Pub. 8 2024 Issue 2

CHC Family Medicine Residency A Teaching Health Center Combining Service and Education By Frank Powers, MD, Program Director, Andy Garrison, MD, Faculty, and Jen Mair, Program Coordinator, CHC Family Medicine Residency THCGME program in the state, aiming to train primary care physicians specifically to work in rural and underserved areas. Utah Continues to Suffer Primary Care Workforce Shortages Family physicians can particularly impact health outcomes in rural and underserved areas. Access to a regular primary care physician has been linked to lower infant mortality, higher birth weights, immunization rates exceeding national standards, reduced healthcare costs, and longer, healthier lives. Yet, the Bureau of Health Workforce projects a shortage of 68,020 full-time equivalent primary care physicians by 2036 in the United States. Shortages are particularly profound in Utah’s rural and underserved populations: Across the state, Utah has fewer primary care providers per population (5.8 per 10,000) than the U.S. average (7.6 per 10,000). Utah has the lowest percentage of active primary care physicians in the United States, with a projected need for 123.9 primary care physicians per year. Additionally, 30.3% of Utah family physicians are over 60 years old, contributing to workforce gaps in the coming decades. Utah’s projected population growth (4 million people by 2030) and the increase in aging patients will increase needs for physician supply. Rural Utah, which comprises 83% of the state’s counties, has significantly fewer primary care providers compared to urban areas; 21.5% of the state’s population lives in rural areas, yet only 11% of the state’s Dr. Frank Powers and patient Imagine you had the opportunity to create your ideal family medicine residency from scratch. Given that family physicians mostly work in community settings, you’d likely situate your ideal residency in a community-based primary care setting, where most learning occurs through caring for continuity patients. Ideally, the residency might be sponsored by a community health center, rather than a hospital system, so as to maximize focus and institutional resources on a single program. You’d also want to ensure that your residents care for a highly diverse patient population, representing multiple languages and cultures. Furthermore, your residents — especially those wanting to work in rural areas — would need experience working in high-volume tertiary care centers to gain emergency medicine, obstetrics, and inpatient medicine experience. Perhaps most importantly, you’d want the funding for the residency to go directly to your program, instead of sharing funds among a multitude of competing departments. Though this vision may seem too good to be true, creating and supporting such primary care residencies is the explicit goal of the Teaching Health Center Graduate Medical Education (THCGME) program. Since 2010, the THCGME program has funded over 81 community-based residencies which have trained over 2,000 primary care physicians and dentists. To date, Utah has not benefited from this program; though this is about to change. In July 2025, the new Community Health Centers Family Medicine Residency (CHCFMR) will welcome their first class of incoming residents. The program will be the first 26

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