Objectives In Georgia, 52 % of the primary care service areas outside metropolitan Atlanta have a deficit of obstetric providers. This study was designed to identify factors associated with the likelihood of Georgia’s obstetric trainees (obstetrics and gynecology (OB/GYN) residents and certified nurse midwifery (CNM) students) to practice in areas of Georgia that lack obstetric providers and services, i.e. rural Georgia. Methods Pilot-tested electronic and paper surveys were distributed to all of Georgia’s OB/GYN residents (N = 95) and CNM students (N = 28). Mixed-methods survey questions assessed characteristics, attitudes, and incentives that might be associated with trainee desire to practice in areas of Georgia that lack obstetric providers and services. Surveys also gathered information about concerns that may prevent trainees from practicing in shortage areas. Univariate and bivariate analyses were performed, and qualitative themes were abstracted from open-ended questions. Results The survey response rate was 87.8 % (108/123). Overall, 24.4 % (19/78) of residents and 53.6 % (15/28) of CNM students expressed interest in practicing in rural Georgia, and both residents and CNM students were more likely to desire to practice in rural Georgia with the offer of any of six financial incentives (P < 0.001). Qualitative themes highlighted trainees’ strong concerns about Georgia’s political environment as it relates to reproductive healthcare. Conclusions Increasing state-level, rurally-focused financial incentive programs and emphasizing the role of CNMs may alleviate obstetric provider shortages in Georgia.
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The research team would like to thank the March of Dimes Georgia Chapter and the Georgia Department of Public Health for their generous funding in support of this research. We would also like to acknowledge the Georgia OB/GYN Society and Pat Cota, Dr. Andrew Dott, Bridget Spelke, and the Georgia Board for Physician Workforce for their guidance. The authors would also like to recognize the ongoing efforts of the GMIHRG research collaborative to address threats to maternal and infant health in Georgia.
Conflict of interest
The authors declare that they have no conflict of interest.
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Smulian, E.A., Zahedi, L., Hurvitz, J. et al. Obstetric Provider Trainees in Georgia: Characteristics and Attitudes About Practice in Obstetric Provider Shortage Areas. Matern Child Health J 20, 1341–1348 (2016). https://doi.org/10.1007/s10995-016-1998-9
- Training programs
- OB/GYN residents
- Certified nurse midwives