graduate medical education (GME) positions to meet demand. For 2011, the annual National Resident Matching Program offered 1,476 entry- level GME positions in Texas. By comparison, 1,445 students graduated from Texas medical schools in 2011.18
The Texas Higher Education Coordinating
Board recommends a ratio of 1.1 entry-level GME positions for each Texas medical school graduate. To meet this goal, Texas would have needed 1,590 entry-level training positions in 2011, or 114 additional positions.
Texas medical school graduates are projected to peak at more than 1,700 around 2015.20
This
will mean an even greater demand for residency training positions to enable graduates to remain in the state. To achieve the 1.1-ratio goal after enrollments reach the peak, Texas would need to add an additional 400 GME positions. This growth will be even more difficult to achieve with the state legislature’s recent 41-percent reduction in overall state support for residency training.
Considering the significant challenges the state faces in meeting its health care workforce needs,
state leaders must mandate a comprehensive health professions workforce analysis that includes all appropriate stakeholders and visualizes the needs of Texas for the near and long term.
Improve rural access to care
Physician shortages constitute a special problem in rural areas of the state. The continued urbanization of Texas exacerbates this longstanding problem. Approximately 12 percent of Texans live in rural counties,21
physicians practice there.22
yet only 10 percent of primary care In 2011, Texas had
52 primary care physicians per 100,000 population in rural areas versus 72 per 100,000 in urban areas.23
Physician shortages in rural areas not
only hinder access to primary and other specialty care but also lead to potential losses in the local economy, difficulties attracting new businesses, and diminished quality of life for residents. A number of factors hurt physicians’ ability to open and sustain rural practices, including heavy concentration of Medicare, Medicaid, and uninsured patients; professional isolation; and high debt after medical school.
Texas Needs More Physicians 10 Largest Specialties — Texas vs. U.S.: Physicians per 100,000 Population
100% 80% 60% 40% 20% 0%
60 TEXAS MEDICINE July 2012
Psychiatry
Child & Adolescent Psych Emergency Medicine Internal Medicine Pediatrics General Surgery Orthopedic Surgery Family Medicine Obstetrics/Gynecology Anesthesiology
TEXAS SPECIALTY RATIO
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