Voices: Utah’s physician shortage is reaching a breaking point

Last year, I went to Tooele to complete my clerkship year, a time during which medical students care for patients in a variety of different team and specialty settings. I gained many things from this experience, but one lesson was impossible to ignore: Utah’s growing physician shortage is reaching a breaking point.

I grew up in Morgan, where my family and I often had to travel to access healthcare, especially for the highly specialized care I required for cardiac complications. For many of the patients I saw in Tooele last year, long distances and long waits to schedule appointments also was a theme, one which dissuaded many of them from seeking care.

Issues related to healthcare access in Utah are far from new, and there have been significant efforts made to address them. For example, my rural clerkship training was made possible through a Health Resources and Services Administration (HRSA) grant aimed at addressing healthcare shortages in underserved areas.

However, the cause of the physician shortage is multifactorial and without additional steps, the problem will only continue to worsen.

A recent report found that Utah has the lowest number of primary care physicians per capita in the nation. At the same time, the state continues to be one of the fastest growing, with an 18.37% population increase since 2020 and an average annual growth of 1.69% since 2009. According to the Kem C. Gardner Policy Institute at the University of Utah, most of this growth is concentrated along the Wasatch Front.

Historically, rural areas have been hardest hit by access shortages due to unequal distribution of resources and services — a reality I witnessed firsthand during my clerkship. Now, with rapid growth in urban and suburban centers, Utah faces the added risk of physician shortages in these areas as well, compounding the state’s access challenges.

Yes, Utah finds itself facing a severe physician shortage, but there have also been important recent changes to the state’s medical training landscape. In the last decade, Utah has seen the addition of two medical school programs (Rocky Vista University and Noorda College of Osteopathic Medicine) with an additional program projected to matriculate its first class within the near future (BYU School of Medicine). Additionally, the state’s flagship university, from which I will graduate in 2027, is pioneering medical education innovations with a novel curriculum and satellite training tracks. Soon it will open the doors of its new, state-of-the-art building.

Together, these changes have resulted in a 300% increase in Utah medical school enrollees over the past 10 years.

Despite this growth, there are still significant barriers to addressing Utah’s physician shortage, chief among them being the shortage of graduate medical education (GME) training positions. GME is another term for residency and fellowship training, the crucial years of training that follow medical school and are essential to developing physicians that are competent and prepared to meet the needs of their patients and communities. As of 2023, Utah was among the bottom three states in primary care GME positions per capita. This metric is important because in the absence of adequate training opportunities, graduating medical students are forced to seek residency training out of state, where they often remain after completing their training.

What’s more, a recent U.S. Centers for Medicare and Medicaid Services (CMS) report notes that Medicaid-funded workforce initiatives, which have helped fund many of Utah’s GME positions, will be phased out without further renewal. This change will lead to further constriction of the state’s physician pipeline as we continue exporting our medical students to out-of-state opportunities — only hoping they will return to practice in Utah.

Further changes must be made to ensure a complete, Utah-oriented medical training apparatus that will retain the talent cultivated by our medical schools, resolve our precarious physician shortage and remove healthcare barriers to historically underserved areas.

On both the state and national levels, medical organizations, industry leaders and legislators are working to improve and increase medical training opportunities. As an aspiring pediatrician, engaged student and forever Utahn, I am taking part in these conversations and fighting for the future health of our state. By learning about, talking about and advocating for medical education in Utah, you can too.

Dallen Calder is a native Utahn and aspiring pediatrician interested in rural and urban underserved health care. As a lifelong patient, he has come to learn that the health of individuals and populations is the foundation for growth and fulfillment.

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