SUNY University at Albany reports that 53% of newly trained doctors in New York state institutions planned on setting up shop here, up from 45% in 2015
By Aaron Gifford
Physician Michael Holcomb’s career training involved multiple stops on the New York State Thruway.
The Fulton native earned an undergraduate degree at the University of Rochester before attending medical school at SUNY Upstate Medical University and completing his residency at Albany Family Medicine in the Capital District.
He recently returned home to Oswego County and now works as a family physician at ConnextCare in Central Square.
He’s overjoyed to serve his community and with an affinity for kayaking, hiking, snowboarding and following the Buffalo Bills, he couldn’t imagine settling anywhere else.
“I always wanted to go to Upstate University and love what New York state has to offer in terms of outdoor recreation,” Holcomb said.
Holcomb is among the growing number of physicians who chose to remain in the Empire State after finishing medical school or residencies here.
The Center for Health Workforce Studies at SUNY University at Albany recently reported that 53% of newly trained doctors in New York state institutions planned on setting up shop here, up from 45% in 2015.
“A rising in-state retention rate suggests that more physicians see long-term opportunity in New York’s healthcare system,” said David Armstrong, Center for Health Workforce Studies project director. “This is encouraging news for a state that invests heavily in graduate medical education and depends on a robust physician workforce to meet population health needs.”
The research report is based on a 2024 survey of 2,300 medical residents and fellows across the state. It also noted that 76% of physicians who attended both high school and medical school in New York state chose to practice here.
By specialty, adult psychiatry had the highest state retention rate at 77%, followed by physical medicine and rehabilitation at 75% and family medicine at 74%.
By contrast, the lowest New York state retention rate by specialty was orthopedics (17%) and pulmonary disease (28%), the report notes. Thirty-two percent of residents who chose to move out of New York cited family as the primary reason for leaving this state after their training.
Physician David DiStefano is proof that the Central New York region has what it takes to attract more newly trained orthopedic surgeons as well. The DeWitt native recently began work as a shoulder and elbow surgeon at Syracuse Orthopedic Specialists in his hometown. He did his undergraduate work at St. Lawrence University before attending SUNY Upstate, doing his residency at Strong Hospital in Rochester and completing a fellowship in Colorado.
Like Holcomb, DiStefano could have worked at a practice almost anywhere in the country but chose to return home because of its low cost of living and proximity to outdoor recreation. He’s a fan of hiking and fishing.
“I love Upstate New York,” DiStefano said. “It’s also a great place to raise a family.”
Both Holcomb and DiStefano looked fondly on brief hospital stays when they were young. DiStefano’s father was also an orthopedic surgeon, though he said he considered various specialty areas during his rotations. Holcomb said his high school job in a pharmacy sparked his interest in medicine.
The Center for Health Workforce Studies report identified the specialty areas that are most in demand in New York state: anesthesiology, hematology-oncology, gastroenterology, child and adolescent psychiatry, and endocrinology.
The list of specialties that are in less demand included general surgery, emergency medicine and pathology.
“While it’s encouraging to see more physicians staying in New York, we must recognize that nearly half still leave the state to practice elsewhere,” Armstrong said. “There’s more work to be done in New York as well as in other states in order to address physician shortages. It’s important to monitor residency outcomes to develop informed strategies for the physician workforce, especially for specialties where demand is strongest and distribute them to the areas where they are needed most.”
Only 4% of those surveyed indicated an interest in working in remote or underserved areas. Holcomb is in that minority. He said he was always well aware of Oswego County’s opioid abuse crisis and rural poverty struggles and aspired to help local folks who need it most.
“Controlling costs and making medical services accessible are the main reasons I went into primary care,” Holcomb said. “Keeping people healthy” is part of the solution. “We have to keep them out of the hospital and avoid those big bills.”
DiStefano, who treated football players at the University of Colorado in addition to members of Denver’s professional soccer, hockey, basketball and baseball teams during his residency, said he enjoys the mix of young and old patients here, from high school and college athletes with sports-related injuries to senior citizens who need elbow and shoulder replacements after years of use.
“I love the whole spectrum,” he said. “It’s a cool feeling to treat people in my hometown.”
There’s a strong demand for physicians in plenty of other areas of this state, should this trend continue. In a separate report, the Center for Health Workforce Studies identified 15 geographic shortage designations, spanning from Buffalo to the Hudson Valley, to the Southern Tier, to New York City.
By county and specialty area, Madison County is most in need of dentists right now, while Cayuga County can use more primary care providers. Both Oswego and Onondaga counties have a shortage of primary care physicians, mental health professionals and dentists, the report noted.
The American Medical Association reports that there’s a major shortage of trained doctors nationally, especially in rural areas. Decreasing reimbursement rates and subsequently early retirements are to blame.
In New York state, 16 rural counties average only .5 pediatricians for every 10,000 people; three of those counties don’t have even one pediatrician. The OB-GYN physician ratio for those counties is even worse, at .4 per 10,000 residents, with four counties lacking that type of specialist, according to the state Comptroller’s Office.
The U.S. Bureau of Health Workforce’s most current projections report says the number of physicians in this country is expected to increase from 936,530 in 2027 to 949,360 in 2037. Still, the projected demand figures indicate that about 1 million physicians are currently needed, increasing to 1.1 million in the decade ahead.
The GME Advocacy Coalition, a group of physicians, patient organizations and hospitals that lobbies for more federal support in training new doctors, said applications to medical schools have increased over the past five years, but are still far below the rate of an aging American population that increasingly needs more care.
By 2034, the number of U.S. residents older than 65 will increase by 42%. Physician shortages are expected across most specialty areas as well as primary care.
Heart disease accounts for about a quarter of deaths among adults past retirement age and about one-third of those older than 85. The number of Alzheimer’s patients, meanwhile, is expected to triple by 2050 and the probability of developing cancer is 10 times higher for men older than 70 than it is for younger men and five times higher for women by the same comparisons, GME reported.
“Regular access to primary care can help manage certain conditions and delay the onset of some diseases, but many adults will have conditions that become more serious despite the best care,” the report said.
“For these patients, access to cardiologists, cardiothoracic surgeons, oncologists and other specialists will be essential. Shortages in both primary care and specialties must be addressed to ensure patients have access to the full spectrum of care they need.”
