programs used by CHCs to increase the
flow of clinicians to underserved areas,
which are widely used by rural and urban
grantees alike (TABLE 4). These data
reflect only clinicians who are currently
participating in one of these
programs. The number of CHC physicians
and dentists who benefited
from these programs would be higher
if alumni of these programs were
included.
There are 3 general categories of recruitment
incentives: educational scholarships,
in which medical and dental
students incur subsequent service paybacks;
loan repayment for service in
designated shortage areas; and J-1 visa
waivers for international medical graduates
(IMGs). Of these, loan repayment
is the most frequently used. Eight hundred
thirty-three (14.5%) of the physicians
currently working in CHCs and
348 (22.6%) of the dentists in CHCs
were receiving either federal or state
loan repayment. Rural programs had a
greater proportion of their staff in each
of these programs. Of the current rural
physician staff, 44.5% are enrolled
in one of these programs, almost twice
as great a proportion as within urban
CHCs.
CHCs in general and rural grantees
in particular are dependent on IMG
physicians. Of the rural CHCs, 37.6%
have current physician staff who have
been given J-1 visa waivers that allow
them to practice in designated shortage
areas. Because some IMGs change
their immigration status after several
years of working in the United States
and no longer depend on J-1 visa waivers
to remain in the country, the total
number of IMGs working in CHCs is
almost certainly higher than that listed
in Table 4.
The pattern is similar for dentists, with
32.6% of current rural dentists either
previous recipients of National Health
Service Corps (NHSC) scholarships or
currently receiving loan repayment from