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 percent. 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. Download paper here
Recommended citation: Moehling, Carolyn, Gregory Niemesh, Melissa Thomasson, and Jaret Treber. (2020). “Medical Education Reforms and the Origins of the Rural Physician Shortage,” Cliometrica, 14(1).