Nevada now has multiple medical schools training future physicians — but that alone doesn’t solve the workforce problem.
So why do we still have a physician shortage?
It’s a fair question, and it reflects a common misunderstanding about how doctors are actually trained. Medical school is not the pipeline. Residency is.
After graduating from medical school, every physician must complete residency training — a period of supervised clinical practice that lasts several years, depending on specialty. This is where physicians learn to practice independently. It is also where they build professional networks, establish roots and, in most cases, decide where they will ultimately practice.
That matters, because where physicians complete residency is one of the strongest predictors of where they stay.
Studies have consistently shown that a majority of physicians practice in the state where they complete their residency training, not where they attend medical school (according to the Association of American Medical Colleges). In other words, if Nevada does not train physicians here, we should not expect them to stay here.
For years, that has been the state’s reality.
Nevada has historically ranked near the bottom nationally in residency positions per capita, limiting its ability to retain the very physicians it helps educate (according to data from the Accreditation Council for Graduate Medical Education). Even as the state has made important investments in medical education — including the development and expansion of its medical schools — the downstream training capacity has not always kept pace with population growth.
The result is a structural gap: We educate future doctors here, but too many leave for residency training elsewhere and never return.
In several specialties, Nevada still lacks in-state residency training options, meaning graduates must leave for years at a time to complete their training — years during which they build careers, networks and lives elsewhere, often permanently.
This is not unique to Nevada, but the impact here is more pronounced given the state’s rapid growth, large rural regions and longstanding primary care shortages.
The solution is not complicated, but it does require sustained focus: expand residency training.
Residency positions are not just educational slots — they are workforce infrastructure. Every new residency position represents a physician who is more likely to practice in that community long-term. From a policy standpoint, few healthcare investments offer a more direct and measurable return.
This is especially true in rural areas.
Physicians who train in rural settings are significantly more likely to practice in rural communities (according to the American Academy of Family Physicians). Without intentional investment in rural training tracks, these communities remain underserved, regardless of how many students the state educates overall.
Nevada has made meaningful progress in recent years. Residency programs have expanded, new training sites have been developed, and partnerships with institutions like the Veterans Affairs health system have strengthened the pipeline. These efforts matter — and they are beginning to show results.
But we are still catching up.
Nevada’s population continues to grow, and with it, the demand for primary care, behavioral health services and specialty care. Closing the gap will require continued investment in graduate medical education, particularly in specialties and regions where shortages are most acute.
It will also require a broader understanding of how the system works.
We do not fix a physician shortage by hoping doctors come here. We fix it by training them here — and building a system that gives them a reason to stay.
That means competitive practice environments, strong health systems and communities where physicians can build both careers and lives. Residency is the foundation, but retention is the outcome of the entire system working as it should.
Nevada has taken important steps forward. Now it has to stay the course.
Because in healthcare, as in most things, where you train is where you stay — and for Nevada’s future, that still matters more than most people realize.