Study: N.C. educates only a quarter of physicians practicing in the state

July 11, 2001

(Embargoed) CHAPEL HILL -- Ask people on the street what percentage of North Carolina doctors attended medical school in the state and, researchers say, most would guess half or more.

But they would be far wrong, a new University of North Carolina at Chapel Hill study shows. The real figure is about a quarter -- 27.5 percent to be exact.

"If we are going to influence the number of physicians who practice in North Carolina, we have to know whether we're training a substantial percentage of them and, if we're not, where the others are coming from," said Dr. Thomas C. Ricketts. "Some people have talked about building another medical school, but that's probably not feasible for several reasons. We really need to depend on the rest of the United States and to compete successfully in a national market for physicians from out of state."

Ricketts is professor of health policy at the UNC School of Public Health and deputy director of UNC's Cecil G. Sheps Center for Health Services Research. He oversaw the new study, which focused on 1999 data and was conducted by assistant center director Erin Fraher and N.C. Health Professions Data System staff.

The study showed that among active, licensed N.C. physicians that year, 12.2 percent attended UNC, 7.1 percent went to Wake Forest University, 5.2 percent attended Duke University and 3 percent studied at East Carolina University. Schools in New York, Virginia, Pennsylvania, Ohio and South Carolina furnished 5.5 percent, 5 percent, 4.9 percent, 3.8 percent and 3.1 percent, respectively. One in 10 doctors practicing here graduated from a foreign medical school, and more than a quarter of those studied in India.

"We found that N.C. physicians who trained in foreign medical schools were more likely to practice in primary health-care shortage areas and in rural counties than those trained in the United States or Canada," Ricketts said. "Almost 30 percent of international medical graduates practiced in non-metropolitan areas compared with about 21 percent of those who went to medical school in the U.S. or Canada."

Thirty-five percent of N.C. doctors completed their residencies in the state, he said. Almost 10 percent served residencies at Duke, almost 9 percent at UNC and 7 percent at Wake Forest. Percentages for New York, Virginia, Pennsylvania Ohio and Texas were 6.5, 5.3, 4.7, 3.7 and 3.3, respectively.

About one in five licensed doctors here in 1999 were women, Ricketts said.

The average age of N.C. physicians was just over 46. Regardless of where they attended medical school, they averaged about 41 hours in clinical care per week. Almost 43 percent of doctors who completed their residency in North Carolina reported a primary-care specialty, compared with just under 40 percent of those who trained out of state.

"One thing that's clear from this study is that we can't solve our physician shortage problem with just North Carolina resources," Ricketts said. "We do have to depend on the rest of the nation and be competitive in attracting physicians here."
The data system is funded by the UNC School of Medicine-based N.C. Area Health Education Centers and UNC's Office of the Provost for Health Affairs. An electronic copy of the report can be downloaded at

Note: Ricketts can be reached at 919-966-5541. Fraher's number is 966-5012.

Sheps center contact: Carolyn Busse, 919-966-3847

School of Public Health contact: Lisa Katz, 966-7467

UNC News Services

University of North Carolina at Chapel Hill

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