(8) There were over 400 dental faculty vacan-
cies in the school year beginning in 2006. 
(9) In 2007, the average debt of a dental stu-
dent at graduation was $172,627. 
(c) FINDINGS RELATED TO PHYSICIAN SHORTAGES, 
EDUCATION, AND DISTRIBUTION.—Congress finds the fol-
lowing: 
(1) By 2020, physician shortages are forecasted 
to be in the range of 55,000 to 200,000. 
(2) Although 21 percent of the population of 
the United States lives in rural areas, only 10 per-
cent of physicians work in rural areas and, for every 
1 physician who goes into practice in regions with a 
low supply of physicians, 4 physicians go into prac-
tice in regions with a high supply of physicians. 
(3) According to a 2004 report by Green et al. 
for the Robert Graham Center of the American 
Academy of Family Physicians, the number of appli-
cants from rural areas accepted to medical school 
has decreased by 40 percent in the last 20 years 
while the number of such applications has remained 
the same. 
(4) In order to respond to forecasted shortages, 
experts have recommended an increase between 15 
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and 30 percent in class size at medical schools over 
the next 10 years. 
(5) There are 55,000,000 citizens of the United 
States who lack adequate access to primary health 
care because of shortages of primary care providers 
in their communities. 
(6) The number of graduates from medical 
school in the United States who choose to practice 
family medicine has plummeted 50 percent in less 
than 10 years. Without congressional intervention, 
such decline will likely continue, and access to care 
in underserved areas will rapidly deteriorate. Family 
physicians represent 58 percent of the rural physi-
cian workforce, 70 percent of non-Federal physicians 
in whole-county health professional shortage areas, 
and 78 percent of primary care physician full-time 
equivalents in the National Health Service Corps. 
(7) Current trends indicate that fewer resident 
trainees from pediatric and internal medicine 
residencies pursue generalist practice at graduation. 
(8) Funding for medical education which is pro-
vided through direct Graduate Medical Education 
(GME) and Indirect Medical Education (IME) 
under the Medicare program is not transparent or 
accountable, nor is it aligned to the types of health 
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professionals most needed or to the areas in which 
health professionals are most needed. 
(9) Physician supply varies 200 percent across 
regions and there is no relationship between regional 
physician supply and health needs. 
(10) The Council on Graduate Medical Edu-
cation’s 18th Report (issued in 2007), entitled ‘‘New 
Paradigms for Physician Training for Improving Ac-
cess to Health Care’’, and 19th Report (issued in 
2007), entitled ‘‘Enhancing Flexibility in Graduate 
Medical Education’’, each call for changes to address 
the healthcare needs of the United States by remov-
ing barriers to expanding and more appropriately 
training the physician workforce. 
(d) FINDINGS RELATED TO NURSING SHORTAGES, 
EDUCATION, AND DISTRIBUTION.—Congress finds the fol-
lowing: 
(1) By 2020, nursing shortages are forecast to 
be in the range of 300,000 to 1,000,000 and the 
Bureau of Labor Statistics of the Department of 
Labor estimates that more than 1,200,000 new and 
replacement registered nurses will be needed by 
2014. 
(2) Nurse vacancy rates are currently 8 percent 
or greater in hospitals and community health centers 
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receiving assistance under section 330 of the Public 
Health Service Act, and for nursing faculty posi-
tions. 
(3) Surveys indicate that 40 percent of nurses 
in hospitals are dissatisfied with their work and, of 
nurses who graduate and go into nursing, 50 per-
cent leave their first employer within 2 years. 
(4) Nursing baccalaureate and graduate pro-
grams rejected more than 40,000 qualified nursing 
school applicants in 2006, with faculty shortages 
identified by such programs as a major reason for 
turning away qualified applicants. 
(5) More than 70 percent of nursing schools 
cited faculty shortages as the primary reason for not 
accepting all qualified applicants into entry-level 
nursing programs. 
(6) The nursing faculty workforce is aging and 
retiring and, by 2019, approximately 75 percent of 
the nursing faculty workforce is expected to retire. 
(7) The average age of nurses in the United 
States is 49 and the average age of an associate pro-
fessor nurse faculty member in the United States is 
56. 
(8) Geriatric patients receiving care from 
nurses trained in geriatrics are less frequently re-
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admitted to hospitals or transferred from skilled 
nursing facilities and nursing facilities to hospitals. 
(e) FINDINGS RELATED TO PUBLIC HEALTH WORK-
FORCE SHORTAGES.—Congress finds the following: 
(1) The United States has an estimated 50,000 
fewer public health workers than it did 20 years ago 
while the population has grown by approximately 22 
percent. 
(2) Government public health departments are 
facing significant workforce shortages that could be 
exacerbated through retirements. 
(3) Twenty percent of the average State health 
agency’s workforce will be eligible to retire within 3 
years, and by 2012, over 50 percent of some State 
health agency workforces will be eligible to retire. 
(4) Approximately 20 percent of local health de-
partment employees will be eligible for retirement by 
2010. 
(5) The average age of new hires in State 
health agencies is 40. 
(6) Four out of 5 current public health workers 
have not had formal training for their specific job 
functions. 
(f) FINDINGS RELATED TO PHYSICIAN ASSISTANT 
SHORTAGES.—Congress finds the following: 
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