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Am Fam Physician. 2013;88(10):704

Author disclosure: No relevant financial affiliations.

With state planners working to address primary care shortages and federal graduate medical education payment reform looming, regional retention statistics for family medicine residency programs are a subject of high interest. Using the 2009 American Medical Association Physician Masterfile, we found that 56% of family medicine residents stay within 100 miles of where they graduate from residency.

Insurance expansion, paired with evidence of a primary care physician shortage and a known geographic maldistribution of primary care physicians,1 has policy-makers and stakeholders eager to understand the influence of family medicine residency program location on postgraduation practice location. It is often quoted that 50% of family medicine residents stay within 100 miles of where they graduate, whereas in reality, little evidence exists to support this claim.2,3 A study in 1995 assessed all residency graduates (not exclusively family physicians) and found that 51% of physicians were practicing in the state in which they graduated from residency.4

2009 data from the American Medical Association Physician Masterfile show that 56% of family medicine residency program graduates practice within 100 miles of their residency program. Of note, 19% locate within five miles, and 39% locate within 25 miles of their residency program (see accompanying figure).

The distribution of physicians continues to compromise access to primary care, a problem compounded by limited volume of training outside of major metropolitan areas and large academic health centers.5 More research is needed to explore the influences of practice site other than training location, but these findings seem to support current efforts to decentralize graduate medical education training through models such as teaching health centers and rural training tracks.

The information and opinions contained in research from the Graham Center do not necessarily reflect the views or the policy of the AAFP.

This series is coordinated by Kenny Lin, MD, MPH, deputy editor.

A collection of Graham Center Policy One-Pagers published in AFP is available at One-Pagers are also available at

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