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HealthBeat

None of Concord Hospital’s family medicine residents stay in N.H. for first time in years

None of the eight doctors who graduated from Concord Hospital’s family medicine residency program this summer stayed in New Hampshire to practice, which is one of the program’s central goals. But that’s an anomaly, say the people who run the program, and the data backs them up.

This was the only year since at least 1997 that no residents stayed in the state, according to data provided by the hospital. The reasons that inform doctors’ choices for where to practice are varied and personal, and this year doesn’t indicate anything particularly alarming, said program officials.

Health policy experts worry about a shortage of primary-care providers, such as family doctors. A 2012 study published in the Annals of Family Medicine predicted America would need 52,000 more primary-care physicians by 2025, while more and more medical students choose to pursue more glamorous or higher-paying work in specialties such as cardiology or surgery.

Training New Hampshire’s family doctors is a goal of the Concord Hospital residency program, said administrator Martha Seery.

“It’s been an institutional priority. It’s part of our mission that we try and retain some of the talent to stay in-state,” she said. “There’s a connection to the community, and often to the hospital, that’s part of what we’re cultivating.”

But loan repayment obligations, such as the National Health Service Corps, a federal program that repays student loans if doctors accept assignments to work with under-served populations, and family obligations – a spouse’s career or a desire to be near parents – often dictate where graduates will practice, said Director Doug Dreffer.

Even still, the Concord program has a higher-than-average retention rate of family doctors.

Including this year, more than 55 percent of the 115 doctors who graduated from the program were practicing in the state as of June – 27 of them work for Concord Hospital.

That’s higher than the national in-state retention rate average of 48 percent among all American family medicine residency programs, according to the Association of American Medical Colleges.

The program’s retention rate also stands in stark contrast to overall medical training retention in the state.

New Hampshire has the lowest overall retention rate of physicians who complete their undergraduate or graduate work here, according to a 2011 report from the medical college association. Only 9.7 percent of doctors who complete undergraduate work here stay to work, and 28.3 percent of doctors who complete their graduate studies here stay.

The program at Concord Hospital is formally called the N.H. Dartmouth Family Medicine Residency at Concord Hospital. A three-year program, it started in 1994 and selects between six and 10 physicians from a national applicant pool each year.

Being connected to Dartmouth, an Ivy League institution, helps draw attention from applicants, as does the program’s leadership-centered curriculum and the individual attention residents can receive at a hospital without other residency programs, said Dreffer.

More than 1,100 doctors applied for eight spots in the Class of 2017, he said.

Attracting such a large and diverse applicant pool can lower a program’s retention rate, said Tina Kenyon, the program’s instructor of community and family medicine.

“Some of them know when they come in where they are going later, because they know they want to return to their home state to practice,” Kenyon said. “Many who left said if all things were equal, they would stay here. They feel supported, they really like the area, really like New Hampshire . . . but it’s multifactorial why people decide to go where they go.”

(Sarah Palermo can be reached at 369-3322 or
spalermo@cmonitor.com or on Twitter @SPalermoNews.)

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