Graduate medical education at MUSC: The best of both worlds

South Carolina leads the nation in exporting tires and completed passenger motor vehicles. Great news for our economy. 

‌Unfortunately, South Carolina is also an exporter of new physicians – not so great news for healthcare in our state, especially when, nationally, we’re in the bottom quartile of critical physician workforce needs in rural areas. Think primary care, family practice, OB-GYN, and general surgery. 

‌It’s even worse when you understand that, nationally, primary care doctors are becoming an endangered species. The American Association of Medical Colleges projects a national physician shortfall of at least 37,000 – and possibly well over 100,000 – over the next decade. That’s staggering, especially for a state like South Carolina, where 27% of residents live in rural areas and have limited access to care. 

‌Back to South Carolina: why are we exporting this rare commodity? Two basic facts: 1) To practice medicine, a physician needs to complete residency training, called Graduate Medical Education, or GME, in a particular field. 2) The State of South Carolina does not have enough available GME slots, however, for the number of physicians who graduate every year.  

‌So, paradoxically, we are losing what we need the most: high-quality physicians. And it’s not just a numbers game. Like real estate, think location, location, location. We need high-quality physicians who are trained in the critical need fields and are able and willing to practice where they’re needed: in the rural and underserved areas of South Carolina. ‌

‌Although MUSC currently trains almost 900 physicians in every specialty through our 81 GME programs and provides greater than 50% of GME education for the state, clearly it is not enough. 

‌The good news is that, through our Regional Health Network (RHN), we have a sustainable presence where the need is highest, and we can develop new residency programs that are eligible for funding from CMS and the state Medicaid program once they get underway, which assures sustainability. 

‌It's time, with partners, to create a pipeline for critical need physicians across South Carolina. The socioeconomic benefits will be transformative. Every doctor brings about $2 million in economic growth to a community. New jobs and new services follow. ‌

‌All of this is to help you to understand why I am so excited about our new GME program at MUSC Health Florence Medical Center. Eight internal medicine residents will start in July. When the program is fully mature, that number will grow to 30 residents. ‌

‌It is the first part of an ambitious plan to establish critical need GME programs at MUSC Health hospitals throughout our Regional Health Network. When medical students have opportunities to stay in state for their residencies, they’re likely to settle and practice near these hospitals where they trained. 

‌Our goal is to “grow our own:” train doctors who will remain in South Carolina. The process is painstaking, involving multiple steps and approvals, building infrastructure, hiring program directors, engaging medical staff, and developing curricula. But I’m proud to say that under the MUSC Regional Health Network, Florence earned accreditation from the American Council on Graduate Medical Education with ZERO citations. Wow! 

‌Our plan is strategic and comprehensive. We’re moving fast, but methodically, matching community needs with accreditation requirements. Next up is MUSC Health Lancaster Medical Center, where we’re working to establish our second general internal medicine program in 2025. Beyond that, we’ll look to MUSC Kershaw and the Midlands’ GME growth. 

‌None of this is happening in a vacuum. This effort wouldn’t be possible without our community and philanthropic partners – the Pee Dee Medical and Health Sciences Education Consortium, Hope Health, the VA, and non-profits such as the Darla Moore Foundation and The Duke Endowment. 

‌We’re bringing the entire MUSC educational knowledge, expertise and infrastructure – our simulation center, library, our research capability and telehealth to bear on this undertaking. A big thank you to our chief integration officer, Tsveti Markova, M.D., and the entire MUSC GME team. 

‌Do we have the right stuff to achieve our goals? You bet. The combination of an academic medical center and a community hospital clinical environment makes this and future programs unique and the best of both worlds for resident training. And when we succeed, we can proudly say we’re NOT an exporter of physicians and make more room for BMW.