By John B. Waits, MD, FAAFP

John B. Waits, M.D.

The U.S. faces a severe doctor shortage. In fact, by 2025, we will need more than 52,000 new primary care doctors to meet the growing demand for health care services across the country. By 2025, Alabama will need almost 500 primary care physicians to meet the state’s health care needs, due both to aging and retiring physicians and population growth. Projections through 2030 raise that number to over 600 primary care physicians. Despite this glaring need, one of the most effective pipelines for producing primary care physicians- the Teaching Health Center Graduate Medical Education Program—could end on May 22, 2020, unless Congress votes to extend the program. As described below, support from Senators Richard Shelby and Doug Jones and Representative Gary Palmer is essential to ensure that we keep this program alive for the medical residents and patients who benefit.

The Cahaba-UAB Family Medicine Residency Teaching Health Center in Centreville (Rural Residency) and West End (Birmingham; Urban Underserved Residency), Alabama is one of only 56 teaching health centers in the nation, located in 27 states and the District of Columbia.

Our mission is to train the next generation of primary care providers to provide excellent comprehensive care in underserved rural and urban communities throughout Alabama and the United States. Since 2013, we have been producing primary care physicians that continue to work in underserved communities throughout their careers. By moving primary care training into the community, we are on the leading edge of innovative educational programming dedicated to meeting not only patient needs but also future health care workforce needs. 

According to research, 8 out of 10 teaching health center graduates say they intend to work in primary care, and more than half want to work in underserved communities compared to only 23% of traditional Graduate Medical Education graduates.

Cahaba Medical Center Resident Graduates

Since Cahaba-UAB Family Medicine Residency began training residents in 2013, 47% have stayed in Alabama and 79% have graduated and accepted primary care positions in underserved communities throughout the country.

Given that it takes approximately 3-4 years to recruit a medical student to this 3-year training, and that we’ve only had 4 graduating classes (2016-2019), this is a significant “return on investment” for the state of Alabama, from this bipartisan national program. 

Residents in training – licensed MDs or DOs who are “apprenticed” to Board-certified physicians see, themselves, over 1 million patients across the country annually. However, because these  positions are training positions, residents cannot bill for the patient care services they provide,

and thus, funding is needed to pay for residents’ salaries and benefits. These residency positions are also highly competitive and receive roughly 100 applications for every position; meaning thousands of prepared and engaged possible primary care physicians are turned away. With the looming primary care shortage on the horizon, investments in Teaching Health Centers Graduate Medical Education training will be critical to meet the needs of the evolving health care delivery system.

There is legislation pending in Congress to extend the Teaching Health Centers Graduate

Medical Education program for five years. Please let Senators Richard Shelby and Doug

Jones and Representative Gary Palmer know that you support this legislation and that you

want them to work with Congressional leadership to finish work on this bill in the next few


By John B. Waits, MD, FAAFP