A region of four million people, some of the poorest health outcomes in California, and just 47 primary care physicians per 100,000 residents. That is the San Joaquin Valley doctor shortage in one sentence, and it is the subject of a fresh CalMatters report this week. For those of us at the start of our medical careers, it is also a window into how doctor shortages actually work, and why fixing them takes decades, not headlines.

The numbers behind the San Joaquin Valley doctor shortage

California’s San Joaquin Valley has historically ranked among the lowest regions in the state for physician supply. A 2017 UCSF health workforce assessment found the Valley had the lowest ratios of licensed physicians, doctors of osteopathy, nurse practitioners and registered nurses per 100,000 residents in all of California.

More recently, the California Health Care Foundation reported that the Valley had just 47 primary care physicians per 100,000 people. The US Department of Health and Human Services recommends 60 to 80 per 100,000, and the California state average sits around 60. The American Medical Association estimates that over 83 million Americans live in areas with insufficient access to primary care. The Valley is not an outlier in the national picture, but it is one of the sharpest examples of it.

A 2020 study by the Council on Graduate Medical Education added another striking figure: 92 percent of the Valley’s population lives in a designated Health Professional Shortage Area, compared with 28 percent of Californians overall.

New medical schools are years away

California lawmakers have noticed. This month, the state approved $2 million to create a medical school at the University of the Pacific, a private university in Stockton, with a planned opening in 2030. It would likely be the second medical school in the Valley to grant a Doctor of Medicine degree.

The first path runs through UC Merced. In 2023, UC launched an eight-year program in which students complete undergraduate and medical education entirely in the Valley, starting at UC Merced and doing clinical rotations at UCSF Fresno. The first cohort finishes its undergraduate phase this year and moves into medical school, with UC Merced aiming to become an independent medical school around 2034.

Meanwhile, the political route has been slower. Assemblymember Jasmeet Bains, herself a family medicine physician, made her third attempt this year with Assembly Bill 1547, which would have compelled the University of California to study a medical school for Kern County. Governor Gavin Newsom vetoed it this month, calling its nearly $3 million budget too costly.

Why “grow your own” matters for new doctors

There is a lesson here that matters to every medical graduate choosing where to train and work. Programs like San Joaquin Valley PRIME+ ask students to commit to

practicing in the Valley, because doctors tend to stay where they train. The Valley’s own experience shows that importing physicians rarely solves a rural shortage; growing them locally has the best evidence behind it.

For a new graduate, an underserved region is both a professional opportunity and a test of stamina. The patient load is heavier, the resources thinner, and the breadth of pathology you see in a month can exceed what a city trainee sees in a year. Many doctors who train in places like this describe it as the steepest, most formative part of their careers.

As I wrote in my first-year reflections, the lessons that shape a doctor rarely come from the lecture hall. They come from the wards where the system is stretched and every pair of hands matters. You can read those reflections in My First Year as a Doctor: 7 Lessons Nobody Taught Me in Medical School.

What this means for medical students choosing a specialty

If you are a medical student weighing specialty and location, shortages like this one are worth watching. Primary care in underserved areas consistently shows some of the strongest employment demand in medicine, alongside programs that can help with the cost of medical education, such as loan repayment tied to service in shortage areas.

None of that makes the choice easy. Rural and underserved practice asks more of a young doctor, and burnout risk is real where support is thin. But the Valley’s story is also a reminder that the places with the fewest doctors are often the places where one new doctor makes the largest difference.

Frequently asked questions

How bad is the doctor shortage in the San Joaquin Valley?

The Valley has about 47 primary care physicians per 100,000 residents, well below the recommended 60 to 80, and 92 percent of its population lives in a designated Health Professional Shortage Area.

When will the new medical schools open?

The University of the Pacific’s planned school in Stockton is set to open in 2030. UC Merced’s path to an independent medical school is aimed at around 2034, with the joint UCSF Fresno program’s first combined cohort already in the pipeline.

Why do new medical schools take so long?

Accreditation, faculty recruitment, clinical training sites and funding all take years. Training a single physician from medical school entry to independent practice takes seven to eleven years, so workforce planning always runs a decade behind need.

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