Across all physician specialties in the United States, there is a projected shortage of more than 187,000 full-time  equivalent (FTE) physicians by 2037 (HRSA, 2024). Montgomery, Alabama is already experiencing a significant physician and health care worker shortage, marked by too few primary care doctors and long wait times for appointments. Statewide, Alabama is short 3,000 physicians, with projections showing it will get worse in the years to come. Contributing factors include low insurance  reimbursement rates, heavy administrative burdens, and competitive recruiting from other states, leading physicians to leave the profession or relocate outside of Alabama.  

To address the crisis, the state has enacted the Alabama Physician Workforce Act, which aims to strengthen and expand the health care workforce by: 

• Easing testing requirements for out-of-state doctors
• Allowing international medical graduates to get licensed faster
• Creating bridge programs for medical graduates who don't match into residency programs 

The  legislation aims to add 2,000 residency positions every year for seven years to reach the goal of 14,000  new residency positions to train doctors. The bill designates that the slots should be distributed across hospitals, with at least 10% of them designated for rural hospitals, hospitals in states with new medical schools, hospitals that serve areas designated as health professional shortage areas, and those that are training more residents than their Medicare-funded residency slots cap allows.  

Even with these efforts, Alabama needs an additional 263 primary care doctors in 55 cities and towns to eliminate the current  primary care physician shortage in the state, according to data from the Alabama Office of Healthcare  Workforce. Retirements, an aging population, rising rates of chronic disease, and persistent challenges recruiting physicians to rural areas continue to strain the system and widen gaps in access to care.

Factors Contributing to Alabama’s Physician Shortage

• Insufficient Primary Care Physicians: Demand far exceeds supply, especially in rural areas.
• Factors Driving Physician Departure:  
  • Low insurance reimbursement rates
  • Excessive administrative work
  • High medical malpractice insurance costs
  • Early retirement or switching professions
• Aging Population: Growing need for medical care as residents age
• Increased Chronic Diseases: Rising chronic diseases and co-morbidities
• Competition from Other States: Neighboring states actively recruit Alabama physicians 

Key Impacts include long wait times, delayed care, increased physician burnout, and exacerbated health disparities in rural areas. 

NMF’s Impact in Alabama

National Medical Fellowships is committed to helping close these gaps by expanding pathways into medicine, supporting clinical research that includes all communities, and ensuring the success of medical students and practicing clinicians.

National Medical Fellowships is proud of its 295 alumni who are serving patients across the state. These dedicated  healthcare professionals are providing care across 66 of Alabama’s 122 designated Health Professional Shortage Areas (54%). In Montgomery and throughout Montgomery County, NMF alumni are providing care to local residents at more than four times the capacity (462%) the rate of non-NMF healthcare  providers who are non-NMF alumni. 

NMF looks forward to continuing its work to address the physician shortage in Alabama and across the country to ensure all patients have access to the high-quality care they deserve.

Defined simply as “the value derived from positive connections between people,” research shows that  “social capital” plays a critical role for medical and graduate students preparing for health professions, as well as for early career practitioners. Research highlights three key types of social capital to be beneficial: 

• Relational capital pertains to the relationships we have with others in our world.
• Cognitive capital is the shared knowledge, values, and understanding that shape how individuals interact with their communities.
• Structural capital includes the systems, networks, and personal branding that enable access to information, support collaboration, strengthen problem-solving, and provide essential emotional and psychological support.

All  three types enhance academic performance, well-being, and future professional success through “social networks and trust.” This support can reduce stress and improve overall satisfaction with medical school and graduate education. Additionally, strong social capital is linked to better health promotion behaviors and can help students succeed in areas such as inter-professional practice, a key skill for healthcare professionals. Yet despite its importance, many students and early career professionals lack sufficient access to social capital and the benefits it provides.