Physicians Who Complete Both Medical School and Residency in North Carolina Are More Likely to Stay Here to Practice

By Evan Galloway

Aug 24, 2026

Roughly 30-40% of the physicians who graduate from one of NC’s medical schools are working in the state five years after graduating. Medical school is not the final step in a physician’s education; physicians must complete a residency in a medical specialty before they can practice medicine. Residency location is one of the strongest predictors of where physicians ultimately practice. Physicians who complete residency training in NC are retained in-state at higher rates than those who complete medical school in NC, making residency training investments an important component of building the state’s physician workforce. But what happens when physicians complete both medical school and a residency in North Carolina?

To answer this question, we looked at two cohorts from our annual medical student tracking report, graduates from 2015 and 2020. We identified North Carolina medical school graduates who also completed a residency or fellowship in NC, who we call “double-NC physicians”. Double-NC physicians work in NC at far higher rates than physicians who completed only medical school or only a residency/fellowship in NC (Figure 1 and Table 1). For the 2020 graduating cohort, 74% of the double-NC physicians were practicing or in continued training in NC five years later; similarly, 70% of the double-NC physicians from the class of 2015 were practicing in NC after ten years. Roughly one quarter of the double-NC physicians in both cohorts were practicing primary care in North Carolina in 2025, compared to 10-15% of all NC graduates in recent years.

Figure 1. North Carolina medical school graduates who attended a North Carolina residency or fellowship stayed in NC at higher rates than those who did not, five and ten years after medical school graduation.

Tables 2 and 3 show outcomes for primary care residency specialties. Double-NC physicians who completed a residency in Family Medicine had in-state retention rates of about 90% across both cohorts. Double-NC physicians who completed a residency in Internal Medicine, Ob/Gyn, and Pediatrics all had retention rates of roughly 60-75%.

Interestingly, about 1 in 7 double-NC physicians initially left NC for an intern year or a residency but they came back for an advanced residency or fellowship and subsequently stayed in NC at a similar rate as the rest of the double-NC group.

Table 1. Retention of North Carolina Medical School Graduates Who Completed or Are Currently in a Residency or Fellowship in North Carolina by Medical School Graduation Year, 2025.

Note. Percentages are shares of the cohort’s NC medical school graduates who also trained in an NC residency or fellowship (the double-NC physicians). Indented rows are subsets of trainees in NC. For inclusion in this table, trainees must have completed or be in progress in an NC residency or fellowship.

Table 2. Retention of 2020 North Carolina Medical School Graduates Who Completed a Residency in North Carolina by Residency Specialty, Primary Care Specialties, 2025.

Table 3. Retention of 2015 North Carolina Medical School Graduates Who Completed a Residency in North Carolina by Residency Specialty, Primary Care Specialties, 2025.

Note. Specialty is the NC residency, not current practice. Trainees who only completed a fellowship in NC are included in the summary table but not in the specialty tables.