Robert C. Bowman, M.D.
Where do we lose the physicians most likely to serve the underserved and what do income changes mean for the specialties that serve the underserved like family medicine?
Matters of Perspective- comparisons of medical schools by types of students admitted by income, and how distribution and choice of FP disappears with increasing income, MCAT, and younger age - medical school leaders view distribution differently, especially those trained at schools with few distributional student types.
Jim Boulger of Duluth first presented this pipeline concept from high school to college to application to admission at Rural Medical Educator meetings
The nation had 3,792,800 that were or should have been seniors in high school. This figure involved the Age 20 - 24 numbers in the 2000 Census divided by the 5 years involved from 20 - 24. The graduation and college data is from Postsecondary Education. The data is matched up to actual class averages. The Family Medicine choices are based on income level as per Cooter's Jefferson Longitudinal Studies and my Birth Origins and FP Choice studies.
|Highest Income||Next Highest||Next Lowest||Lowest|
|Age 20 - 24 2000 Census (Divided by 5)||948,200||948,200||948,200||948,200|
|High School Graduates||93%||91%||83%||66%|
|Ratio of college completion to medical school admissions||50||78||81||84|
|Medical School Admissions in Allopathic US schools|
|Admissions Per 100,000|
|All in Census Year Group||1096.81||326.94||168.74||84.37|
|High School Graduates||1179.4||359.3||203.3||127.8|
|Actual data average 16219||10505||3196||1667||851|
|Medical School Completion||99%||97%||96%||94%|
|Allopathic Medical School Graduates||10296||3007||1536||752|
|Family Physicians - Choice varies by income level of admitted students||5%||8%||13%||22%|
|Match rate in family medicine for Allopathic Students = 7.0%|
|Family Physicians Future 2008 predicted based on increased higher income admissions and continued declines in admission of lower income students|
|Match rate in family medicine for Allopathic Students = 6.0%|
Graduation data from www.postsecondaryeducation.org
Maps of Graduation indicate state variations in high school and college data.
Unless the nation reverses course and admits more lower income, whites, males, older students or others likely to choose family medicine, the nation will have increasing difficulty with health care access, particularly in rural and poverty locations.
Physician Workforce Studies
Physician Distribution in the United States
State By State Education Status
States Graduating More Family Physicians
Most Rural FP Grads
Underserved - Overview and Models