Most physicians in the United States complete their residency training in a hospital. They spend years in emergency departments, inpatient wards, and hospital-based outpatient clinics. It’s excellent training for hospital medicine. It’s not always excellent preparation for practicing primary care in a community where most patients have never been admitted to a hospital — because their problems are managed, when they’re managed at all, in outpatient settings that look very different from academic medical centers.
The Teaching Health Center Graduate Medical Education (THCGME) program, established through the Affordable Care Act in 2010 and administered by HRSA, funds a different model. THC residency programs base their training in community health centers — Federally Qualified Health Centers, rural health clinics, and tribal health centers — rather than hospitals. Residents spend the majority of their time in outpatient community settings, seeing the patients and conditions that define primary care in underserved America.
The numbers behind the program are significant. In Academic Year 2024-2025, HRSA was funding the training of over 1,254 residents in 88 community-based residency programs. Since the program began in 2011, more than 3,090 new primary care physicians and dentists have completed THCGME residencies and entered the workforce. Of those, 1,895 were family medicine physicians.
The program trains residents across nine primary care specialties: family medicine, internal medicine, pediatrics, internal medicine-pediatrics, obstetrics and gynecology, psychiatry, general dentistry, pediatric dentistry, and geriatrics.
The research on this is consistent and worth understanding regardless of whether you’re a medical student evaluating programs or a parent trying to assess what your child is getting into.
Physicians who train in community-based settings — particularly in federally designated shortage areas and underserved communities — are significantly more likely to practice in those settings after they graduate. This isn’t surprising when you think about it: you tend to build relationships, develop competence, and feel comfortable in environments you’ve trained in. A physician who has spent three years managing complex patients in a community health center environment, without the immediate backstop of hospital specialists down the hall, develops a clinical confidence and breadth that transfers directly to practice in underserved communities.
HRSA data shows that 67% of THCGME clinical training sites are in medically underserved communities, 49% are in primary care shortage areas, and 20% are in rural locations. These aren’t incidental characteristics — they’re the point.
For patients in those communities, this matters enormously. HRSA estimates a projected shortage of 70,610 primary care physicians by 2038, with shortages projected to be particularly acute in rural areas. The THCGME program is one of the only federal initiatives that has actually increased the number of physician trainees in the past 25 years.
One thing that many medical students evaluating THC residencies don’t fully understand is the relationship between THC training and the National Health Service Corps loan repayment program.
FQHC-based residency programs are typically at NHSC-eligible sites, which means residents who complete their training and remain at or join an NHSC-approved site can apply for NHSC loan repayment — up to $75,000 to $80,000 in tax-free loan forgiveness for a two-year service commitment. For physicians carrying $200,000 or more in medical school debt, which describes most physicians entering practice today, this benefit reshapes the financial calculus entirely.
Some states also offer additional loan repayment layered on top of the NHSC — Florida’s FRAME program, for example, can provide up to $150,000 in additional repayment for physicians practicing in underserved areas. Physicians who train in THC programs often enter practice already familiar with these programs and positioned to take immediate advantage of them.
What follows is a selection of Teaching Health Center residency programs currently operating across the country — not a comprehensive directory, but a curated look at programs that are particularly distinctive in their setting, their community, or their approach. All programs listed are either current THCGME awardees or established FQHC-based residencies.
Miami, Florida | jtchs.org
The organization behind this program is the first FQHC in Florida and the fifth established in the entire United States — founded in 1967 by Jessie Collins Trice, the first Black person to graduate from the University of Miami’s nursing program, who started the clinic in a trailer in the Brownsville neighborhood of Miami. The residency program, launched recently and housed in the Annie Neasman Teaching and Research Annex, trains four residents per cohort who rotate through pediatrics, women’s health, psychiatry, behavioral health, optometry, and podiatry at JTCHS clinics, with inpatient experience at North Shore Medical Center, Jackson Memorial Hospital, and Larkin Community Hospital. Florida ranks fifth in the nation for health professional shortage areas, and JTCHS serves one of Miami-Dade County’s most medically underserved communities. This program is training physicians in the same neighborhood where the American FQHC movement took root.
Miami, Florida | chisouthfl.org
One of Florida’s most comprehensive FQHC networks, CHI received THCGME funding for both family medicine and psychiatry residency programs — a dual investment that reflects the integrated behavioral-physical health model that FQHCs are increasingly building toward. With 13 health centers serving Miami-Dade and Monroe Counties and one of the most culturally and linguistically diverse patient populations in the country, CHI’s training environment is an immersive preparation for the realities of community health in urban South Florida. Residents will encounter patients speaking Spanish, Haitian Creole, and dozens of other languages in a healthcare environment that treats that complexity as the norm, not the exception.
Miami, Florida | borinquenhealth.org
Borinquen has deep roots in Miami’s Puerto Rican and broader Latino community, and its family medicine residency reflects that identity directly. The THCGME-funded program trains residents in a bilingual Spanish-English environment serving patients whose healthcare needs reflect the specific experiences of Miami’s Caribbean and Latin American immigrant populations. Borinquen explicitly serves LGBTQ+ patients, meaning residents gain experience with gender-affirming primary care alongside the full breadth of community family medicine. The program is particularly relevant for Spanish-speaking physicians or those hoping to build bilingual practice competency.
Clearwater, Florida | evarahealth.org
The Tampa Bay area’s THCGME-funded program, Evara Health (formerly Community Health Centers of Pinellas) serves a patient population spread across one of Florida’s most complex regional healthcare markets. Residents train in an environment that balances urban Clearwater and St. Petersburg communities with suburban and rural Pinellas County populations, gaining experience with the full diversity of primary care demand in West Central Florida. For physicians interested in practicing in the Tampa Bay region — one of Florida’s fastest-growing metros — this program builds direct community roots.
Bakersfield, California | clinicasierravista.org
The Central Valley of California is one of the most medically underserved agricultural regions in the United States, and Clinica Sierra Vista has been serving its farmworker and low-income communities since 1971. The THCGME family medicine residency here trains physicians in a patient environment defined by agricultural labor, occupational health risks, limited preventive care access, and significant Spanish and indigenous language diversity. The Central Valley has physician shortages that rival rural Appalachia in severity, and this program is one of the primary pipelines addressing them. Clinica appears on both the 2023-2024 and 2025-2026 THCGME awardee lists, reflecting sustained federal investment.
Scranton, Pennsylvania | thewrightcenter.org
The Wright Center is one of the most prolific THC programs in the country — appearing multiple times across THCGME awardee lists with family medicine, internal medicine, geriatrics, and psychiatry training programs, and operating across multiple sites including Scranton, Wilkes-Barre, and an Ohio location. The Scranton program trains residents in one of Pennsylvania’s most economically depressed post-industrial cities, serving a patient population with significant chronic disease burden, behavioral health needs, and a rapidly aging demographic. The program’s breadth across specialties makes it unusual — most THC programs focus on a single specialty, while the Wright Center has built what amounts to a community health academic medical center model in northeastern Pennsylvania.
New York, New York | institute.org
The Institute for Family Health operates two THCGME-funded family medicine programs — one in Harlem and one in the Mid-Hudson Valley — that represent two very different faces of New York’s primary care shortage. The Harlem program trains physicians in one of New York City’s most historically underserved urban neighborhoods, with a patient population defined by poverty, chronic disease, and the legacy of healthcare disinvestment. The Mid-Hudson program, based in more rural communities north of the city, trains physicians in a suburban-to-rural transition environment with its own distinct shortage dynamics. Together they create a training continuum from dense urban community health to small-town primary care.
Asheville, North Carolina | mahec.net
MAHEC is one of the most comprehensive THC programs in the Southeast, with THCGME-funded programs in family medicine, obstetrics and gynecology, and general dentistry — a combination that reflects the full primary care scope of the mountain communities it serves in Western North Carolina. The Asheville and Hendersonville programs train physicians and dentists in communities that are both tourist destinations and home to significant populations of working-poor rural residents, many of whom lack insurance and have historically had limited access to obstetric and dental care. For physicians interested in the intersection of rural practice and full-scope primary care including maternity care, MAHEC is one of the few THC programs that specifically includes OB/GYN training.
Chicago, Illinois | eriefamilyhealth.org
The partnership between Erie Family Health Center — one of Chicago’s oldest and largest FQHCs — and Northwestern University’s Feinberg School of Medicine represents a model of academic medicine embedded in community health that is still uncommon. Erie serves Chicago’s diverse West Side communities with a patient base that is predominantly Latino and African American, and its family medicine residency trains physicians in a high-complexity urban environment with academic medical resources behind it. The Northwestern affiliation gives residents access to specialty consultation and research infrastructure that most FQHC-based programs cannot offer, without removing them from the community health training environment.
Toppenish and Yakima, Washington | yvfwc.com
One of the most distinctive programs in the country, Yakima Valley Farm Workers Clinic traces its founding to the farmworker health movement of the 1970s and continues to serve one of Washington State’s largest agricultural worker populations in the Yakima Valley. The program has THCGME funding for both family medicine and dental residencies — addressing the dual shortage of physicians and dentists in agricultural communities where seasonal and migrant workers often have no other healthcare access. Residents here train in a patient environment with significant Spanish and indigenous language needs, high rates of occupational injury and agricultural-related illness, and communities whose healthcare access has been structurally limited for generations. For physicians drawn to the specific mission of farmworker health, this program has no peer.
Detroit, Michigan | dwchauthority.org
Detroit’s THCGME programs span family medicine, internal medicine, pediatrics, and psychiatry — one of the broadest specialty footprints of any single THC awardee in the country. Training in Detroit means training in a post-industrial urban environment with some of the most acute health disparities in America: elevated rates of asthma, diabetes, cardiovascular disease, and behavioral health conditions against a backdrop of poverty, environmental contamination, and systematically underinvested public infrastructure. For physicians who want to understand what community health looks like at its most challenging and most consequential, Detroit’s program offers an education that no hospital-based residency in a wealthier city can replicate.
Lawrence, Massachusetts | glfhc.org
Lawrence is one of the poorest cities in Massachusetts, with a population that is more than 80% Latino and a primary care shortage that has persisted for decades. Greater Lawrence Family Health Center’s THCGME-funded family medicine residency trains physicians specifically to serve this community — in Spanish, with cultural competency that goes beyond language to include the specific health experiences of Puerto Rican, Dominican, and other Caribbean communities in a post-industrial New England city. For Spanish-speaking physicians or those drawn to bilingual urban community practice, Lawrence is one of the most immersive training environments in the Northeast.
Wai’anae, Hawaii | wcchc.com
The only FQHC-based family medicine residency in Hawaii, the Waianae Coast program is training physicians specifically to serve the Native Hawaiian and Pacific Islander communities of Oahu’s Wai’anae Coast — one of the most medically underserved populations in the state. The program accepted its first three residents in July 2025, making it one of the newest in the country. Residents train in the James and Abigail Campbell Clinic in Nānākuli, with rotations through WCCHC’s clinic system including a stand-alone emergency department, and inpatient experience at Queen’s Medical Centers. For physicians with connections to Hawaii or drawn to Native Hawaiian and Pacific Islander health — a population with significant chronic disease disparities and limited physician access — this is a historically important program.
Spokane, Washington | spokaneteachinghealthcenter.org
The Spokane program offers THCGME-funded training in both family medicine and internal medicine, serving communities in Eastern Washington that are geographically and economically distant from the Seattle metro. Spokane sits at the center of a largely rural healthcare market where primary care access is limited and physician recruitment is consistently challenging. Residents here train in a mid-sized city that serves as the regional healthcare hub for much of Eastern Washington, Northern Idaho, and portions of Montana and Oregon — a catchment area defined by agricultural economies, tribal communities, and small-town populations. For physicians interested in becoming anchors of regional healthcare rather than one of many providers in a saturated urban market, Spokane’s program offers a different kind of formation.
If you or someone you know is considering a Teaching Health Center residency, the questions worth asking go beyond match rank and prestige:
Who are the patients? The clinical experience of a THC residency is defined by the community it serves. A farmworker health center in California and an urban FQHC in Detroit both offer community health training — but the patient populations, languages, and conditions are entirely different. Know whose health you want to spend your career working on.
What is the inpatient experience? THC programs vary in how they handle required hospital rotations. Most have affiliations with nearby hospitals for inpatient training. The quality and integration of those partnerships matters for board preparation and for physicians who may want to maintain hospital privileges.
What is the NHSC eligibility status of the training site? Most THC sites are NHSC-eligible, but confirm this directly. It affects your loan repayment options immediately upon completing residency.
What percentage of graduates stay in the community or in similar settings? Ask programs directly about their retention data. Programs that are doing this work well know their numbers — and the numbers for THCGME-trained physicians are consistently strong compared to hospital-based training.
What does the faculty look like? Physicians who chose community health careers and stayed are different mentors than academic hospitalists who supervise residents as part of a hospital’s teaching mission. The faculty culture of a THC program is its most important quality determinant.
The Teaching Health Center program is, at its core, a bet that where you train shapes who you become as a physician. The evidence supports that bet. The 3,090 physicians and dentists who have completed THCGME training represent a pipeline of clinicians who were deliberately formed in the communities they now serve — not extracted from elite academic environments and placed in shortage areas as an afterthought.
For the patients in those communities — in Brownsville and Bakersfield and Barco and Harlem and Wai’anae — that distinction is not academic. It is the difference between a physician who understands their community because they were trained in it and one who is trying to adapt to it.
Finding the right healthcare professional requires more than filling a role.
It requires identifying individuals who align with an organization’s mission, culture, and long-term goals.
All-Genz works closely with healthcare leaders to deliver candidates who are prepared to make an immediate and lasting impact.
Contact us using the form below and we will get back to you ASAP.
Copyright @ 2024 | Gold Medal Consultants
Please select a convenient time on the calendar to speak with our recruiting team.
Purpose of the call: