Lawmakers and Health Experts Call for More Residency Slots in Rural Areas

Residency training is key to increasing healthcare access in underserved communities, experts say

Published on Feb. 24, 2026

Got story updates? Submit your updates here. ›

Several lawmakers and witnesses at a House hearing on advancing the next generation of the healthcare workforce emphasized the need for more residency training slots in rural areas to increase access to healthcare in underserved communities. They noted that rural hospitals face challenges in establishing new residency programs due to lack of resources, staff, and patient volume, while also receiving lower reimbursements than urban hospitals. Experts said that doctors are five times more likely to stay in practice in a rural area if they train there, but only 2% of residencies are currently in rural America.

Why it matters

Increasing the number of residency training slots in rural areas is seen as crucial to addressing healthcare disparities and improving access to care in underserved communities. Lawmakers and experts argue that this will help attract and retain more physicians in rural practices, which have historically struggled to recruit and retain medical talent.

The details

Witnesses at the hearing, including the CEO of a rural Missouri health system and the director of lifestyle medicine at the University of South Carolina School of Medicine, discussed the challenges rural hospitals face in establishing new residency programs and the importance of incorporating lifestyle medicine and disease prevention into physician training. However, one Democratic lawmaker criticized the hearing as an attempt to distract from Republican efforts to cut Medicaid funding, which he argued would hurt healthcare delivery in rural areas.

  • The House hearing took place on Tuesday.

The players

Rep. Adrian Smith

A Republican from Nebraska who chaired the Ways and Means Health Subcommittee hearing in the subcommittee chair's absence.

Jason Shenefield

CEO of Phelps Health, a health system in rural Missouri.

Jennifer Trilk

Director of lifestyle medicine at the University of South Carolina School of Medicine in Greenville.

Rep. Mike Thompson

A Democratic representative from California who was critical of the hearing.

Andrew Racine

President of the American Academy of Pediatrics.

Got photos? Submit your photos here. ›

What they’re saying

“Rural hospitals must overcome a lack of resources, staff, and patient volume to establish new residency programs while simultaneously getting reimbursed less than their urban counterparts.”

— Rep. Adrian Smith, Republican from Nebraska (medpagetoday.com)

“Residency training shapes where physicians ultimately practice. When residents train in rural communities, they build relationships, understand the culture, and see firsthand the opportunity to make a difference.”

— Jason Shenefield, CEO of Phelps Health (medpagetoday.com)

“Chronic disease now accounts for 90% of the nation's $4.9 trillion in annual healthcare spending, much of which is borne by Medicare and Medicaid. Conditions like type 2 diabetes, heart disease, and hypertension are largely driven by modifiable behaviors, yet physician training remains predominantly reactive, focused on managing complications rather than preventing disease progression.”

— Jennifer Trilk, Director of lifestyle medicine at the University of South Carolina School of Medicine (medpagetoday.com)

“It hurts.”

— Andrew Racine, President of the American Academy of Pediatrics (medpagetoday.com)

What’s next

The judge in the case will decide on Tuesday whether or not to allow Walker Reed Quinn out on bail.

The takeaway

This hearing highlights the critical need to increase the number of residency training slots in rural areas to improve healthcare access and outcomes in underserved communities. Experts argue this will help attract and retain more physicians in rural practices, but significant challenges remain in terms of funding and resources for rural hospitals to establish new programs.