More Residency Slots Needed in Rural Areas, Lawmakers and Health Experts Say

MedPage Today (02/24/26) Frieden, Joyce

Lawmakers and witnesses at a House hearing emphasized that expanding residency training in rural areas is essential to improving healthcare access. They noted that although Congress created more than 1,000 new graduate medical education slots with 10% reserved for rural hospitals, large urban hospitals have taken 97% of the 800 slots awarded so far, leaving only 2% of residencies in rural America despite evidence that physicians are five times more likely to practice rurally if they train there. Witnesses described the steep financial and logistical barriers rural systems face — including $5 million –$7 million in build-out costs and only about 15 federal planning grants available annually — and highlighted the need for training in lifestyle medicine, which addresses chronic diseases responsible for 90% of the nation's $4.9 trillion in annual healthcare spending. The hearing also featured partisan disagreement over Medicaid cuts, with one witness stating such cuts would harm rural healthcare, and raised concerns from some lawmakers about reliance on international medical graduates versus expanding opportunities for U.S.-trained physicians and nonphysician providers.

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