North Carolina physicians : medical school training : North Carolina, other U.S. & Canada, and international medical graduates.

              NOTES: Physicians are active, in- state, nonfederal, nonresident- in- training physicians licensed by the N. C. Medical Board as of October, 1997. Primary care includes a

primary specialty of family practice, general practice, internal medicine, obstetrics/ gynecology, or pediatrics. Four ( 4) physicians missing medical school information

were not included in this profile. The 160 Canadian graduates were grouped with the U. S. graduates because of their similar training background. This fact sheet was

compiled by Laura M. Smith, Data Coordinator, N. C. Health Professions Data System, Cecil G. Sheps Center for Health Services Research, University of North Carolina

at Chapel Hill, May, 1999.

1997 NORTH CAROLINA PHYSICIANS:

MEDICAL SCHOOL TRAINING

North Carolina, Other U. S. & Canada, and International Medical Graduates

T he medical school background of the 14,366 North Carolina ( N. C.) physi-cians

licensed in 1997 is highlighted in this profile. 28.4% ( 4,086) gradu-ated

from a North Carolina medical school. The majority of physicians

practicing in the

state, 8,900 ( 62.0%),

completed medical

school elsewhere in

the U. S. or Canada.

Approximately nine

percent ( 9.6%;

1,376) of the physi-cians

are internation-al

medical graduates

( IMGs) who com-pleted

their medical

school training out-side

the U. S. and

Canada. See Figure 1

and notes for details.

Location

In North Carolina, a larger percentage of

IMGs ( 28.0%) list a primary practice loca-tion

in a nonmetropolitan county than the

physicians who graduated from U. S. or

Canadian schools, including N. C. ( 20.5%).

Ten percent ( 10.0%) of IMGs are located in

whole county Health Professions Shortage

Areas ( HPSAs) compared to 3.9% of the

other U. S. and Canadian graduates and

4.7% of the N. C. graduates.

Hours

The graduates of other U. S. and Canadian

medical schools who practice in N. C. indi-cate

that they work an average of 43.8 total

clinical care hours per week, in comparison

to 44.7 hours for N. C. graduates, and 45.7

for IMGs.

Age & Gender

The distribution by gender and age

of licensed North Carolina physi-cians

does not differ substantially

by where they trained. Just under

20% ( 19.4%) of other U. S. and

Canadian graduates are female,

20.1% of international medical

graduates, and 18.9% of North

Carolina graduates are female. The

average age of physicians from

N. C. medical schools is 46.9, from

other U. S. and Canadian graduates

is 45.8, and of the IMGs is 47.

Specialty

North Carolina physicians who

completed medical school in-state

( 46.6%) are more likely to

choose a primary care specialty

than the other U. S. and

Canadian graduates ( 37.9%) or

IMGs ( 44.2%). See Figure 2.

( See notes for definition of pri-mary

care.)

Practice Setting

Although the majority of North Carolina

physicians practice in an office setting as part

of a group, there are other considerable varia-tions

according to the location of a physician’s

medical school education. The N. C. medical

school graduates are more likely to practice in

a group office, while other U. S. and Canadian

graduates are more likely to practice in a hos-pital

or a facility affiliated with a medical

school, and the IMGs are more likely to be

solo practitioners than their respective coun-terparts.

See Table 1.

Table 1: Active N. C. Physician Practice Setting by Location of Medical School

UNC ( 12.7%)

Wake Forest ( 7.4%)

Duke ( 5.6%)

ECU ( 2.7%)

New York ( 5.3%)

Virginia ( 5.0%)

Pennsylvania ( 4.7%)

Ohio ( 3.7%)

South Carolina ( 3.2%)

Other States & 

Canada ( 40.0%)

India ( 2.5%)

IMGs ( 7.1%)

IMGs ( 9.6%)

US & Canada

( 62.0%)

North Carolina ( 28.4%)

NC US & Canada IMGs

0

10%

20%

30%

40%

50%

60%

70%

Primary Care

Specialty

46.6%

53.4%

37.9%

62.1%

44.2%

55.8%

Place of Medical School Training

Percentage in Specialty

Setting

% of NC

Grads

% of US &

Can % of IMGs % of Total

Solo practitioner's office 15.1% 14.1% 28.1% 15.7%

Free- standing clinic 5.6% 5.2% 4.4% 5.2%

group office 45.2% 39.2% 26.7% 39.8%

staff or group model HMO 1.6% 1.9% 2.0% 1.8%

hospital 18.2% 21.6% 21.1% 20.5%

medical school or parent university 11.1% 14.9% 12.7% 13.5%

locum tenens/ nursing home 1.0% 1.2% 1.5% 1.1%

other 2.3% 2.0% 3.4% 2.2%

each column adds up to 100% Missing practice setting= 2,413

Figure 1: Medical School Location of Active

Licensed North Carolina Physicians, 1997

Figure 2: Specialty Choice of Active N. C.

Physicians by Medical School Location

NOTES: Physicians are active, in- state, nonfederal, nonresident in training physicians licensed by the N. C. Medical Board as of October 1997. Primary care includes a

primary specialty of family practice, general practice, internal medicine, obstetrics/ gynecology, or pediatrics. The 78 physicians who completed training in Canada were

grouped with U. S. trained physicians because of their similar training background. Internship data were substituted for 973 of the physicians with no residency data.

For 254 North Carolina medical school graduates missing residency information, Association of American Medical Colleges residency data were used. The remaining

318 with missing residency and internship data were not included in this profile. The internationally- trained physicians were not included in this analysis because of the

small sample size. This fact sheet was compiled by Laura M. Smith, Data Coordinator, N. C. Health Professions Data System, Cecil G. Sheps Center for Health Services

Research, University of North Carolina at Chapel Hill, May, 1999.

1997 NORTH CAROLINA PHYSICIANS:

POSTGRADUATE TRAINING

North Carolina and Other U. S. & Canadian Trained Physicians

T he postgraduate or residency training background of the 14,366 North

Carolina ( N. C.) physicians licensed in 1997 is highlighted in this profile.

Approximately 35.6% of the physicians completed their residency training

in the state ( 5,002). Of the nine accredited residency training programs, Wake

Forest, Duke, and UNC- Chapel Hill account for 74.1% of the N. C.- trained

physicians. The majority of licensed physicians ( 9,007) indicate having complet-ed

their graduate

medical educa-tion

( GME) train-ing

in other U. S.

states or Canada.

A total of 39

physicians report-ed

training in

another country

( not included in

this analysis). See

Figure 3 and

notes for details.

Location

In North Carolina, 15.5% of the N. C. resi-dency

trained physicians work in nonmetro-politan

counties, less than their other U. S. &

Canadian trained counterparts ( 24.4%). In

addition, a smaller percentage of the physi-cians

trained in N. C. residencies ( 50.9%)

work in counties that are designated as par-tial

or whole Health Professions Shortage

Areas ( HPSAs) than physicians trained in

other states or Canada ( 53.9%). Over three

percent ( 3.6%) of the graduates of N. C.-

based residencies and approximately five per-cent

( 5.2%) of the other U. S. or Canadian

trained physicians practice in whole HPSAs.

Hours

Other physicians who trained in non- N. C.,

U. S., or Canadian programs spend an average

of 44.7 total hours a week in clinical care,

slightly more time than their N. C. trained

Age & Gender counterparts ( 43.7).

The average age of graduates

of N. C.- based graduate med-ical

education who are practic-ing

in the state is 45.7 com-pared

to 46.8 years of age for

graduates of other U. S. or

Canadian residencies. A total

of 23.7% of the N. C. residen-cy

trained physicians are

women, compared to 16.6%

of the physicians trained in

other states or Canada.

Practice Setting

Most physicians practicing in North Carolina,

regardless of the location of their residency training,

practice in an office setting as part of a group. The

N. C. residency trained physicians are more likely to

practice in a medical school setting and are less like-ly

to be solo practitioners than their U. S. and

Canadian counterparts. See Table 2.

Duke ( 10.1%)

UNC ( 9.3%)

Wake Forest ( 7.0%)

Charlotte ( 2.8%)

ECU ( 2.3%)

Moses Cone ( 1.2%)

MAHEC ( 0.7%)

Coastal AHEC ( 0.6%)

FAHEC ( 0.3%)

Other NC Programs ( 1.3%)

NY ( 6.2%)

VA ( 5.2%)

OH ( 3.4%) PA ( 4.6%)

TX ( 3.4%)

Other States

& Canada ( 41.2%)

North Carolina ( 36%)

Other US &

Canada ( 64.1%)

Setting

% of N. C.

Residents

% of U. S. &

CAN

Residents % of Total

solo practitioner's office 13.4% 17.2% 15.8%

free- standing clinic 5.6% 5.0% 5.2%

group office 37.8% 41.3% 40.0%

staff or group model HMO 1.5% 2.0% 1.8%

hospital 20.8% 20.4% 20.5%

medical school or parent university 17.2% 11.0% 13.3%

locum tenens/ nursing home 1.1% 1.1% 1.1%

other 2.5% 2.0% 2.2%

each column adds up to 100% Missing practice setting= 2,305

NC US & Canada

0

10%

20%

30%

40%

50%

60%

70%

Primary Care

Specialty

42.5%

57.5%

40.0%

60.0%

Place of Medical School Training

Percentage in Specialty

Figure 3: Location of Residency Training

Programs for N. C. Licensed Physicians

Table 2: Active N. C. Physician Practice Setting by Residency Training Location

Figure 4: Reported Specialty of Active

N. C. Physicians by Residency Training Location

Specialty

42.5% of the North Carolina

physicians who completed an

in- state residency indicated a

primary care specialty, com-pared

to 40.0% of the physi-cians

who trained out of state.

See Figure 4. ( See notes

for definition of primary care.)