Georgia Graduate Medical Education Exit Survey Report Based on responses to the 2023 GME Exit Survey, administered May-July 2023 Georgia Board of Health Care Workforce Published Fall 2023 Contents Introduction ..................................................................................................................... 4 Methodology.................................................................................................................... 4 Table 1: Respondents and Survey Completion Rate by Program, 2023...................... 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, 2023............................................................................. 8 Figure 2: Percent Female, 2019-2023 ......................................................................... 8 Table 2: Specialties Completing by Gender, 2023....................................................... 9 Table 3: Racial and Ethnic Distribution, 2023 .............................................................. 9 Figure 3: Racial Distribution, 2023............................................................................. 10 Figure 4: Percent Black Race & Percent Hispanic, 2019-2023.................................. 11 Table 4: Citizenship Distribution, 2023 ...................................................................... 12 Figure 5: Citizenship Status, 2023 ............................................................................. 12 Figure 6: Percent Non-US Citizen, 2019-2023 .......................................................... 13 Table 5: Age Distribution, 2023 ................................................................................. 14 Figure 7: Age Distribution, 2023 ................................................................................ 14 Education ...................................................................................................................... 15 Table 6: Degree Type, 2023 ...................................................................................... 15 Figure 8: Percent Osteopathic Degree, 2019-2023 ................................................... 15 Table 7: Residence Upon Graduating from High School, 2023 ................................. 16 Figure 9: Residence Upon Graduating from High School, 2023 ................................ 16 Table 8: Residence Upon Graduating from Medical School, 2023 ............................ 17 Figure 10: Location of Medical School, 2023 ............................................................. 17 Figure 11: Respondent Attended Which Georgia Medical School, 2023 ................... 18 2 Financial Information ..................................................................................................... 19 Table 9: Education Debt, 2023 .................................................................................. 19 Figure 12: Current Level of Education Debt, 2023..................................................... 19 Figure 13: Percent Having no Education Debt, 2019-2023........................................ 20 Table 10: Total Scholarship Money Received for Medical School, 2023 ................... 20 Figure 14: Total Scholarship for Medical School........................................................ 21 Table 11: Expected Gross Income in First Year of Practice, 2023 ............................ 22 Figure 15: Expected Gross Income in First Year of Practice, 2023 ........................... 22 Practice Information ...................................................................................................... 23 Table 12: Top 5 intended Primary Activities after Current Year of Training, 2023 ..... 23 Figure 16: Top 5 Intended Primary Activities after Current Year of Training, 2023 .... 23 Table 13: Practice Setting, 2023................................................................................ 24 Table 14: Expect to be at Principal Practice for 4 or More Years by Program, 2023 . 25 Table 15: Practice Location, 2023 ............................................................................. 26 Figure 17: Percent Staying in Georgia after Graduation, 2019-2023......................... 26 Table 16: Practice Area, 2023 ................................................................................... 27 Figure 18: Percent Planning Rural Practice, 2019-2023............................................ 27 Job Search .................................................................................................................... 28 Table 17: Actively Job Searched, 2023 ..................................................................... 28 Table 18: Job Offers and Acceptance, 2023.............................................................. 28 Table 19: Job Search Approaches, 2023................................................................... 28 Table 20: Difficulty Finding a Job Rating, 2023 ......................................................... 29 Table 21: Specific Difficulties in Finding a Job, 2023 ................................................. 29 Other Reasons for Difficulty in Finding a Job, 2023 ................................................... 30 Table 22: Ratings and Perception of Training, Educational Debt Repayment, Practice Opportunities, and Rural Practice, 2023 .................................................................... 31 Table 23: Reason for Leaving Georgia, 2023 ............................................................ 32 Other Reasons for Leaving Georgia, 2023 ................................................................ 33 Map 1: Location of Primary Activity After Current Year of Training, 2023 ..................... 34 Acknowledgments ......................................................................................................... 35 3 Introduction This report is the Georgia Board of Health Care Workforce's 21st 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 medical residents' demographic characteristics, compensation & debt levels, retention rates, practice plans, assessments of the job market, and training experiences. Methodology In 2023, 800 Georgia GME graduates completed the GME Exit Survey. This year, the Georgia Board of Health Care Workforce (GBHCW) updated its data collection system to streamline the analysis process. GBHCW data staff created an online form and sent the link to all residency program Directors and Coordinators via email. The GBHCW data team then sent weekly reminders and status update emails to each school until the completion deadline of July 10th. Analyses presented here were conducted using Microsoft Excel. 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 Archbold Medical Center Atrium Health Floyd Medical Center Atrium Health Navicent AU/UGA Medical Partnership-St. Mary's Healthcare Emory University School of Medicine Gateway Behavioral Health Community Service Board HCA Healthcare/Mercer University School of Medicine Houston Healthcare System Medical College of Georgia Memorial Satilla Morehouse School of Medicine Northeast Georgia Medical Center Northside Hospital Gwinnett Phoebe Putney Memorial Hospital Piedmont Athens Regional Piedmont Columbus Regional Midtown Piedmont Macon Medical Center South Georgia Medical Education and Research Consortium WellStar Health System 4 Table 1: Respondents and Survey Completion Rate by Program, 2023 Program Name Emory University School of Medicine (Atlanta) Medical College of Georgia (Augusta) WellStar Health System Morehouse School of Medicine (Atlanta) Northeast Georgia Medical Center (Gainesville)* Atrium Health Navicent (Macon)* HCA Healthcare/ Mercer university School of Medicine Piedmont Macon Medical Center (Macon) Northside Hospital Gwinnett (Lawrenceville) Piedmont Athens Regional Medical Center (Athens) AdventHealth Redmond (Rome)* Piedmont Columbus Regional Midtown (Columbus) AU/UGA Medical Partnership-St. Mary's Healthcare (Athens) Atrium Health Floyd (Rome) Gateway Behavioral Health Community Service Board Houston Medical Center (Warner Robins) South Georgia Medical Education and Research Consortium Phoebe Putney Memorial Hospital Archbold Medical Center MCG @ AU-Memorial Satilla Health Totals Completions 383 110 54 51 35 28 28 27 19 13 10 10 8 6 6 4 4 2 1 1 800 Percent of Total Respondents 47.9% 13.8% 6.8% 6.4% 4.4% 3.5% 3.5% 3.4% 2.4% 1.6% 1.3% 1.3% 1.0% 0.8% 0.8% 0.5% 0.5% 0.3% 0.1% 0.1% 100.0% Total Graduates 439 166 68 54 30 23 41 27 20 22 13 11 10 7 6 7 4 8 0 2 Survey Completion Rate 87.2% 66.3% 79.4% 94.4% 116.7% 121.7% 68.3% 100.0% 95.0% 59.1% 76.9% 90.9% 80.0% 85.7% 100.0% 57.1% 100.0% 25.0% 50.0% 958 83.5% *Note: these programs had more than 100% response rate, possibly due to some respondents submitting multiple surveys. 5 Executive Summary Demographics 50.6% of respondents identify as male; 49.4% identify as female. Female-identified respondents were more likely than male-identified respondents to be completing a primary care/core specialty in 2023 (64.8% versus 52.2%). Female-identified respondents made up 50.0% or more of the respondents in the following primary care/core specialties: family medicine (57.3%); OB/GYN (92.0%); psychiatry (56.3%); and pediatrics (68.2%). 72.6% of respondents are native-born US citizens, which is slightly higher than the 67.6% reported in 2022. The percentage of respondents identifying as Black this year is 18.5%, which is an increase from 17.2% in 2022. The percentage of respondents identifying as Hispanic this year is 7.9%, which is an increase from 5.9% in 2022. Geography 27.3% of respondents graduated from a high school in Georgia, which is slightly lower than the 28.8% reported last year. 47.0% of respondents plan to be in Georgia for their primary activity after completion of their program, which is a decrease of 2.9 percentage points from last year. Medical School The percentage of respondents holding an osteopathic degree is 15.6%, which is higher than the 10.5% of respondents last year. 25.9% of respondents attended medical school in Georgia. This is slightly higher than the 23.5% reported in 2022. Debt and Salary 48.6% of respondents report having $200,000 or greater in educational debt. 29.4% of respondents report having no educational debt. This is lower than the 34.6% reported last year. 30.1% of respondents expect a starting salary of $200,000 or less a year. Retention Internal Medicine residents make up 41.0% of the 251 respondents planning to stay in Georgia for practice; General Surgery residents make up 1.6%. 67.0% of respondents who went to high school in Georgia plan to stay in Georgia next year. This is lower than the 72.0% reported last year. 60.9% of respondents who went to medical school in Georgia plan to stay in Georgia next year. This is lower than the 71.4% reported last year. 6 63.0% of people who answered the question considered one or more job offers in Georgia. This is lower than the 71.7% reported last year. The most-selected reasons for leaving Georgia after GME are: proximity to family (25.0% selected); fellowship or additional medical training (21.8%); and better jobs in desired location outside Georgia (15.5% 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 3.2 on a scale where 1 is very few jobs and 5 is many jobs. This is slightly lower than the mean average of 3.4 reported last year. The average of respondents' overall assessments of practice opportunities in their specialty nationally is 3.8 on a scale where 1 is very few jobs and 5 is many jobs. This is slightly lower than last year's mean average of 4.0. Satisfaction with Training The average response to the statement "Overall, I am satisfied with the training I received," is 4.3 on a scale where 1 is very dissatisfied and 5 is very satisfied. This is slightly lower than the average of 4.4 reported last year. The average agreement with the statement "I would choose to train at the same site again," is 4.1 on a scale where 1 is strongly disagree and 5 is strongly agree. This is lower than the average of 4.2 reported last year. 7 Demographic Analysis Figure 1: Gender Distribution, 2023 Gender Distribution Male 50.6% Female 49.4% Figure 2: Percent Female, 2019-2023 50.0% 49.5% 49.0% 48.5% 48.0% 47.5% 47.0% 46.5% 46.0% 45.5% 45.0% 44.5% 47.2% 2019 Percent Female, 2019-2023 49.4% 49.3% 46.3% 2020 2021 2022 49.4% 2023 8 Table 2: Specialties Completing by Gender, 2023 Specialty Completing in Female 2023 Frequency Percent Emergency Medicine 19 47.5% Family Medicine 55 57.3% General Surgery 11 42.3% Internal Medicine 100 49.0% OB/GYN 23 92.0% Pediatrics 30 68.2% Psychiatry 18 56.3% Primary Care/Core Subtotal 256 64.8% All Other Specialties 139 41.9% Male Frequency Percent 21 52.5% 41 42.7% 15 57.7% 104 51.0% 2 8.0% 14 31.8% 14 43.8% 211 52.2% 193 58.1% Total 395 49.4% 404 50.6% Table 3: Racial and Ethnic Distribution, 2023 Total 40 96 26 204 25 44 32 467 332 799 Race/Ethnicity White Asian or Pacific Islander Black/African American Multi-Race Others Native American/Alaskan Native Total Frequency 398 192 147 36 19 2 794 Percent 50.1% 24.2% 18.5% 4.5% 2.4% 0.3% 100.0% 9 Figure 3: Racial Distribution, 2023 Racial Distribution Other 2.4% MultiRace 4.5% Black/African American 18.6% Asian or Pacific Islander 24.2% White 50.3% 10 Figure 4: Percent Black Race & Percent Hispanic, 2019-2023 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, 2019-2023 Percent Black Percent Hispanic 14.5% 15.5% 17.2% 18.4% 11.6% 6.2% 6.2% 8.1% 5.9% 7.9% 2019 2020 2021 2022 2023 11 Table 4: Citizenship Distribution, 2023 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 579 136 36 36 10 797 Percent 72.6% 17.1% 4.5% 4.5% 1.3% 100.0% Figure 5: Citizenship Status, 2023 J-1, J-2 Exchange Visitor 4.5% Citizenzhip Status Permanent Resident 4.5% H-1, H-2, H-3 Temporary Worker 1.3% Naturalized U.S. 17.1% Native Born U.S. 72.6% 12 Figure 6: Percent Non-US Citizen, 2019-2023 16.0% 14.0% 12.0% 10.0% 8.0% 6.0% 4.0% 2.0% 0.0% 13.3% Percent non-US Citizen, 2019-2023 14.4% 15.2% 15.1% 2019 2020 2021 2022 10.3% 2023 13 Table 5: Age Distribution, 2023 Age Grouping 25-29 30-34 35-39 40 and Above Total Frequency 118 492 143 47 800 Percent 14.8% 61.5% 17.9% 5.9% 100.0% Figure 7: Age Distribution, 2023 Age Distribution 600 500 400 300 200 100 0 25-29 30-34 35-39 40 and Above 14 Education Table 6: Degree Type, 2023 Degree Type Allopathic (MD) Osteopathic (DO) Total Frequency 675 125 800 Percent 84.4% 15.6% 100.0% Figure 8: Percent Osteopathic Degree, 2019-2023 18.0% 16.0% 14.0% 12.0% 10.0% 8.0% 6.0% 4.0% 2.0% 0.0% Percent Osteopathic Degree, 2019-2023 15.6% 9.6% 11.2% 10.9% 10.5% 2019 2020 2021 2022 2023 15 Table 7: Residence Upon Graduating from High School, 2023 Residence Upon Graduating from High School Other US State Georgia Other Country Frequency 472 218 110 Total 800 Percent 59.0% 27.3% 13.8% 100.0% Figure 9: Residence Upon Graduating from High School, 2023 Residence Upon Graduating from High School Other Country 13.8% Georgia 27.3% Other U.S. State 59.0% 16 Table 8: Residence Upon Graduating from Medical School, 2023 Location of Medical School Other US State Georgia Offshore Island / Caribbean Medical School Other Country Total Frequency 388 207 108 97 800 Percent 48.5% 25.9% 13.5% 12.1% 100.0% Figure 10: Location of Medical School, 2023 Residence Upon Graduating from Medical School Other Country 12.1% Offshore Island / Caribbean Medical School 13.5% Other U.S. State 48.5% Georgia 25.9% 17 Figure 11: Respondent Attended Which Georgia Medical School, 2023 Respondent Attended Which Georgia Medical School 32 Morehouse School of Medicine 39 PCOMGeorgia 41 Mercer University School of Medicine 45 Medical College of Georgia 50 Emory University School of Medicine 593 Does not Apply/Out of State 0 100 200 300 400 500 600 700 18 Financial Information Table 9: Education Debt, 2023 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 235 65 99 180 133 67 21 800 Percent 29.4% 8.1% 12.4% 22.5% 16.6% 8.4% 2.6% 100.0% Figure 12: Current Level of Education Debt, 2023 250 235 Current Level of Education Debt 200 150 100 50 0 $0 180 99 65 133 67 21 Less than $100,000 - $200,000 - $300,000 - $400,000 - $500,000 or $100,000 $199,999 $299,999 $399,999 $499,999 Greater 19 Figure 13: Percent Having no Education Debt, 2019-2023 35.0% 34.0% 33.0% 32.0% 31.0% 30.0% 29.0% 28.0% 27.0% 26.0% Percent Having No Education Debt, 2019-2023 34.6% 32.6% 30.3% 30.2% 29.4% 2019 2020 2021 2022 2023 Table 10: Total Scholarship Money Received for Medical School, 2023 Scholarship Money Received for Medical School $0 Less than $100,000 $100,000 - $199,999 $200,000-$299,999 $300,000 or Greater Total Frequency 625 130 25 15 5 800 Percent 78.1% 13.6% 3.1% 1.9% 0.6% 100.0% 20 Figure 14: Total Scholarship for Medical School Scholarship Money Received for Medical School 700 625 600 500 400 300 200 100 0 $0 130 Less than $100,000 25 $100,000 $199,999 15 $200,000 $299,999 5 $300,000 - or Greater 21 Table 11: Expected Gross Income in First Year of Practice, 2023 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 132 85 246 147 73 38 721 Percent 18.3% 11.8% 34.1% 20.4% 10.1% 5.3% 100.0% Figure 15: Expected Gross Income in First Year of Practice, 2023 Expected Gross Income in First Year of Practice 300 250 246 200 150 132 100 85 50 147 73 38 0 Less than $100,000 - $200,000 - $300,000 - $400,000 - $500,000 or $100,000 $199,999 $299,999 $399,999 $499,999 Greater 22 Practice Information Table 12: Top 5 intended Primary Activities after Current Year of Training, 2023 Top 5 Intended Primary Activities after Current Year of Training Patient Care / Clinical Practice Additional Subspecialty Training or Fellowship Chief Resident Teaching / Research Undecided Total Frequency Percent 513 66.5% 204 26.4% 31 4.0% 13 1.7% 11 1.4% 772 100.0% Figure 16: Top 5 Intended Primary Activities after Current Year of Training, 2023 Top 5 Intended Primary Activities after Current Year of Training Teaching / Research 1.7% Chief Resident Undecided 1.4% 4.0% Additional Subspecialty Training or Fellowship 26.4% Patient Care/Clinical Practice 66.5% 23 Table 13: Practice Setting, 2023 Practice Setting Academic Setting Group Practice-as Employee Hospital-Inpatient Hospital-Ambulatory Care Group Practice-as Owner/Partner Other Hospital-Emergency Room Freestanding Health Center/Clinic Solo Practice Military Partnership (2 Person) Insurance Nursing home Total Frequency 275 162 146 41 36 32 28 15 12 9 5 1 1 763 Percent 36.0% 21.2% 19.1% 5.4% 4.7% 4.2% 3.7% 2.0% 1.6% 1.2% 0.7% 0.1% 0.1% 100.0% 24 Table 14: Expect to be at Principal Practice for 4 or More Years by Program, 2023 Program Name AdventHealth Redmond (Rome) Archbold Medical Center Atrium Health Floyd (Rome) Atrium Health Navicent (Macon) AU/UGA Medical Partnership-St. Mary's Healthcare (Athens) Emory University School of Medicine (Atlanta) Gateway Behavioral Health Community Service Board HCA Healthcare/Mercer University School of Medicine Houston Healthcare System (Warner Robins) Medical College of Georgia (Augusta) MCG @ AU-Memorial Satilla Health Waycross Morehouse School of Medicine (Atlanta) Northeast Georgia Medical Center (Gainesville) Northside Hospital Gwinnett (Lawrenceville) Phoebe Putney Memorial Hospital Piedmont Athens Regional Medical Center (Athens) Piedmont Columbus Regional Midtown (Columbus) Piedmont Macon Medical Center (Macon) South Georgia Medical Education and Research Consortium WellStar Health System Total Expect to be at Principal Practice for 4 or More Years Yes No Total Frequency Percent Frequency Percent 5 0.9% 5 2.0% 10 1 0.2% 0 0.0% 1 5 0.9% 1 0.4% 6 20 3.6% 8 3.3% 28 6 1.1% 2 0.8% 8 267 48.1% 116 47.3% 383 4 0.7% 2 0.8% 6 22 4.0% 6 2.4% 28 3 0.5% 1 0.4% 4 80 14.4% 30 12.2% 110 1 0.2% 0 0.0% 1 34 6.1% 17 6.9% 51 26 4.7% 9 3.7% 35 11 2.0% 8 3.3% 19 1 0.2% 1 0.4% 2 7 1.3% 6 2.4% 13 6 1.1% 4 1.6% 10 16 2.9% 11 4.5% 27 4 0.7% 0 0.0% 4 36 6.5% 18 7.3% 54 555 100.0% 245 100.0% 800 25 Table 15: Practice Location, 2023 Location of Primary Activity After Graduation Year Other State Georgia Outside of US Total Frequency 416 376 8 800 Percent 52.0% 47.0% 1.0% 100.0% Figure 17: Percent Staying in Georgia after Graduation, 2019-2023 60.0% Percent Staying in Georgia After Graduation, 2019-2023 50.0% 40.0% 44.2% 44.9% 49.9% 47.0% 30.0% 26.4% 20.0% 10.0% 0.0% 2019 2020 2021 2022 2023 26 Table 16: Practice Area, 2023 Practice Area Inner City Suburban Other Area within Major City Small City (City Population Less than 50,000) Rural (County Population Less than 50,000) Total Frequency Percent 235 29.4% 226 28.3% 209 26.1% 81 10.1% 49 6.1% 800 100.0% Figure 18: Percent Planning Rural Practice, 2019-2023 8.0% 7.0% 6.0% 5.0% 4.0% 3.0% 2.0% 1.0% 0.0% Percent Planning Rural Practice, 2019-2023 6.2% 7.1% 6.8% 6.1% 4.5% 2019 2020 2021 2022 2023 27 Job Search Table 17: Actively Job Searched, 2023 Actively Job Searched No Yes Total Frequency 202 598 800 Table 18: Job Offers and Acceptance, 2023 Percent 25.3% 74.8% 100.0% Been Offered a Job Yes and accepted Not been offered Yes and declined Total Frequency 628 125 47 800 Table 19: Job Search Approaches, 2023 Percent 78.5% 15.6% 5.9% 100.0% 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 33.3% 18.5% 14.5% 12.6% 7.9% 28 Table 20: Difficulty Finding a Job Rating, 2023 Difficulty Finding a Job Rating Neutral Somewhat easy Very easy Somewhat difficult Very difficult Total Frequency 292 206 151 125 26 800 Table 21: Specific Difficulties in Finding a Job, 2023 Percent 36.5% 25.8% 18.9% 15.6% 3.3% 100.0% Difficulty in Finding a Job Other reason Not a favorable work/life balance Would not be satisfied with the job Lack of mentoring opportunities Did not have passion for the practice Practice did not communicate well Not enough challenge Practice was not collaborative Practice did not advocate for patients Frequency 408 207 151 59 57 57 31 24 7 Percent 51.0% 25.9% 18.9% 7.4% 7.1% 7.1% 3.9% 0.3% 0.9% Note: respondents could choose multiple options. The percentage shown is the percentage of respondents selecting that option. 29 Other Reasons for Difficulty in Finding a Job, 2023 In addition to the above answer options, respondents could give an open-ended answer choice. Their responses fell under the following categories: Location: these include wanting a desirable location or proximity to a city. Visa and Contractual Obligations: these include answers such as needing to find a job in a HPSA (Health Professional Shortage Area), positions that sponsor visas, and military obligations. Position-Related Factors: these include employers being hesitant to hire new residency graduates, tedious employment processes, a lack of open positions in their specialty, and desiring practice opportunities without midlevel practitioners. Pay-Related Issues: some respondents mentioned the pay was below national average or otherwise not adequate to meet their expectations. 30 Table 22: Ratings and Perception of Training, Educational Debt Repayment, Practice Opportunities, and Rural Practice, 2023 Question or Statement Rating Scale 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? 1 = DID NOT CONSIDER 5 = STRONGLY CONSIDERED 1 = VERY UNLIKELY 5 = VERY LIKELY 1 = VERY DISSATISFIED 5 = VERY SATISFIED Number of Responses 800 800 800 What is the likelihood you will return to Georgia to practice when your training is complete 1 = VERY UNLIKELY 5 = VERY LIKELY 800 What is your overall assessment of practice opportunities in your specialty within 50 miles of 800 the site where you trained? 1 = VERY FEW JOBS 5 = MANY JOBS What is your overall assessment of practice opportunities in your specialty nationally? 800 Overall, I am satisfied with the training I received. 800 1 = STRONGLY DISAGREE 5 = STRONGLY AGREE I would choose to train at the same site again. 800 Average 2.3 2.9 3.7 3.3 3.2 3.8 4.3 4.1 31 Table 23: Reason for Leaving Georgia, 2023 Reason for Leaving Georgia Frequency Percentage Proximity to Family 200 Fellowship or Additional Medical Training 174 Better Jobs in Desired Location Outside Georgia 124 Better Salary Offered Outside Georgia 107 Better Jobs in Desired Practice Setting Outside Georgia 100 Better Job for Spouse/Partner Outside Georgia 76 Other Reason 73 Never Intended to Practice in Georgia 61 Overall Lack of Jobs/Practice Opportunities in Georgia 33 Better Jobs Outside Georgia that Meet Visa Requirements 24 Other Service Obligation 22 Cost of Starting a Practice 5 Cost of Malpractice Insurance in Georgia 1 25.0% 21.8% 15.5% 13.4% 12.5% 9.5% 9.1% 7.6% 4.1% 3.0% 2.8% 0.6% 0.1% Note: Respondents could select multiple reasons for leaving Georgia. The percentage shown is the percentage of respondents selecting that option. 32 Other Reasons for Leaving Georgia, 2023 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: Fellowship-related: Respondents mentioned leaving for additional training in a fellowship and needing more control over the fellowship matching process. Family: Respondents reiterated that they were leaving Georgia for family reasons or to accommodate a spouse's job or medical training. Political and policy related: Respondents mentioned the political climate (especially surrounding abortion and gun control) and policies such as Medicaid expansion and income tax burden. Service and Visa Considerations: Respondents mentioned military service and visa requirements for themselves and their spouses. Returning to Georgia: A few respondents clarified that they intend to return to Georgia after completing all their training. Job-Related Considerations: A few respondents mentioned leaving Georgia to find better jobs. Environmental Considerations: Some respondents mentioned the weather, traffic, urbanity, and proximity to natural features like mountains. 33 Map 1: Location of Primary Activity After Current Year of Training, 2023 34 Acknowledgments This report was produced under the direction of Chet Bhasin, FACHE, Executive Director; Leanna Greenwood, MA, Data Team Supervisor; Augustine Agbontaen, MSIT, Data Analyst; and G.E. Alan Dever, MD PhD, 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 Chairman James Barber, MD Vice Chairman William Kemp Secretary/Treasurer Lily Henson, MD Garrett Bennett, MD Scott Bohlke, MD Kitty Carter-Walker, MD Carolyn Clevenger, DNP William Fricks, MD Steven Gautney, MSHA Michael Groover, DMD Indran Indrakrishnan, MD Terri McFadden, MD Amy Reeves, PA-C James Smith Jr, MD Joseph Walker, MD 35