YOUNGSTOWN, Ohio – Dr. James Kravec grew up on Youngstown’s west side and graduated from Youngstown State University and Northeast Ohio Medical University then trained at an Akron hospital.
But the chief clinical officer at Mercy Health Lorain and Youngstown, wanted to return to the Mahoning Valley to practice. Not all new physicians share that sentiment.
In fact, Ohio faces a primary care physician shortage, especially in its rural communities.
Northeast Ohio Medical University and Mercy Health in Ohio announced a plan to change that. Through an expanded partnership, NEOMED medical students will receive more clinical training in Mercy Health facilities.
“We add about between 50 and 70 new physicians and advanced practice clinicians every year and many of them are from our community,” Kravec says. “We want to make sure that we don’t lose physicians to other areas. If they want to, we want them to choose to stay here. We want to have jobs for them.”
MORE DOCTORS NEEDED
Mercy Health employs 450 physicians across 35 primary care locations and 11 walk-in clinics in the tri-county area, according to Kravec.
Mercy Health needs and will continue to need more physicians, operating Mercy Health St. Elizabeth-Youngstown, a level one trauma center; Mercy Health St. Elizabeth-Boardman, Mercy Health St. Joseph-Warren; the new Mercy Health Behavioral Health Hospital and Mercy Health Rehabilitation Hospital both in Liberty; and soon, Mercy Health-Champion Emergency Center. There are walk-in clinics in several smaller communities in the area.
Increasing the number of Valley physicians makes sense to Kravec and to NEOMED.
“A strong economy depends on healthy communities, making workforce development essential to Ohio’s future,” says NEOMED President Dr. John Langell in a prepared statement. “Our longstanding partnership with Mercy Health is central to that mission.”
Together NEOMED and Mercy Health will expand clinical education and training across Mercy Health’s statewide network of both hospitals and outpatient facilities, giving medical students more opportunities to learn in places where they are most likely to build careers and serve patients, he says.
“This partnership strengthens physician education, advances interdisciplinary training and helps ensure communities across Ohio – particularly those facing workforce shortages – have access to highly skilled healthcare professionals,” Langell continues.
Mercy Health’s relationship with medical education goes back to the founding of St. Elizabeth Hospital in 1911. Kravec says from the early years there were trainees and interns.
NEOMED, founded in 1973, graduated its first physicians in 1981. St. Elizabeth Hospital and Mercy Health have helped train NEOMED students since the 1970s.
BOLSTERING PIPELINE
First and second year NEOMED students learn physical exam skills at Mercy, Kravec says. In their third and fourth years they participate in clinical rotations at Mercy hospitals and clinics. Mercy Health also accepts graduates from NEOMED and other schools for the hospital’s residency programs, which is the time after medical school before the physicians are officially on their own.
“We have a great history of medical education and a great history with NEOMED,” Kravec says. “This affiliation agreement is taking it to the next level.”
Mercy Health is training about 150 residents and fellows in its Youngstown area hospitals.
The agreement will continue and expand that training. In addition to using NEOMED facilities to train Mercy Health residents, the agreement means a simulation facility at Mercy Health St. Elizabeth – Youngstown for residents, medical students, nurses and therapists, Kravec says. He also says nursing and physician leaders will receive advanced problem-solving quality infection prevention training through NEOMED.
“We’re going to be working on a pipeline of physicians into our communities, retaining physicians into our community,” Kravec says. “We’re going to be working on a residency program pipeline where medical students can potentially save a year of medical school and come right to Mercy for a residency program.”
Two medical students already have condensed their medical school time and started the residency early, but Kravec says the goal is to expand that program. Additionally, Mercy Health accepted more NEOMED students to shadow and conduct research this summer, giving them opportunities beyond bookwork at an early stage.
“I remember my time fondly as a medical student,” Kravec says. “I got a chance to do that and work with some great physicians and great researchers. That energizes young students and helps them want to continue their education.”
NEOMED in July welcomed its largest class of first-year medical students with 211. When Kravec graduated from NEOMED 25 years ago, there were about 105 graduates. The class size has doubled and Kravec points out that means more clinical rotations spots needed for students.
“We’re going to be able to take more medical students from NEOMED in our hospitals just to be able to give them the exposure to great physicians and nurses and nurse practitioners and therapists that we have in our facilities at Mercy and Youngstown with the hope of training them and hopefully they can stay in our community,” Kravec says.
With more than 50% of NEOMED students staying in Ohio to practice after graduating, the school aims to increase those numbers.
NEOMED is moving the needle.
“We have risen significantly in national rankings for graduates who choose to practice in rural communities, reflecting our commitment to improving healthcare access across Ohio,” Langell says.
And many of those NEOMED students are staying in the Youngstown area to practice.
“Of course, we want the best and brightest students, which NEOMED students are, to stay in our communities,” Kravec says. “NEOMED is the greatest pipeline of physicians for our medical staff. We have about 1,000 physicians on our medical staff in the Mercy Health Youngstown hospitals and we have more of them from NEOMED than anywhere else. And that’s going to continue growing. We’re very excited about that.”
PHYSICIAN SHORTAGES
In 2025, the U.S. Department of Health and Human Services estimated Ohio faced a deficit of 1,200 primary care physicians. Overall a 141,160 shortage in physicians is expected by 2038 and the same organization projected a shortage of 70,610 primary care physicians across the country by 2038, which will be particularly acute in non metro areas.
In Columbiana County for instance, the county’s Health Needs Assessment showed that in 2021, the ratio was one primary care physician for 3,380 patients. Across the state of Ohio that same ratio is 1,330 to 1.
The ratio of primary care physicians to Columbiana County patients has been getting worse each year since 2014, according to the same assessment, which is created through a partnership between local hospitals, public health and social service agencies.
“We’re falling behind,” says Wes Vins, commissioner of the Columbiana County General Health District. “We’re losing providers compared to what’s going on in the state and the nation, and so our providers in our county are being asked to provide the same services to more residents.”
And there has been a significant loss of specialists, Vins says, including mental health providers, where Ohio has a 1 to 290 ratio for every 100,000 residents and Columbiana County’s ratio is 1 to 600.
Vins notes there are several programs such as through the Community Action Agency and local hospitals seeking to bring in more physicians. At the health district, officers meet resident physicians to give them a tutorial about public health services that can be provided for free through the health department for those without insurance.
While some residents drive to Mahoning County or into Pennsylvania for medical care, Vins says many do not have transportation or the economic means to travel.
“If we want to improve the health of our community, I think having access to care is very, very important,” Vins says, adding there are three pieces to the problem – a lack of providers, a lack of transportation and a lack of medical health coverage.
Physician retirements exacerbate the shortage. The Cicero Institute reports by 2030, nearly 40% of U.S. physicians will reach retirement age and 30.5% of Ohio physicians are within retirement range.
“Many physicians are either working less than a full time equivalent or they’re retiring at an earlier age or they’re leaving the field of medicine,” Kravec says. “That’s not Mercy, that’s not Youngstown. That’s national.”
MORE FUNDING
Recognizing concerns about declining access to healthcare, Ohio was granted more than $200 million in federal dollars last year through the Centers for Medicare & Medicaid Services and the U.S. Department of Health and Human Services through the Rural Health Transformation Program.
The program focuses on all but 15 of Ohio’s 88 counties, including Columbiana County, but not Trumbull or Mahoning.
According to announcements from Gov. Mike DeWine’s office at the time, Ohio’s plan for the funding includes programs to boost the Rural Healthcare Workforce Pipeline by creating partnerships between healthcare providers and educational institutions to encourage Ohio medical students to find long-term employment in Ohio’s rural communities.
The Ohio 2026-27 biennium budget invested $1 million in each of the fiscal years to support graduate medical education residency slots for residents placed in family medicine or psychiatry, another area where Ohio has a shortfall. The objective is to expand residency training capacity in Ohio, so more future doctors can do their residency within the buckeye state.
In the past, congress limited the number of residency slots and hospital finances make it challenging to grow residency programs in certain hospitals, Kravec explains.
Possible solutions include more people entering the profession and using the help of advanced practice clinicians like nurse practitioners and physician assistants, he adds. Kravec also believes technology is changing how physicians practice and interact with patients. Some younger people prefer less personalized care.
“As a primary care physician myself, we want to have a relationship with our patients, but many people are choosing different routes,” Kravec says, citing walk-in clinics as a good example. “We have to be available and open for that as well.”
Pictured at top: NEOMED is working with Mercy Health to expand medical education opportunities and address physician shortages across Ohio.
