Teaching Health Center Graduate Medical Education (THCGME): Expanding the Primary Care Workforce

The Teaching Health Center Graduate Medical Education (THCGME) Program helps communities grow their health workforce by training physicians and dentists in community-based settings with a focus on rural and underserved communities.

This unique training model changes the physician training paradigm by providing the majority of training in community-based outpatient settings where most people receive their health care.

The program aims to:

• Increase physicians and dentists trained in community-based settings
• Improve health outcomes for members of underserved communities
• Expand health care access in underserved and rural areas

How is our program different?

While most residency programs base their training in hospitals, our programs train residents in outpatient settings in the community, such as community health centers.

Teaching health centers receive a payment for each resident they train to cover the training costs, including the resident’s salary and benefits.

Where do we serve?

Most teaching health centers are in community health centers, rural health clinics, and tribal health centers. These sites are embedded in the communities they serve, providing primary care, dental, and behavioral health services in areas of the country that often lack access to quality care.

In Academic Year 2023-2024, the program is funding the training of over 1,096 residents in 81 community-based residency programs. For details, see:

• 2023-2024 Teaching Health Center Graduate Medical Education Awardees
• 2022-2023 Teaching Health Center Graduate Medical Education Awardees

Why do we need THCGME?

HRSA’s National Center for Health Workforce Analysis estimates a projected shortage of 35,260 primary care physicians—including family medicine, general internal medicine, geriatrics, and pediatrics—by 2035. These shortages are projected to be particularly acute in rural areas. The THCGME program is one of the only federal programs to increase the number of physician trainees in the past 25 years.

Last year, THCGME residents treated over 792,000 patients during more than 1.2 million patient encounters, significantly enhancing access to care in primary care in underserved areas. Those annual numbers continue to grow as programs mature and expand.

How do we help communities establish THCGME residency programs?

The Teaching Health Center Planning and Development (THCPD) Program grants support the work of building a program, developing a training curriculum, recruiting clinical faculty, retooling workflow to integrate residents, and getting accredited, all of which are time-consuming and require resources and staffing.

HRSA also funds a technical assistance center that supports Planning and Development grantees to assist in teaching health center development.

How many THCGME-trained physicians and dentists have entered the workforce?

Since the THCGME program began in 2010, 2,027 new primary care physicians and dentists have completed residencies and entered the workforce. This includes:

• 1,235 new family medicine physicians
• 466 new internal medicine physicians
• 107 new pediatricians
• 21 new obstetric and gynecological physicians
• 7 new geriatricians
• 69 new psychiatrists
• 122 new advanced general dentists

Clinical training sites

THCGME program accomplishments and outcomes

THCGME awardees regularly submit data and reports about their funded programs to HRSA for analysis. The National Center for Health Workforce Analysis analyzes the data, evaluates the programs, and produces annual reports on THCGME’s outcomes and impacts.

• THCGME Accomplishments and Outcomes – Academic Year 2021-2022 (PDF - 81 KB)
• THCGME Accomplishments and Outcomes – Academic Year 2020-2021 (PDF - 151 KB)
• THCGME Accomplishments and Outcomes – Academic Year 2019-2020 (PDF - 74 KB)
• THCGME Accomplishments and Outcomes – Academic Year 2018-2019 (PDF - 157 KB)

Press releases

• HRSA Administrator Carole Johnson and U.S. Representative Cathy McMorris Rodgers Visit the Spokane Teaching Health Center to Highlight Innovative Community-Based Training Program for Primary Care Physicians (02/23/2023)
• HHS Awards Over $155 Million to Expand Training for Primary Care Residents in Underserved and Rural Communities (07/01/2022)