The 10 States Most (and Least) Likely to Retain Medical Residents

The latest crop of final-year medical residents are just a few months away from beginning their first physician job after training. Are they likely to stay in state or find an opportunity elsewhere?

That depends largely on the state where they trained, according to a new report from the Association of American Medical Colleges (AAMC).

AAMC tracks medical school graduates and residents on an annual basis, compiling data on a number of characteristics, specialty preferences and post-residency activities. The new 2018 Report on Residents found that more than half of graduating residents (54.2%) end up practicing in the state in which they did their training. Yet physician retention rates vary widely by state.

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Here are the states with the highest and lowest physician retention rates, based on the state of residency training:*

The 10 Top States for Retention of Medical Residents

California – 77.7%
Puerto Rico (territory) – 73.6%
Alaska – 69.0%
Texas – 66.1%
Montana – 64.8%
Florida – 61.7%
Oregon – 61.4%
Oklahoma – 60.4%
Colorado – 59.5%
Idaho – 58.9%
Mississippi – 57.6%

The 10 States with the Lowest Retention Rates of Medical Residents

Wyoming – 27.2%
Delaware – 34.5%
District of Columbia – 35.8%
Rhode Island – 38.8%
New Hampshire – 38.8%
Connecticut – 41.7%
Vermont – 45.1%
New Jersey – 45.2%
Iowa – 45.2%
Pennsylvania – 45.4%

*Results based on AAMC data from practicing MDs and DOs who completed their residency training from 2008 through 2017 and are not currently active in any GME program. 

For full details, see AAMC’s state-by-state breakdown of physician retention rates. 

Additional findings about physicians post-residency 

The AAMC 2018 Report of Residents also found that, of those who completed their residencies from 2008 to 2017, almost a quarter (23.1%) are practicing in Medically Underserved Areas. This practice also varies widely by state. On the extreme ends of the spectrum, less than 1% of those who completed residency and go on to practice in Utah are practicing in a Medically Underserved Area, while more than 90% of residents who completed training and practice in Puerto Rico do so. See the chart of how many doctors practice in Medically Underserved Areas after completing residency training.

Reality of the physician job market vs. expectations 

Will new physicians end up where they expect? The 2017 Survey of Final-year Medical Residents, conducted by Merritt Hawkins, found that a great majority of residents (92%) would prefer to practice in communities of 50,000 or more people, while only 3% would prefer to practice in communities of 25,000 or less.

The fact that nearly a quarter of newer physicians are currently working in Medically Underserved Areas, many of which are smaller communities, may show that these former medical residents will go where the jobs are—or at least they are willing to change their perspective and provide care where it is needed.

Medical Moonlighting for Residents: The Pros and Cons 

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