To identify the U.S. medical schools with the most graduates practicing in rural, urban, and economically distressed areas of Appalachia.Method
Using June 2009 American Medical Association Physician Masterfile data, the authors identified physicians who graduated from medical school during 1991–2005 and were practicing in the 420 counties of the United States' Appalachian region. They then determined the U.S. medical schools with the most 2001–2005 graduates practicing in primary care (PC) or non-PC specialties in urban or rural areas and the most 1991–2005 graduates practicing in economically distressed/at-risk counties.Results
Ten U.S. medical schools, led by the West Virginia School of Osteopathic Medicine, produced 50.5% (197/390) of 2001–2005 graduates practicing PC in rural areas of Appalachia; 10 schools, led by the University of Alabama School of Medicine, produced 44.1% (366/829) of graduates practicing PC in urban areas. During 2001–2005, 10 schools, led by the West Virginia University School of Medicine, graduated 42.1% (128/304) of non-PC physicians practicing in rural counties; 11 schools, led by the University of Alabama School of Medicine, graduated 38.5% (323/840) of non-PC physicians practicing in urban areas. All schools on the top 10 lists are located within states with Appalachian counties. University of Kentucky College of Medicine had the most 1991–2005 graduates practicing in economically distressed or at-risk counties.Conclusions
Physicians practicing in Appalachia are largely graduates of medical schools in or near the region. New schools being developed in the region may help reduce its continuing physician shortages.