MONDAY, June 29, 2026 (NewsDay News) — 1,000 new residency positions created between 2023 and 2025 could exacerbate the urban-rural learning gap, according to a research letter published online June 15.Journal of the American Medical Association.
Tarun Ramesh, MD, of Massachusetts General Hospital in Boston, and colleagues examined the geographic and specialty distribution of new residency positions funded by rounds 1 through 4 of the 2021 Consolidated Appropriations Act (800 graduate medical education (GME) positions) and more 20202 (GME) programs.
The researchers found that of the positions authorized by the 2021 law, 100 percent were in areas of medical professional shortage, compared to 81.6 percent of those authorized by the 2023 act. Just over half of the positions (53 percent) in Round 1 of the 2021 law were for primary care. Over the four periods, the percentage of primary care positions decreased, while the percentage of psychiatry increased. From cycles 1 to 4, first aid positions decreased by 22 percent. More than half of the positions (54.5 percent) created by the 2023 appropriations bill are allocated to psychiatry. For the 2021 apportionment, six percent of the positions in the first round were for rural counties, with each subsequent round reduced to three percent in the 4th round. Only one percent of the positions in the 2023 appropriations act were allocated to rural counties. For graduate year 1 positions compared to the 2021 baseline, interventional radiology (15.8 percent) and psychiatry (12.5 percent) accounted for the largest increases, while primary care positions increased by two percent.
“We found that new residency positions consistently do not reach rural areas or meet primary care goals,” said senior author Ph.D. Hao Yu, of Harvard University in Boston, said in a statement.
One author has disclosed financial ties to the biopharmaceutical industry.
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