Instate Born Medical Students and FP Choice

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

Physician Workforce Studies

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

rbowman@unmc.edu

www.ruralmedicaleducation.org

 

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