Medical education reforms and the origins of the rural physician shortage

Carolyn M. Moehling, Gregory Niemesh, Melissa A. Thomasson () and Jaret Treber
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Carolyn M. Moehling: Rutgers University, New Brunswick, USA & NBER, Cambridge, USA
Melissa A. Thomasson: NBER, Cambridge, USA & Miami University, Oxford, USA
Jaret Treber: Kenyon College, Gambier, USA

Cliometrica, Journal of Historical Economics and Econometric History, 2020, vol. 14, issue 2, 181-225

Abstract: In the first two decades of the twentieth century, medical schools increased standards for admission and added basic science to their curricula. During this time period, the probability a new medical school graduate located in a rural area declined by 40%. Using novel data from the American Medical Directories, we find that physicians trained in more rigorous programs with higher admission standards were less likely to set up practice in rural areas. While all physicians were being drawn to metropolitan areas during this period, the pull was stronger for graduates of the higher quality schools. We also find some evidence that physicians trained in the more scientifically and clinically based programs were more strongly attracted to places with more hospitals. These findings suggest that the medical education reforms of the early twentieth century contributed to the urban–rural disparity in access to physician care.

Keywords: Medical; education; ·; Flexner; ·; Rural; physicians (search for similar items in EconPapers)
JEL-codes: I18 J13 J18 N31 N32 (search for similar items in EconPapers)
Date: 2020
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