Rural Health Initiatives

Addressing the rural healthcare provider shortage to improve health across Western North Carolina.

State appropriations for the University of North Carolina have enabled UNC Health Sciences at MAHEC to expand health sciences education and training in Western North Carolina to address the region's unique rural health needs.

These state-funded initiatives include the development of new residency programs in general surgery and psychiatry; rural medicine fellowships; expansion of existing family medicine residency programs and medical student training; establishment of a new WNC-based master of public health program; increased rural training for learners from high school through post-graduate internships; a state-of-the-art medical simulation center; and an academic health center focused on rural population health research.

Why this focus and why now?

There is a substantial need for more healthcare providers in WNC.

  • All 16 WNC counties are primary care health professional shortage areas (HPSAs).  
  • There is an estimated shortage of 85 primary care providers and general surgeons across WNC. 
  • An estimated 20% of adults in WNC have a behavioral health diagnosis, and our suicide rate is significantly higher than national benchmarks. 
  • Opioid-related injuries and deaths in our region are among the highest in the state and nation.

Access to effective healthcare, a healthy workforce, and lower overall healthcare costs are key factors to promote regional growth.

This is not only a WNC problem, but a statewide and a national problem:

  • The number of physican specialists has grown by 90% since 1975, while the number of primary care physicians has grown at a much slower rate.
  • The number of psychiatrists has only grown by 7.5%, and the majority of WNC counties have no practicing psychiatrist.
  • Only 10% of graduating surgery residents are practicing as general surgeons - the only type of surgeon needed in rural areas. 

So why not just train more surgeons, psychiatrists and family doctors?

The average cost of training a resident is $150,000 per year for family medicine and $200,000 per year for ob/gyn. The primary source of funding for resident training is Medicare. Since 1997, the number of positions funded by Medicare has been capped at 1996 levels, even though the population has increased and aged. Despite the cap on new residencies, the number of subspecialty residents has increased by 40%, while primary care residents have only increased by 13%.    

In 1993, a General Statute required 60% of students in North Carolina’s two public medical schools and 50% in the two private medical schools to enter into primary care. But reports by the Sheps Center at UNC Chapel Hill show the state’s need for primary care physicians is not being met. 

Why UNC Health Sciences at MAHEC?

MAHEC’s track record is strong. For more than 40 years, we have trained physicians, pharmacists, dentists, and allied health professionals to provide primary care in WNC. Since 1974, more than 551 physicians and dentists have graduated from MAHEC's residency and fellowship programs. More than 314 of our graduates established practices in North Carolina, nearly all of them right here in WNC. More than 60% of MAHEC's family medicine residents remain in WNC upon graduation.

Each year, healthcare providers and public health professionals from all 16 WNC counties benefit from UNC Health Sciences at MAHEC’s educational programs.

MAHEC's rural health initiatives have the potential to make a substantial health and economic impact in WNC with the support of the newly established UNC Health Sciences at MAHEC and long-standing collaborative partnerships with healthcare systems and community organizations across the region.

For more information about any of MAHEC's rural health initiatives, please contact Lauren White Gibson at