Physician Shortage Area Program
1015 Walnut Street, Suite 401
Philadelphia, PA 19107
The Physician Shortage Area Program (PSAP) is an admissions and educational program designed to increase the supply and retention of physicians in rural areas and small towns, with a focus on Primary Care doctors for Pennsylvania and Delaware. The Program recruits, trains and supports medical students who have grown up or spent a substantial part of their lives in a rural area or small town in the United States and intend to practice in a similar area after residency training. Primary care disciplines continue to be the areas of greatest need, but those contemplating other specialties will also be considered for the PSAP.
For more than 100 years, the shortage of physicians in rural areas of the United States has been a major health policy problem. Approximately one-fifth (20%) of the nation’s population lives in a rural area, but only about 10 percent of the nation’s physicians are located there. This is considered to be one reason rural Americans have higher rates of death, disability and chronic disease than their urban counterparts.
PSAP has been highly successful in increasing the number of rural family physicians. Since the Program began in 1974, we have trained more than 300 PSAP physicians. The outcomes, published in the New England Journal of Medicine and the Journal of the American Medical Association, have shown that PSAP graduates:
- Are more than eight times as likely as their peers to become rural family physicians
- Have a retention rate of 79% after 11-16 years in practice
- Account for 21% of family physicians practicing in rural Pennsylvania who graduated from one of the state's seven medical schools, even though they represent only 1% of graduates from those schools
Rural Physician Shortages in Pennsylvania & Delaware
The rural physician workforce shortage is a particularly serious problem in the states of Pennsylvania and Delaware, where more than 20% of people live in rural areas.
Pennsylvania has the third largest rural population of any state. In addition, Pennsylvania’s physicians are poorly distributed across the state. Almost one-half of the doctors practice in 3 counties (Philadelphia, Montgomery, and Allegheny near Pittsburgh), while almost three quarters (75%) of the population live in the other 64 counties. Fifty-five of Pennsylvania’s 67 counties contain federally designated Health Profession Shortage Areas (HPSAs) or Medically Underserved Areas (MUAs).
The state of Delaware also has a critical shortage of physicians, with two of its three counties (Sussex and Kent Counties in southern Delaware) designated as rural HPSAs.
There is reason for hope. While the shortage of rural physicians is not likely to be totally resolved in the near future, the emergence of health system networks in Pennsylvania and Delaware means better professional and financial support for those committing to practice in rural locations.
The Physician Shortage Area Program (PSAP) provides for up to 24 places in Sidney Kimmel Medical College’s (SKMC’s) first-year class. Priority is given to applicants enrolled in one of the seven colleges & universities that are members of the PSAP Cooperative:
- Allegheny College
- Bucknell University
- Franklin & Marshall College
- Indiana University of Pennsylvania
- Pennsylvania State University
- University of Delaware
- University of Scranton
Students from other schools are also welcome to apply.
To summarize, successful applicants to the PSAP:
- Have grown up in a rural or small town.
- Are interested in returning to a similar community to practice after they finish their medical training.
- Are otherwise competitive candidates for medical school. Special consideration is given to residents of Pennsylvania and Delaware and to graduates of the seven PSAP Cooperative undergraduate schools. Applicants from other states and other undergraduate schools are also encouraged to apply.
All incoming PSAP students are provided with an advisor in the Department of Family & Community Medicine at the beginning of medical school. These advisors provide curricular and career guidance, and are available as mentors throughout all four years.
PSAP students also get a “Big Sib", a second year medical student from the PSAP, to help orient them to medical school life and to guide them through the Program.
Rural Area Medicine Experience
PSAP students are required to take at least one of their required Phase 2 clinical clerkships in a smaller community. Current sites include Excela Latrobe Hospital (for Family Medicine) and Wellspan York Hospital (for Family Medicine, Internal Medicine, General Surgery or Obstetrics/Gynecology). PSAP is also piloting a longitudinal curriculum for the six Phase 2 clinical rotations in affiliation with Atlantic Health System. This option features sites in rural and suburban communities in New Jersey.
Students are also encouraged to take at least one of their Phase 3 clinical rotations in a rural/small town setting. PSAP students are given schedule priority for outpatient clinical rotations with family physicians in smaller community settings. Many of these doctors are graduates of PSAP, SKMC or its residency programs and enjoy having students in their practices.
Frequently Asked Questions
Applicants who have grown up or spent a substantial part of their lives in a rural area or small town in the United States and intend to practice in a similar area after residency training. Primary care disciplines continue to be the areas of greatest need and are highest priority for the Physician Shortage Area Program (PSAP).
Family Medicine, General Internal Medicine and General Pediatrics are the three major primary care disciplines. Doctors trained in these specialties practice in in the context of caring relationships with their patients over time. Within many communities, they are the first point of contact for those seeking care for their health. Primary care is focused on the whole person, whereas procedural specialist care is centered on particular diseases or organ systems of the body.
Family Medicine continues to be one of the more popular medical specialties, with almost 10% of national medical school graduates entering the field. Family physicians treat patients of all ages and are skilled at handling most medical problems. General internists also treat a broad variety of conditions and focus on the longitudinal care of adults. Most internists do not see children. Pediatricians care for children from newborn to young adulthood. Women’s health care is shared among all three disciplines, with approaches specific to the age-related needs of those they serve. Many Family Medicine training programs also provide specific training in obstetrical care, especially for those who plan to practice in rural areas.
Many rural communities also have a shortage of other physicians, especially obstetrics and gynecology, general surgery, and emergency medicine. As a result, applicants planning any specialty, or who are unsure of their future specialty, will also be considered for the PSAP.
Students entering the Physician Shortage Area Program at Sidney Kimmel Medical College are required to participate fully in the Program’s curriculum during medical school. Components of the Program include:
- Meeting periodically with your faculty advisor from the Department of Family & Community Medicine for curricular and career guidance.
- Mentoring sessions with a “big sib” second year PSAP medical student.
- Faculty mentorship and introduction to other mentors within Sidney Kimmel Medical College or in one of the other Colleges of Thomas Jefferson University, depending on your academic, clinical, and community interests.
- A required Phase 2 clinical clerkship at one of the PSAP affiliated community sites located outside of the Philadelphia metropolitan area.
- Opportunities for a Phase 3 (4th year) rotation or elective in a rural or small-town location (can include an Indian Health Service site or rural health center/FQHC).
- For those pursuing Family Medicine, a Phase 3 sub-internship rotation at a site with an approved Family Medicine residency program is strongly encouraged.
- Students get to choose specialty and location for residency training after medical school.
- After graduation, students are expected to practice in a rural area or small town, preferably within Pennsylvania or Delaware, for their professional career.
Applicants to the PSAP must first apply to Sidney Kimmel Medical College of Thomas Jefferson University through AMCAS. Once the AMCAS application has been received and verified by SKMC’s Office of Admissions, a Secondary Application is sent to the student. Candidates interested in the PSAP should check “Physician Shortage Area Program (PSAP)” on the Secondary Application, complete the application online and submit the required three (3) additional letters of recommendation by November 15.
You can view the PSAP Secondary Application. It includes a list of Pennsylvania and Delaware counties that are defined as rural/small town underserved. Students from other rural/small town areas of Pennsylvania, Delaware or other states are also invited to apply to the Program.