Lawmakers advised to boost in-state medical residencies to better retain physicians

by | Dec 4, 2023



  • The Florida House Select Committee on Health Innovation on Monday discussed the need to increase medical residency slots in Florida to keep more doctors in the state.
  • Wendy Scott of OPPAGA, the state’s research arm, reported that Florida medical school graduates are more likely to stay in Florida if they also complete their residency there.
  • Surveys by OPPAGA revealed that physicians leave Florida for reasons like family proximity, further training, and lifestyle choices. Challenges in retaining doctors include high living costs and limited job opportunities for spouses.
  • The legislature was advised to prioritize Florida graduates for residency programs and to create a strategic plan for graduate medical education.

The Florida House Select Committee on Health Innovation convened on Monday to address the growing need for physicians in the state, noting the need to expand medical residency programs statewide.

Wendy Scott, Staff Director for the Health and Human Services Policy Area within OPPAGA, the Legislature’s Research Office, led the presentation, highlighting the state’s current status and future projections of medical professionals. Scott pointed out that enhancing residency slots, especially for graduates of Florida’s medical schools, is vital for retaining more physicians within the state.

The committee noted that while Florida is making strides in increasing the number of medical school graduates, the bottleneck appears to present itself in the number of available residency positions. Scott told lawmakers on the committee that the best retention rates are observed when medical professionals complete both their education and residency in Florida.

“Of Florida medical school graduates who started graduate medical education (GME) between calendar years 2008 and 2015 who also went to a Florida GME program, approximately 75 percent were licensed and practicing in Florida two years after completion of their GME training,” Scott told the House committee. “In contrast, only 42 percent of those who started their GME training, but went to medical school outside of Florida were retained as Florida physicians. The main takeaway here is that retention consistently remains higher for people that go to both medical school and GME in Florida.”

As elucidated in Scott’s presentation, OPPAGA conducted surveys to better understand why physicians are leaving Florida after their residencies. The findings from 84 healthcare facilities reflect that 84 percent of physicians wanted to be closer to family, 69 percent sought additional training outside Florida, and 33 percent preferred to live in another state. Another survey of 57 sponsoring institutions identified high living costs, childcare issues, and limited job opportunities for spouses as major challenges in attracting and retaining medical professionals.

Based on the findings, OPPAGA recommended to the legislature several strategies to improve the retention rates, including the prioritization of Florida medical school graduates for state residency programs, enhancing recruitment and retention strategies, and expanding workforce surveys.

OPPAGA also suggested periodic analysis of the state’s GME system to improve data collection and reliability, increased financial transparency for healthcare facilities receiving GME funding, and the development of a state-level strategic plan focusing on GME goals and funding priorities.

“I think if we can retain more of our Florida medical school students to go to residency positions here in Florida, we’re more likely to keep them as physicians,” said Scott. “Do we have an opportunity to grow our residency positions? Absolutely.”

Comparisons with other states, such as California and Texas, were drawn to illustrate the potential for expanding residency programs, with both states having successfully managed to retain a higher number of medical graduates, partly attributed to the comparatively larger number of residency slots.

A discussed strategy to mitigate this shortfall involved modifying the residency match algorithm to prioritize Florida medical school graduates for the state’s residency programs, a move aimed at increasing the number of local graduates who secure in-state positions and thereby enhancing their retention liklihood.

“As part of our recommendations [to the legislature] we talked about considering directing sponsoring institutions to prioritize Florida medical school students so when they are putting their match in who their preferences are,” said Scott in response to a question asked by Rep. Karen Gonzalez Pittman. “We think it could be a helpful recommendation for them to prioritize Florida Medical School graduates.”

According to data presented to the House Healthcare Regulation Subcommittee by representatives from the state Department of Health last month, 20 percent of Florida’s physicians, amounting to 65,000 healthcare professionals, are aged 60 or above and are likely to retire within the next five to ten years.

Supplementary data aggregated by the Association of American Medical Colleges also showed that Florida ranks sixth among all states in terms of the highest percentage of physicians over 60 years of age, with the insinuation that rural counties in Florida are on the cusp of an exacerbated healthcare crisis as a growing number of physicians are approaching retirement age, with no clear succession plans in place.

Per the Physicians Survey conducted by the state, physicians aged 50 to 59 comprise the largest group of Florida practitioners, at 25.2 percent, with an average overall age of 53. Moreover, 4.7 percent, or 2,512 registered physicians in Florida reported that they plan to move out of the state within the next five years. Using feedback from the survey, the agency identified nine counties where at least 25 percent of their physicians indicated that they intend to retire within the next five years.

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