Is Rural Residency Training of Family Physicians an Endangered Species? An Interim Follow-up to the 1999 National BBA Study

Research center:
Lead researcher:
Project funded:
September 2003
Project completed:
December 2005
The shortage of physicians in rural America has persisted as physicians continue to settle preferentially in metropolitan and suburban areas. One of the strategies to ameliorate this situation is the establishment of rural residency training. Since the completion of our earlier survey of family medicine residencies in the United States after the passage of the Balanced Budget Act (BBA) of 1997, there has been a precipitous decline in the proportion of U.S. medical school graduates (USMGs) who have chosen to pursue residency training in family medicine. As a result, match rates of U.S. programs have been declining rapidly, and quite a few programs have closed. The impact of these trends on rural family medicine training capacity is unknown.

This study examined the proportion of rural-based family medicine residencies that have ceased operations since 2000, the residency-match experiences of the surviving programs, the proportion of USMGs and international medical graduates, major issues confronting these rural residencies, and likely impacts of these changes on the preparation of future family physicians for rural America.

For this national study we used a combination of data collected in the landmark baseline survey of 1999 with primary data collected through a mail survey of the rural-based family medicine residency-training programs. The survey examined the match rates of the rural-based programs over the last five years; which programs have downsized, consolidated, or actually closed since 1999; what the plans are of these programs for the next two years, and to what extent would continuing decline in match rates affect them; and the implications for the rural areas that these programs serve. Results of this study have been presented at local, regional, and national meetings.


  • Will Rural Family Medicine Residency Training Survive?
    Journal Article
    WWAMI Rural Health Research Center
    Date: 2006
    This report shares the results of a study examining the recent performance of rural residencies in the National Resident Matching Program as an indicator of their viability.