Georgia Graduate Medical Education Exit Survey Report Based on responses to the 2022 GME Exit Survey Georgia Board of Health Care Workforce Published Winter 2023 Contents Introduction ..................................................................................................................... 4 Methodology.................................................................................................................... 4 Table 1: Respondents and Survey Completion Rate by Program, 2022...................... 5 Executive Summary ........................................................................................................ 6 Demographics ............................................................................................................. 6 Geography ................................................................................................................... 6 Medical School ............................................................................................................ 6 Debt and Salary ........................................................................................................... 6 Retention ..................................................................................................................... 6 Practice Opportunities ................................................................................................. 7 Satisfaction with Training ............................................................................................. 7 Demographic Analysis..................................................................................................... 8 Figure 1: Gender Distribution, 2022............................................................................. 8 Figure 2: Percent Female, 2018-2022 ......................................................................... 8 Table 2: Specialties Completing by Gender, 2022....................................................... 9 Table 3: Racial and Ethnic Distribution, 2022 .............................................................. 9 Figure 3: Racial Distribution, 2022............................................................................. 10 Figure 4: Percent Black Race & Percent Hispanic, 2018-2022.................................. 11 Table 4: Citizenship Distribution, 2022 ...................................................................... 12 Figure 5: Citizenship Status, 2022 ............................................................................. 12 Figure 6: Percent Non-US Citizen, 2018-2022 .......................................................... 13 Table 5: Age Distribution, 2022 ................................................................................. 14 Figure 7: Age Distribution, 2022 ................................................................................ 14 Education ...................................................................................................................... 15 Table 6: Degree Type, 2022 ...................................................................................... 15 Figure 8: Percent Osteopathic Degree, 2018-2022 ................................................... 15 Table 7: Residence Upon Graduating from High School, 2022 ................................. 16 Figure 9: Residence Upon Graduating from High School, 2022 ................................ 16 Table 8: Residence Upon Graduating from Medical School, 2022 ............................ 17 Figure 10: Location of Medical School, 2022 ............................................................. 17 Figure 11: Respondent Attended Which Georgia Medical School, 2022 ................... 18 2 Financial Information ..................................................................................................... 19 Table 9: Education Debt, 2022 .................................................................................. 19 Figure 12: Current Level of Education Debt, 2022..................................................... 19 Figure 13: Percent Having no Education Debt, 2018-2022........................................ 20 Table 10: Expected Starting Salary, 2022 ................................................................. 20 Figure 14: Expected Gross Income in First Year of Practice, 2022 ........................... 21 Practice Information ...................................................................................................... 22 Table 11: Primary Activity after Current Year of Training, 2022................................. 22 Figure 15: Primary Activity After Current Year of Training, 2022 ............................... 22 Table 12: Practice Setting, 2022................................................................................ 23 Table 13: Expect to be at Principal Practice for 4 or More Years by Program, 2022 . 24 Table 14: Practice Location, 2022 ............................................................................. 25 Figure 16: Percent Staying in Georgia After Graduation Year, 2018-2022 ................ 25 Table 15: Practice Area, 2022 ................................................................................... 26 Figure 17: Percent Planning Rural Practice, 2018-2022............................................ 26 Job Search .................................................................................................................... 27 Table 16: Actively Job Searched, 2022 ..................................................................... 27 Table 17: Job Offers and Acceptance, 2022.............................................................. 27 Table 18: Job Search Approaches, 2022................................................................... 27 Table 19: Difficulty Finding a Job, 2022..................................................................... 28 Figure 18: Percent Reporting Difficulty Finding a Job, 2018-2022............................. 28 Table 20: Specific Difficulties in Finding a Job, 2022 ................................................. 29 Other Reasons for Difficulty in Finding a Job, 2022 ................................................... 29 Table 21: Ratings and Perception of Training, Educational Debt Repayment, Practice Opportunities, and Rural Practice, 2022 .................................................................... 30 Table 22: Reason for Leaving Georgia, 2022 ............................................................ 31 Other Reasons for Leaving Georgia, 2022 ................................................................ 32 Map 1: Location of Primary Activity After Current Year of Training, 2022 ..................... 33 Acknowledgements ....................................................................................................... 34 3 Introduction This report is the Georgia Board of Health Care Workforce's 20th annual report of physicians graduating from Georgia's graduate medical education (GME) programs. The purpose of this survey is to inform the medical education community and state health care workforce planners about the experiences of graduates and inform about the supply and demand for new physicians in the state of Georgia. The survey offers insight into residents' demographic characteristics, compensation and debt levels, retention rates, practice plans, assessments of the job market, and training experiences. Methodology In 2022, 708 Georgia GME graduates completed the GME Exit Survey. This year, surveys were sent to each of the residency programs for distribution to their graduates as PDF documents and an online survey link. GBHCW staff then compiled all survey data electronically. The response rates for each question vary and are reported as the "total" for each question. All Georgia GME programs with graduates participated in the survey, and are as follows: AdventHealth Redmond (Rome) Atrium Health Floyd (Rome) Atrium Health Navicent (Macon) AU/UGA Medical Partnership-St. Mary's Healthcare (Athens) Colquitt Regional Medical Center (Moultrie) Emory University School of Medicine (Atlanta) Houston Medical Center (Warner Robins) MCG @ AU-Memorial Satilla Health (Waycross) Medical College of Georgia (Augusta) Memorial Health University Medical Center (Savannah) Morehouse School of Medicine (Atlanta) Northeast Georgia Medical Center (Gainesville) Northside Hospital Gwinnett (Lawrenceville) Piedmont Athens Regional Medical Center (Athens) Piedmont Columbus Regional Midtown (Columbus) Piedmont Macon Medical Center (Macon) WellStar Atlanta Medical Center (Atlanta) WellStar Kennestone Regional Medical Center (Marietta) 4 Table 1: Respondents and Survey Completion Rate by Program, 2022 Program Name Emory University School of Medicine (Atlanta) Morehouse School of Medicine (Atlanta)* Medical College of Georgia (Augusta) Atrium Health Navicent (Macon)* Memorial Health University Medical Center (Savannah) Piedmont Macon Medical Center (Macon) WellStar Atlanta Medical Center (Atlanta) Northeast Georgia Medical Center (Gainesville)* Northside Hospital Gwinnett (Lawrenceville) AdventHealth Redmond (Rome)* Piedmont Columbus Regional Midtown (Columbus) AU/UGA Medical Partnership-St. Mary's Healthcare (Athens) WellStar Kennestone Regional Medical Center (Marietta) Atrium Health Floyd (Rome) Colquitt Regional Medical Center (Moultrie) Piedmont Athens Regional Medical Center (Athens) Houston Medical Center (Warner Robins) MCG @ AU-Memorial Satilla Health Total Completions 382 62 48 38 28 26 22 21 19 13 12 11 9 8 3 3 2 1 Percent of Total Respondents 54.0% 8.8% 6.8% 5.4% 4.0% 3.7% 3.1% 3.0% 2.7% 1.8% 1.7% 1.6% 1.3% 1.1% 0.4% 0.4% 0.3% 0.1% Total Graduates Survey Completion Rate 435 87.8% 51 121.6% 169 28.4% 32 118.8% 44 63.6% 24 92.3% 22 100.0% 20 105.0% 22 86.4% 11 118.2% 12 100.0% 11 100.0% 19 47.4% 8 100.0% 4 75.0% 14 21.4% 5 40.0% 2 50.0% 708 100.0% 891 79.5% *Note: these programs had more than 100% response rate, possibly due to some respondents submitting multiple surveys. 5 Executive Summary Demographics 50.7% of respondents identify as male; 49.3% identify as female. This indicates an increase in the percentage of respondents identifying as female from 2021, when 46.3% identified as female. Female-identified respondents were more likely than male-identified respondents to be completing a primary care/core specialty in 2022 (58.8% versus 49.7%). Female-identified respondents made up 50.0% or more of the respondents in the following primary care/core specialties: family medicine (58.6%); OB/GYN (80.0%); general surgery (54.2%); psychiatry (52.9%); and pediatrics (78.6%). 67.9% of respondents are native-born US citizens, which is slightly higher than the 65.4% reported in 2021. The percentage of respondents identifying as Black this year is 17.2%, which is a very slight increase from 15.4% in 2021. The percentage of respondents identifying as Hispanic this year is 5.9%, which is a decrease from 8.1% in 2021. Geography 28.8% of respondents graduated from a high school in Georgia, which is slightly higher than the 24.8% reported last year. 49.9% of respondents plan to be in Georgia for their primary activity after completion of their program, which is an increase of 5 percentage points from last year Medical School The percentage of respondents holding an osteopathic degree is 10.5%, which is slightly lower than the 10.9% of respondents last year. 23.5% of respondents attended medical school in Georgia. This is slightly lower than the 24.8% reported in 2021. Debt and Salary 48.6% of respondents report having $200,000 or greater in educational debt. 34.6% of respondents report having no educational debt. This is slightly higher than the 31.2% reported last year. 22.2% of respondents anticipate a starting salary of $200,000 a year or less, which is comparable to last year. Retention The primary care/core specialty with the highest percentage of respondents planning to stay in Georgia after graduation is psychiatry (75.0%). The primary care/core specialty with the lowest percentage of respondents planning to stay in Georgia is general surgery (25.0%). 6 72.0% of respondents who went to high school in Georgia plan to stay in Georgia next year. This is higher than the 65.0% last year. 71.4% of respondents who went to medical school in Georgia plan to stay in Georgia next year. This is higher than the 62.4% last year. 71.7% of people who answered the question considered one or more job offers in Georgia. This is up from 68.9% last year. The most-selected reasons for leaving Georgia after GME are: additional training or fellowship (22.2% selected); proximity to family (19.5% selected); and better jobs in desired location outside Georgia (11.9% selected). These are the same three top choices as last year. Practice Opportunities The average of respondents' overall assessments of practice opportunities in their specialty within 50 miles of the site where they trained is 3.4 on a scale where 1 is very few jobs and 5 is many jobs. This is slightly higher than the average of 3.2 reported last year. The average of respondents' overall assessments of practice opportunities in their specialty nationally is 4.0 on a scale where 1 is very few jobs and 5 is many jobs. This is slightly higher than last year's mean average of 3.8. Satisfaction with Training The average response to the statement "Overall, I am satisfied with the training I received" is 4.4 on a scale where 1 is very dissatisfied and 5 is very satisfied. This is the same as last year's average. The average agreement with the statement "I would choose to train at the same site again," is 4.2 on a scale where 1 is strongly disagree and 5 is strongly agree. This is the same as last year's average. 7 Demographic Analysis Figure 1: Gender Distribution, 2022 Gender Distribution Male 50.7% Female 49.3% Figure 2: Percent Female, 2018-2022 50.0% 49.5% 49.0% 48.5% 48.0% 47.5% 47.0% 46.5% 46.0% 45.5% 45.0% 44.5% 46.9% 2018 Percent Female, 2018-2022 49.4% 47.2% 46.3% 2019 2020 2021 49.3% 2022 8 Table 2: Specialties Completing by Gender, 2022 Specialty Completing in 2022 Emergency Medicine Family Medicine General Surgery Internal Medicine OB/GYN Pediatrics Psychiatry All Other Specialties Female Frequency Percent 14 42.4% 41 58.6% 13 54.2% 72 43.6% 16 80.0% 33 78.6% 9 52.9% 139 44.3% Male Frequency Percent 19 57.6% 29 41.4% 11 45.8% 93 56.4% 4 20.0% 9 21.4% 8 47.1% 175 55.7% Total 337 49.2% 348 50.8% Total 33 70 24 165 20 42 17 314 685 Note: some specialties do not total 100.0% because of missing data on the gender question. Table 3: Racial and Ethnic Distribution, 2022 Race/Ethnicity White Asian or Pacific Islander Black/African American Multi-Race Native American/Alaskan Native Total Frequency 320 227 120 30 1 698 Percent 45.8% 32.5% 17.2% 4.3% 0.1% 100.0% 9 Figure 3: Racial Distribution, 2022 Racial Distribution MultiRace 4.3% Native American/Alaskan Native 0.1% Black/African American 17.2% White 45.8% Asian or Pacific Islander 32.5% 10 Figure 4: Percent Black Race & Percent Hispanic, 2018-2022 20.0% 18.0% 16.0% 14.0% 12.0% 10.0% 8.0% 6.0% 4.0% 2.0% 0.0% Percent Black Race & Percent Hispanic Ethnicity, 2018-2022 Percent Black Percent Hispanic 14.3% 11.6% 14.5% 15.4% 17.2% 4.8% 6.2% 6.2% 8.1% 5.9% 2018 2019 2020 2021 2022 11 Table 4: Citizenship Distribution, 2022 Citizenship Status Native Born U.S. Naturalized U.S. J-1, J-2 Exchange Visitor Permanent Resident H-1, H-2, H-3 Temporary Worker Total Frequency 477 120 56 42 8 703 Percent 67.9% 17.1% 8.0% 6.0% 1.1% 100.0% Figure 5: Citizenship Status, 2022 H-1, H-2, H-3 Citizenship Status Temporary Worker 1.1% Permanent Resident J-1, J-2 6.0% Exchange Visitor 8.0% Naturalized U.S. 17.1% Native Born U.S. 67.9% 12 Figure 6: Percent Non-US Citizen, 2018-2022 15.5% 15.0% 14.5% 14.0% 13.5% 13.0% 12.5% 12.0% Percent non-US Citizen, 2018-2022 15.1% 15.2% 14.4% 13.3% 2018 2019 2020 2021 15.1% 2022 13 Table 5: Age Distribution, 2022 Age Grouping 25-29 30-34 35-39 40 and Above Total Frequency 97 440 121 37 695 Percent 14.0% 63.3% 17.4% 5.3% 100.0% Figure 7: Age Distribution, 2022 500 450 400 350 300 250 200 150 100 50 0 25-29 Age Distribution 30-34 35-39 40 and Above 14 Education Table 6: Degree Type, 2022 Degree Type Allopathic (MD) Osteopathic (DO) Total Frequency 624 73 697 Percent 89.5% 10.5% 100.0% Figure 8: Percent Osteopathic Degree, 2018-2022 12.0% 10.0% Percent Osteopathic Degree, 2018-2022 11.2% 10.9% 9.6% 10.5% 8.0% 6.0% 7.2% 4.0% 2.0% 0.0% 2018 2019 2020 2021 2022 15 Table 7: Residence Upon Graduating from High School, 2022 Residence Upon Graduating from High School Other US State Georgia Other Country Total Frequency 389 201 109 699 Percent 55.7% 28.8% 15.6% 100.0% Figure 9: Residence Upon Graduating from High School, 2022 Residence Upon Graduating from High School Other Country 15.6% Georgia 28.8% Other U.S. State 55.7% 16 Table 8: Residence Upon Graduating from Medical School, 2022 Location of Medical School Other US State Georgia Other Country Total Frequency 346 163 184 693 Figure 10: Location of Medical School, 2022 Location of Medical School Percent 49.9% 23.5% 26.6% 100.0% Other Country 26.6% Georgia 23.5% Other U.S. State 49.9% 17 Figure 11: Respondent Attended Which Georgia Medical School, 2022 Respondent Attended which Georgia Medical School PCOM-Georgia 26 Morehouse School of Medicine 30 MCG (@AU or @UGA) 32 Mercer University School of Medicine 33 Emory University School of Medicine 45 Does not Apply/Out of State 0 491 100 200 300 400 500 600 18 Financial Information Table 9: Education Debt, 2022 Current Level of Education Debt $0 Less than $100,000 $100,000-$199,999 $200,000-$299,999 $300,000-$399,999 $400,000-$499,999 $500,000 or Greater Total Frequency 227 35 76 122 109 56 32 657 Percent 34.6% 5.3% 11.6% 18.6% 16.6% 8.5% 4.9% 100.0% Figure 12: Current Level of Education Debt, 2022 250 227 200 Current Level of Education Debt 150 122 109 100 76 50 35 56 32 0 19 Figure 13: Percent Having no Education Debt, 2018-2022 40.0% 35.0% 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% Percent Having no Education Debt, 2018-2022 30.3% 30.2% 32.6% 34.6% 7.5% 2018 2019 2020 2021 2022 Table 10: Expected Starting Salary, 2022 Expected Gross Income in First Year of Practice Less than $100,000 $100,000-$199,999 $200,000-$299,999 $300,000-$399,999 $400,000-$499,999 $500,000 or Greater Total Frequency 48 55 189 117 37 18 464 Percent 10.3% 11.9% 40.7% 25.2% 8.0% 3.9% 100.0% 20 Figure 14: Expected Gross Income in First Year of Practice, 2022 Expected Gross Income in First Year of Practice 200 189 180 160 140 117 120 100 80 60 48 55 40 20 37 18 0 21 Practice Information Table 11: Primary Activity after Current Year of Training, 2022 Primary Activity after Current Year of Training Patient Care/Clinical Practice Additional Training or Fellowship Other* Teaching/Research Total Frequency 448 189 36 17 690 Percent 64.9% 27.4% 5.2% 2.5% 100.0% Figure 15: Primary Activity After Current Year of Training, 2022 Primary Activity After Current Year of Training Teaching/Research 2.5% Other 5.2% Additional Training or Fellowship 27.4% Patient Care/Clinical Practice 64.9% 22 Table 12: Practice Setting, 2022 Practice Setting Hospital-Inpatient Group Practice-As Employee Hospital-Ambulatory Care Other Group Practice-As Owner/Partner Hospital-Emergency Room Solo Practice Partnership (2 Person) Military Freestanding Health Center/Clinic HMO Total Frequency 208 164 71 43 33 33 14 11 10 7 6 648 Percent 34.7% 27.3% 11.8% 7.2% 5.5% 5.5% 2.3% 1.8% 1.7% 1.2% 1.0% 100.0% 23 Table 13: Expect to be at Principal Practice for 4 or More Years by Program, 2022 Program Name AdventHealth Redmond (Rome) Atrium Health Floyd (Rome) Atrium Health Navicent (Macon) AU/UGA Medical Partnership-St. Mary's Healthcare (Athens) Colquitt Regional Medical Center (Moultrie) Emory University School of Medicine (Atlanta) Houston Medical Center (Warner Robins) MCG @ AU-Memorial Satilla Health Medical College of Georgia (Augusta) Memorial Health University Medical Center (Savannah) Morehouse School of Medicine (Atlanta) Northeast Georgia Medical Center (Gainesville) Northside Hospital Gwinnett (Lawrenceville) Piedmont Athens Regional Medical Center (Athens) Piedmont Columbus Regional Midtown (Columbus) Piedmont Macon Medical Center (Macon) WellStar Atlanta Medical Center (Atlanta) WellStar Kennestone Regional Medical Center (Marietta) Total Expect to be at Principal Practice for 4 or More Years No Yes Frequency Percent Frequency Percent Total 5 2.8% 7 1.7% 12 3 1.7% 5 1.2% 8 9 5.0% 23 5.5% 32 5 2.8% 5 1.2% 10 1 0.6% 2 0.5% 3 88 48.9% 235 56.5% 323 0 0.0% 1 0.2% 1 0 0.0% 1 0.2% 1 6 3.3% 31 7.5% 37 6 3.3% 18 4.3% 24 24 13.3% 25 6.0% 49 8 4.4% 8 1.9% 16 7 3.9% 7 1.7% 14 0 0.0% 3 0.7% 3 2 1.1% 9 2.2% 11 8 4.4% 14 3.4% 22 6 3.3% 16 3.8% 22 2 1.1% 6 1.4% 8 180 100.0% 416 100.0% 596 24 Table 14: Practice Location, 2022 Location of Primary Activity After Graduation Year Other State Georgia Outside of US Total Frequency 335 344 11 690 Percent 48.6% 49.9% 1.6% 100.0% Figure 16: Percent Staying in Georgia After Graduation Year, 2018-2022 Percent Staying in Georgia After Graduation, 20182022 60.0% 50.0% 49.9% 40.0% 44.2% 44.9% 49.9% 30.0% 20.0% 26.4% 10.0% 0.0% 2018 2019 2020 2021 2022 25 Table 15: Practice Area, 2022 Practice Area Frequency Percent Inner City 214 Other Area Within Major City 173 Suburban 167 Small City (City Population Less Than 50,000) 81 Rural (County Population Less Than 50,000) 46 31.4% 25.4% 24.5% 11.9% 6.8% Total 681 100.0% Figure 17: Percent Planning Rural Practice, 2018-2022 Percent Planning Rural Practice, 2018-2022 8.0% 7.0% 6.0% 6.2% 6.2% 7.1% 6.8% 5.0% 4.0% 4.5% 3.0% 2.0% 1.0% 0.0% 2018 2019 2020 2021 2022 Note: Before 2019, the definition of "rural" entailed an area with a county population of 35,000 or less; starting in 2019, the definition of "rural" entails an area with a county population of 50,000 or less. 26 Job Search Table 16: Actively Job Searched, 2022 Actively Job Searched No Yes Total Frequency 171 457 628 Table 17: Job Offers and Acceptance, 2022 Been Offered a Job Yes and accepted Not been offered Yes and declined Total Frequency 461 79 28 568 Table 18: Job Search Approaches, 2022 Job Search Approaches Independent job search Third party representation Announcements/career fairs Other Want ads Frequency 236 131 103 89 56 Note: Respondents could select multiple job search approaches. Percent 27.2% 72.8% 100.0% Percent 81.2% 13.9% 4.9% 100.0% Percent 33.3% 18.5% 14.5% 12.6% 7.9% 27 Table 19: Difficulty Finding a Job, 2022 Had Difficulty Finding a Job No Yes Total Frequency 434 92 526 Percent 82.5% 17.5% 100.0% Figure 18: Percent Reporting Difficulty Finding a Job, 2018-2022 Percent Reporting Difficulty Finding a Job, 2018-2022 30.0% 25.0% 24.5% 26.1% 20.0% 15.0% 14.3% 15.5% 17.5% 10.0% 5.0% 0.0% 2018 2019 2020 2021 2022 28 Table 20: Specific Difficulties in Finding a Job, 2022 Difficulty in Finding a Job Frequency Not a favorable work/life balance 62 Would not be satisfied with the job 45 Lack of mentoring opportunities 20 Practice did not communicate well 15 Practice was not collaborative 12 Not enough challenge 9 Did not have passion for the practice 8 Practice did not advocate for patients 4 *Note: respondents could choose multiple options. Other Reasons for Difficulty in Finding a Job, 2022 In addition to the above answer options, respondents had the option to give an openended answer choice. Their responses fell under the following categories: Visa and Contractual Obligations: these include answers such as needing to find a job in a HPSA (Health Professional Shortage Area), visa-sponsoring positions. Position-Related Opportunities: these include not finding an appropriate mix of clinical, teaching, and research tasks within a position, and wanting to practice only within their specialty, and wanting a job that would provide the option to grow. Pay-Related Issues: Some respondents mentioned the pay was below national average or otherwise not adequate to meet their expectations. 29 Table 21: Ratings and Perception of Training, Educational Debt Repayment, Practice Opportunities, and Rural Practice, 2022 Question or Statement In your job search, how strongly did you consider practicing in a rural area (county population less than 50,000)? If all of your medical school debt were forgiven, how likely would you consider a five-year obligation to practice in a rural setting (GA county population less than 50,000)? What is your level of satisfaction with your salary/compensation? What is your overall assessment of practice opportunities in your specialty within 50 miles of the site where you trained? What is your overall assessment of practice opportunities in your specialty nationally? Rating Scale 1 = DID NOT CONSIDER 5 = STRONGLY CONSIDERED 1 = VERY UNLIKELY 5 = VERY LIKELY 1 = VERY DISSATISFIED 5 = VERY SATISFIED 1 = VERY FEW JOBS 5 = MANY JOBS Number of Responses 585 599 591 600 614 Average 2.3 2.9 3.7 3.4 4.0 Overall, I am satisfied with the training I received. 634 4.4 1 = STRONGLY DISAGREE 5 = STRONGLY AGREE I would choose to train at the same site again. 637 4.2 30 Table 22: Reason for Leaving Georgia, 2022 Reason for Leaving Georgia Fellowship or Additional Medical Training Proximity to Family Better Jobs in Desired Location Outside Georgia Better Job for Spouse/Partner Outside Georgia Better Salary Offered Outside Georgia Better Jobs in Desired Practice Setting Outside Georgia Other Reason Never Intended to Practice in Georgia Overall Lack of Jobs/Practice Opportunities in Georgia Other Service Obligation Better Jobs Outside Georgia That Meet Visa Requirements Cost of Malpractice Insurance in Georgia Cost of Starting a Practice Frequency 157 138 84 70 69 56 54 44 43 20 18 4 3 Note: Respondents could select multiple reasons for leaving Georgia. 31 Other Reasons for Leaving Georgia, 2022 In addition to the above reasons for leaving Georgia after the current year of training, some respondents entered another reason in an open-ended format. The responses are organized into the following themes: Living Conditions or Preferences: Respondents mentioned living conditions in the South, quality of schools, experiences of racism, traffic, diversity, wanting a more desired location or geography, safety concerns, and the political atmosphere. Financial, Contractual, and Visa Considerations: Respondents mentioned better insurance or tax situations in other states, as well as military or visa requirements. Licensing or Practice Considerations: A few respondents mentioned not wanting to or not being able to stay at their current institution, needing extra licensing to practice in their specialty, or further specialty training being unavailable in Georgia. 32 Map 1: Location of Primary Activity After Current Year of Training, 2022 33 Acknowledgements This report was produced under the direction of Chet Bhasin, FACHE, Executive Director; Leanna Greenwood, MA, Data Team Supervisor; G.E. Alan Dever, MD PhD, Consultant; and Cherri Tucker, Consultant. The Board would like to thank Georgia's Graduate Medical Education programs for their assistance with this survey. Thank you to the Georgia Board of Health Care Workforce Board Members for their leadership and support. Board Members Terri McFadden-Garden, M.D. - Chair James Barber, M.D. - Vice Chair William R. "Will" Kemp - Secretary/Treasurer Garrett Bennett, M.D. W. Scott Bohlke, M.D. Carolyn Clevenger, DNP Steven Gautney, MSHA Michael J. Groover, D.M.D. Lily Jung Henson, M.D. Indran Indrakrishnan, M.D. Amy Reeves, PA-C Antonio Rios, M.D. James Lofton Smith, Jr., M.D. Joseph L. Walker, M.D. 34