enrollment rate, GME rate, and GME retention rate, there is statistically significant variation in growth slopes between regions, as seen by the low p values for Year*Region Effect. This means some regions are experiencing greater growth in these metrics than others. For example, Figure 1 illustrates that the Mid-Atlantic region experienced a decline in GME rate, contrasting with the upward trend in other regions. However, metrics such as total active physicians, UME retention rate, and combined UME-GME retention rate did not exhibit statistically significant differences. Despite this, the region effect stays significant since regions did not start at the same value in 2006. These findings emphasize regional disparities in baseline metrics and growth rates, emphasizing the need to consider geographical context in physician supply. Conclusions This study examines the importance of regional investments in both UME and GME to enhance physician workforce supply. For example, in the Northeast region, metrics such as UME Rate, GME Rate, and total active physicians have all experienced positive growth over time. Future research could explore UME and GME funding, such as federal Medicare allocations 5 , to understand how financial resources influence physician supply. Additionally, studies tracking post-2020 trends can capture recent policies and economic changes on the physician workforce. By continuing to optimize medical education pathways, policymakers can make informed decisions to mitigate the projected physician shortage.

Outcome

Year Effect

Region Effect

Year*Region Effect

Total Active Physicians

<0.0001

<0.0001

0.0635

Student Enrollment Rate

<0.0001

<0.0001

0.0012

GME Rate

<0.0001

<0.0001

0.0129

GME Retention Rate UME Retention Rate UME GME Retention Rate

<0.0001

0.0019

0.0017

<0.0001

0.0012

0.6368

0.0044

0.0033

0.2871

Table 1. P-values from Generalized Estimating Equations testing for increase over time (Year Effect), testing for whether different regions were at different rates in 2006 (Region Effect), and whether the rate of increase is different among regions (Year*Region Effect).

References

Figure 1. GME Rate per 100,000 people from 2006-2020 by region.

1. Global Data Plc. The Complexities of Physician Supply and Demand: Projections from 2021 to 2036. Washington, DC: AAMC; 2024. Accessed December 20, 2023. 2. Dewan, M. J., & Norcini, J. J. (2020). We must graduate physicians, not doctors. Academic Medicine , 95 (3), 336 – 339. https://doi.org/10.1097/acm.0000000000003055 3. Ahmed, H., & Carmody, J. B. (2020). On the Looming Physician Shortage and Strategic Expansion of Graduate Medical Education. Cureus , 12 (7), e9216. https://doi.org/10.7759/cureus.9216 4. State Physician Workforce Data Report. AAMC. Accessed December 21, 2023. 5. He, K., Whang, E., & Kristo, G. (2021). Graduate Medical Education Funding Mechanisms, challenges, and solutions: A narrative review. The American Journal of Surgery , 221 (1), 65 – 71. https://doi.org/10.1016/j.amjsurg.2020.06.007

2025 Research Recognition Day

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