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Hawai?i Med School Grads are Staying, But is it Enough to Solve Doctor Shortage?

University of Hawaii John A. Burns School of Medicine

There is a national physician shortage…and Hawai‘i is not immune. According to the Association of American Medical Colleges, the United States could be short more than 100,000 doctors by 2030. But Hawai‘i may have a solution. HPR’s Ku’uwehi Hiraishi has this story.

Hawai’i’s high cost of living and low salaries compared to the rest of the country make it difficult for doctors to see Hawai’i as an option. Despite the odds, there is one group choosing Hawai’i. Dr. Kelley Withy directs the Hawaii Pacific Basin Area Health Education Center.

Credit University of Hawaii John A. Burns School of Medicine
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University of Hawaii John A. Burns School of Medicine
2017 University of Hawai'i at Manoa Commencement. There is an 85 percent chance they will stay to practice here in Hawai'i.

“We are the number one state at retaining our graduates,” says Dr. Withy, “If they go to both medical school and residency here - so that’s the three to five years after medical school that you have to continue training - we keep 85 percent of those students. So we’re better than anywhere else at keeping them.”

But there aren’t enough training opportunities in medical school or in residency.  

“We would have to probably double to triple the size of all the training programs,” says Dr. Withy, “And the first thing we would have to do to be able to do that is to get more teachers, so basically doctors in the community who are willing to teach.”

Credit University of Hawaii John A. Burns School of Medicine
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University of Hawaii John A. Burns School of Medicine
Hawai'i medical students receive training at John A. Burns School of Medicine (JABSOM). Training opportunities beyond medical school are limited, especially on O'ahu. To solve Hawai'i's doctor shortage, seeking training opportunities on neighbor islands are key.

Dr. Withy says O’ahu has reached its capacity but opportunity is ripe on the neighbor islands.

“We’re going to try and match up teachers with the students,” says Dr. Withy, “And at the same time we’re going to try to find families to host the students while they’re there. And we’re going to try to get airfare discounts and car shipping discounts, so that we can help all these students afford it.”

Making it easier for doctors to practice in Hawai’i is at the core of solving the state’s doctor shortage. The latest physician workforce assessment found the state is short 418 doctors. This doesn’t include specialty-specific needs by island, which could mean an extra 200 doctors. So how do we solve it?

“There’s no silver bullet here,” says Dr. Withy, “I like to say we need the buckshot approach.”

Credit University of Hawaii John A. Burns School of Medicine
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University of Hawaii John A. Burns School of Medicine

Dr. Withy’s office coordinates much of the state’s efforts to reduce the doctor shortage - offering mentorships, student loan repayment, continuing education, and more. But she says it’s not enough.

“It would be great if we could provide some tax relief for doctors and health professionals who set up their own practice. It would be nice if tax relief for people who are willing to teach. It would be nice if we had some free housing for new doctors. But I don’t see that happening when we barely have enough housing as it is,” says Dr. Withy, “So there’s a lot of things that could happen but there’s no one thing that’s going to solve the problem.”

Kuʻuwehi Hiraishi is a general assignment reporter at Hawaiʻi Public Radio. Her commitment to her Native Hawaiian community and her fluency in ʻōlelo Hawaiʻi has led her to build a de facto ʻōiwi beat at the news station. Send your story ideas to her at khiraishi@hawaiipublicradio.org.
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