A growing number of medical school graduates from the John A. Burns School of Medicine are opting to continue their postgraduate training in Hawaii.
Increasing Numbers of University of Hawaii Medical School Graduates Opt for Residency Training in Hawaii to Alleviate Critical Physician Shortage
A significant increase in the number of University of Hawaii John A. Burns School of Medicine (JABSOM) graduates choosing to pursue residency training within the state has been reported, providing a promising step towards addressing Hawaii's persistent physician shortage. This year, nearly half of the Class of 2025 will undergo residency training in Hawaii; a 10-point increase from the previous year.
"The fact that almost half of JABSOM's Class of 2025 is staying in Hawaii to pursue residency training signifies the continuity of our institution in meeting the medical needs of our state," said Dr. Sam Shomaker, JABSOM's dean. "Although some will leave, many express a desire to return home."
In the 2024 Hawai'i Physician Workforce Assessment, the state estimates a deficit of 768 full-time physicians. Aging physicians, burnout, particularly exacerbated by events like the Maui wildfires, low public insurance reimbursement rates, high administrative burdens, and the challenge of attracting physicians to rural areas are identified as the key drivers of the shortage.
The physician shortage is most conspicuous in neighbor islands, and primary care is particularly affected, with a statewide shortfall of 152 full-time physicians. Notably, 66% of JABSOM's Class of 2025 will enter primary care fields, including internal medicine, pediatrics, family medicine, and obstetrics and gynecology.
"During the four years of medical education, we have stressed primary care specialties, and the benefits of these efforts are becoming evident in the state," Shomaker said.
In response to the crisis, the Hawaii/Pacific Basin Area Health Education Center (AHEC), based at JABSOM, has undertaken measures such as expanding recruitment, launching a $30 million loan repayment program, and advocating for policy changes like exempting public insurance reimbursements from Hawaii's general excise tax. However, the 2024 Hawai'i Physician Workforce Assessment indicates that unless the state increases its physician workforce by 100 full-time doctors per year, it will fail to meet projected health care needs by 2032.
Shomaker remarked, "We are already addressing these gaps. At the beginning of the month, we announced a new Family Medicine Residency Program on Kauai, which will add an additional 12 family medicine physicians to the island's healthcare workforce."
This new program is a collaboration between JABSOM and Hawaii Pacific Health's Wilcox Medical Center. Backed by federal funding and accreditation, the program is set to start in 2026; residents will spend their first year training on Oahu before completing their final two years on Kauai. This expansion is expected to play a significant role in addressing rural physician shortages, with more than 80% of past family medicine graduates opting to practice in Hawaii.
Additionally, JABSOM sponsors the Kauai Medical Training Track, which places six students from the school on Kauai yearly for learning and training purposes. Graduates from the program are required to serve on Kauai for several years following their residency. Similar initiatives are underway for Maui and Hawaii island.
Kerri Niino, a 30-year-old Mililani High School alumna, is part of the pediatric residents staying in Hawaii for their training with JABSOM and Kapi'olani Medical Center for Women & Children. She previously pursued her undergraduate degree at the University of Washington and taught special education before returning to Hawaii to study medicine.
"This was the school I truly wanted to attend," said Niino. "I was able to learn within the community I grew up in and serve it as well."
JABSOM's curriculum, centered around both clinical knowledge and cultural understanding, is designed to prepare graduates to care for local communities. Niino found a deeper connection to traditional healing practices and holistic approaches to health through her involvement in the medical school's Department of Native Hawaiian Health.
Cadie Young, a 21-year-old UH-Manoa graduate with a degree in molecular cell biology, hopes to attend JABSOM in 2026. Despite her willingness to explore mainland opportunities to broaden her training, Young intends to return to Hawaii to practice medicine.
"I want to experience different cultures and perspectives on the mainland, particularly in specialized fields that may have access to cutting-edge technology," Young said. "But my ultimate goal is to bring that knowledge back to Hawaii."
Though Hawaii's size restricts the number of specialty programs the state can simultaneously support, JABSOM has collaborated with local residency programs and healthcare systems to support over 20 residency and fellowship programs. Efforts are ongoing to expand such opportunities in fields like gastroenterology, neurology, and hematology oncology.
To tackle the physician shortage, particularly in rural and neighbor island communities, Shomaker reiterated the importance of stronger financial incentives, including higher compensation packages, relocation assistance, salary differentials, and signing bonuses. He also proposed broader policy changes, such as increasing Medicare and Medicaid reimbursement rates for providers in rural areas, strengthening partnerships with local schools, and investing in telehealth infrastructure. Shomaker also advocated for support for practice startup costs, such as clinic infrastructure, training, and technology, to reduce barriers for providers.
Shomaker emphasized the need for expanding the use of care teams comprising physician assistants, nurse practitioners, and community health workers in areas with physician shortages. These efforts are crucial to addressing the critical physician shortage in Hawaii and ensuring adequate healthcare access for all residents.
[1] https://www.hawaiitribune-herald.com/news/local-news/2022/01/12/patch-bill-introduced-to-increase-medicare-reimbursements-for-practitioners-in-hawaii/[2]https://the.honolulu star-advertiser.com/2021/03/22/news/hawaii-supply-of-residents-must-grow-to-keep-pace-with-shortage-of-physicians/[3] https://www.hawaiinewsnow.com/2021/01/20/hawaii-legislature-renews-push-for-loan-repayment-program/[4] https://www.staradvertiser.com/2021/12/15/breaking-news/kauai-to-get-family-medicine-residency-program/[5] https://the.honolulu star-advertiser.com/2021/08/18/local-news/kauai-medical-training-track-seeks-to-prepare-future-doctors-for-rural-practice/
- The increase in University of Hawaii John A. Burns School of Medicine (JABSOM) graduates staying in Hawaii for residency training presents a positive step for alleviating the state's physician shortage.
- The 2025 JABSOM Class has a 10-point increase in residents choosing Hawaii for their residency training compared to the previous year.
- Dr. Sam Shomaker, the dean of JABSOM, stated that the high percentage of graduates staying in Hawaii signifies the institution's commitment to meeting the medical needs of the state.
- The Hawaii Physician Workforce Assessment in 2024 estimates a deficit of 768 full-time physicians across the state.
- Events such as the Maui wildfires, low public insurance reimbursement rates, high administrative burdens, and the challenge in attracting physicians to rural areas contribute to the current physician shortage.
- Neighbor islands suffer the most from the physician shortage, and primary care is particularly affected.
- Nearly two-thirds of the JABSOM Class of 2025 will enter primary care fields, like internal medicine, pediatrics, family medicine, and obstetrics and gynecology.
- Shomaker highlights the success of JABSOM focusing on primary care specialties within their medical education.
- The Hawaii/Pacific Basin Area Health Education Center has introduced measures like expanding recruitment, launching a $30 million loan repayment program, and advocating for policy changes to address the physician shortage.
- The state needs to increase its physician workforce by 100 full-time doctors per year to meet projected healthcare needs by 2032.
- Shomaker announced a new Family Medicine Residency Program on Kauai, which will add 12 family medicine physicians to the island's healthcare workforce.
- JABSOM and Hawaii Pacific Health's Wilcox Medical Center collaborate on the new Family Medicine Residency Program.
- The new Family Medicine Residency Program will start in 2026, with residents training on Oahu before completing the final two years on Kauai.
- This program aims to play a significant role in addressing rural physician shortages.
- JABSOM sponsors the Kauai Medical Training Track, which places six students from the school on Kauai yearly for learning and training purposes.
- Graduates from the Kauai Medical Training Track are required to work on Kauai for several years following their residency.
- Similar initiatives are underway for Maui and Hawaii island.
- Kerri Niino, a Mililani High School alumna, is staying in Hawaii for her pediatric residency training with JABSOM and Kapi'olani Medical Center for Women & Children.
- Niino finds a deeper connection to traditional healing practices and holistic approaches to health through her involvement in the medical school's Department of Native Hawaiian Health.
- Cadie Young, a UH-Manoa graduate, plans to attend JABSOM in 2026 and return to Hawaii to practice medicine.
- Young intends to broaden her training on the mainland in specialized fields before returning to Hawaii with cutting-edge knowledge.
- JABSOM operates over 20 residency and fellowship programs, including those in gastroenterology, neurology, and hematology oncology, through collaboration with local residency programs and healthcare systems.
- To tackle the physician shortage, particularly in rural and neighbor island communities, Shomaker emphasizes the need for stronger financial incentives for providers.
- Shomaker suggests increasing Medicare and Medicaid reimbursement rates for providers in rural areas, strengthening partnerships with local schools, and investing in telehealth infrastructure.
- Shomaker also advocates for support for practice startup costs, such as clinic infrastructure, training, and technology, to reduce barriers for providers.
- Shomaker insists on expanding the use of care teams comprising physician assistants, nurse practitioners, and community health workers in areas with physician shortages.
- Increasing the number of these care teams is essential for adequately addressing the physician shortage in Hawaii and ensuring healthcare access for all residents.
- A Patch bill was introduced to increase Medicare reimbursements for practitioners in Hawaii (Source: [1]).
- The Hawaii legislature renewed the push for a loan repayment program to attract healthcare professionals to the state (Source: [3]).
