Leaders at hospital providers nationwide tell me the same thing: “We can’t find enough physicians.” But here’s what the data actually shows—the issue isn’t just quantity, it’s location.

Data from our proprietary Covista Care Capacity Monitor—fielded by Gallup and surveying over 1,300 clinicians and 160 healthcare executives across all 50 states— confirms what healthcare leaders experience daily: physician shortages have become a measurable care quality crisis, with geography and community access playing an outsized role.

The Geographic and Socioeconomic Reality

85% of healthcare executives outside large metro areas say a shortage of talent in their geographic area is a major barrier to hiring, compared to just 45% in large metros. Within those metros, underserved urban communities face physician shortages just as severe, with safety-net hospitals and community clinics reporting the same physician recruitment challenges.

The hardest roles to fill? Family medicine (62%) and internal medicine (56%)—precisely the specialties rural communities and underserved urban neighborhoods alike need most. Whether practicing in a rural clinic or an urban safety-net hospital, physicians face similar capacity pressures—with clinicians in underserved areas consistently reporting that staffing shortages significantly impact care quality.

From my perspective overseeing medical education within America’s largest healthcare educator—graduating 790 MDs in 2023-2024 and 24,000 healthcare professionals across all disciplines—the data reveals why traditional recruitment strategies aren’t working: we’re trying to solve geographic problems with solutions that ignore where care gaps actually exist.

Why Recruitment Can’t Solve Geographic and Community Access Gaps

The conventional approach assumes the solution is recruiting harder. But recruitment can’t solve a problem that starts with capacity. U.S. medical schools have limited seats, turning away qualified students who are committed to becoming physicians and serving the communities that need them most. Broadening pathways to medical education creates access for these students. But that’s only part of the solution.

Even with an expanded medical school pipeline and the ability to graduate more practice-ready physicians, where they complete residency training largely determines where they practice. When residency placements concentrate in urban academic centers, physicians don’t end up in the underserved areas that need them most.

This structural mismatch explains why 68% of executives nationwide cite shortage of available talent in their geographic area as a major barrier. Whether they lead rural hospitals or urban safety-net systems.

Geographic and Community-Based Solutions for Systemic Problems

The answer isn’t to recruit harder. It’s to rethink how residency and clinical pathways connect to community needs—whether that community is a rural town or an urban neighborhood that’s been systematically underserved.

Here’s what we know from preparing physicians at scale: where they complete residency, training largely determines where they practice. Exposing students early to underserved communities through clinical rotations shapes where they pursue residencies. We provide clinical rotations in underserved areas, including hospitals like Sinai Chicago and Jamaica Hospital Medical Center, preparing graduates to serve patients where the need is great. The impact is measurable: more than 450 Covista students and graduates matched into primary care residencies, with over 55% training in primary care health professional shortage areas. We’ve created infrastructure connecting medical education to the communities facing the greatest physician shortages.

To further this momentum, healthcare systems must articulate what “practice-ready” means for their specific environment. Physicians prepared for rural practice need different clinical experiences than those bound for suburban academic centers. The same is true for physicians serving underserved urban communities, where clinical and social complexity requires specific preparation. The more precisely healthcare systems define these requirements, the more effectively education partners can build pathways that deliver.

The Strategic Shift Required

The Care Capacity Monitor reveals that 87% of executives are prioritizing adequate staffing for 2026. But the data also shows that it’s time to recalibrate strategies and solutions.

For healthcare executives, this means treating workforce development as infrastructure requiring long-term partnerships with education institutions—not as a recruiting problem to solve quarterly. It means articulating specific needs by specialty and location years ahead and building the pathways that connect medical education to your community’s residency programs. For a rural health system, urban safety-net hospital, or community health center, this could mean partnering with an education institution to create dedicated residency slots in their community, with commitments made three to five years in advance.

The physician shortage isn’t just a supply problem. It’s a geographic and access mismatch between where healthcare systems need physicians and where traditional training pathways concentrate them. Solving it requires education partners who can build pathways connecting medical graduates to the residency programs and clinical experiences all communities need—whether rural or underserved urban—and have the scale and commitment to create that alignment at the volume required.

Scott Liles serves as President of Medical and Veterinary at Covista, America’s largest healthcare educator. Covista graduated 790 MDs in 2023-2024—more than any U.S. medical school—and 24,000 healthcare professionals annually across all clinical disciplines.

The Covista Care Capacity Monitor combines survey data from 1,347 clinicians and 167 healthcare executives with labor market analysis from U.S. Census, Bureau of Labor Statistics, Lightcast and IPEDS. Explore the platform at covista.com/research.

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