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Am Fam Physician. 2014;89(7):518

Author disclosure: No relevant financial affiliations.

The Primary Care Residency Expansion (PCRE) program was created by the Health Resources and Services Administration in 2010 to help address the shortage of primary care physicians. If historical graduate placement trends for funded programs remain stable, the PCRE program would have a potential impact of more than 600 new physicians working in primary care.

In response to looming primary care work-force shortages, the Health Resources and Services Administration funded a five-year, $168 million grant to expand enrollment in primary care residency programs beyond their authorized graduate medical education caps.1 By the end of the grant period in 2015, the program will have supported the training of 900 new residents in family medicine, general internal medicine, and general pediatrics.

Because the first cohort of residents has yet to enter into practice, historical data have been used to project the potential impact of the PCRE program. Graduates of these residency programs from 2006 to 2008 were evaluated based on their practice location using the 2013 American Medical Association Physician Master-file and the National Plan and Provider Enumeration System.2

The proportion of PCRE residents projected to work in primary care does not account for those who will become hospitalists. This is likely offset by the higher proportion of PCRE residents training in primary care tracks, which have been shown to positively influence the decision to practice in primary care.3 The findings highlight the potential impact of targeted investment in primary care residency training, with family medicine residency programs representing the highest return on investment for production of physicians working in primary care, health professional shortage areas, and rural areas (see accompanying table). Future directions in graduate medical education funding should focus on programs that have a proven track record of producing physicians working in shortage areas to better align taxpayers' investment in physician training with society's pressing health care needs.

Type of residencyNumber of residentsProjected work areas
Primary careHealth professional shortage areaRural areas
Family medicine425393 (92%)110 (26%)50 (12%)
Internal medicine285112 (39%)69 (24%)14 (5%)
Pediatrics19097 (51%)39 (21%)3 (2%)
Total900602 (67%)218 (24%)67 (7%)

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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