Long-Term Retention of Graduates from a Program to Increase the Supply of Rural Family Physicians

TLDR

In light of national recommendations to increase medical school enrollment, expanding programs like the PSAP could substantially and sustainably grow the rural physician workforce. The study aims to assess long‑term retention of rural family physicians who graduated from Jefferson Medical College’s Physician Shortage Area Program (PSAP). The authors identified 1,937 Jefferson graduates from 1978‑1986, determined which were practicing rural family medicine at first location, and compared the 2002 rural practice status of PSAP versus non‑PSAP graduates over an 11‑16‑year period. PSAP graduates had a significantly higher long‑term rural retention rate (68% vs 46%, p = .03) and survived longer in the same rural locality than non‑PSAP peers (p = .04), marking the first evidence of retention exceeding the median duration and demonstrating an eight‑fold recruitment boost and sustained retention of at least 11‑16 years.

Abstract

To determine the long-term retention of rural family physicians graduating from the Physician Shortage Area Program (PSAP) of Jefferson Medical College.Of the 1,937 Jefferson graduates from the classes of 1978-1986, the authors identified those practicing rural family medicine when their practice location was first determined. The number and percent of PSAP and non-PSAP graduates practicing family medicine in the same rural area in 2002 were then identified, and compared to the number of those graduates practicing rural family medicine when they were first located in practice 11-16 years earlier.After 11-16 years, 68% (26/38) of the PSAP graduates were still practicing family medicine in the same rural area, compared with 46% (25/54) of their non-PSAP peers (p = .03). Survival analysis showed that PSAP graduates practice family medicine in the same rural locality longer than non-PSAP graduates (p = .04).These results are the first to show long-term rural primary care retention that is longer than the median duration. This outcome combined with previously published outcomes show that the PSAP represents the only program that has resulted in multifold increases in both recruitment (eight-fold) and long-term retention (at least 11-16 years). In light of recent national recommendations to increase the total enrollment in medical schools, allocating some of this growth to developing and expanding programs similar to the PSAP would make a substantial and long lasting impact on the rural physician workforce.