LEWISBURG, W.Va. — A small medical school located in the mountains of southern West Virginia is quietly becoming one of the state’s most effective tools for addressing physician shortages in rural America, according to a new statewide report on health sciences education.
The West Virginia School of Osteopathic Medicine, based in Lewisburg, a historic town near the Virginia border, ranks first among the state’s medical schools in producing doctors who remain in West Virginia after graduation, practice primary care, and serve rural communities, according to the West Virginia Higher Education Policy Commission’s 2025 Health Sciences and Rural Health Report.
Released in early December, the report evaluates West Virginia’s health care workforce pipeline at a time when many states — particularly rural ones — are struggling to recruit and retain physicians. The findings highlight the school as a model for training doctors willing to practice in underserved areas.
“The commission’s report provides evidence that we’re still doing an excellent job in the areas in which the school has long been a leader,” said James W. Nemitz, the school’s president. “Of the state’s medical schools, we’re No. 1 in producing physicians for rural areas of West Virginia and for the state as a whole.”
A rural-focused medical school
Lewisburg, where the school is located, sits in Greenbrier County, about 200 miles southwest of Washington, D.C., in a region known for its scenic mountainous terrain. Like many rural areas across the United States, much of West Virginia faces shortages of primary care physicians, especially outside major population centers.
With roughly 200 students per class, the school is the largest medical school in West Virginia. During the 2024–25 academic year, enrollment in its Doctor of Osteopathic Medicine program totaled 810 students, according to the report.
Affordability is a key part of the school’s approach. It posted the lowest tuition among West Virginia’s three medical schools for both in-state and out-of-state students. The report also notes that in-state tuition at West Virginia’s medical schools ranks among the most affordable in the nation—a factor often cited as important in encouraging graduates to remain in the state.
Academic metrics suggest the school remains competitive nationally. The mean undergraduate grade point average of its first-year class exceeded the national average for incoming osteopathic medical students.
Doctors who stay and serve rural areas
The report places particular emphasis on where graduates ultimately practice, a measure increasingly used by policymakers to evaluate medical education investments.
Among graduates from classes from 2015 to 2020, 187 alumni of the school are currently practicing in West Virginia, more than any other medical school in the state. By comparison, the second-highest institution produced 162 in-state physicians, while the third produced 69.
The gap widens when rural practice is considered. Eighty-six graduates from those same years are practicing in rural West Virginia communities, compared with 32 combined from the state’s other two medical schools.
Primary care outcomes show a similar pattern. The report found that 126 graduates from the school’s 2015–2020 classes are practicing primary care in West Virginia, surpassing the combined total of 103 from the other two institutions. Primary care specialties include family medicine, internal medicine, pediatrics, and obstetrics and gynecology.
Primary care pipeline continues
The school’s emphasis on primary care is also evident among recent graduates. For the Class of 2025, 105 students—56% of the class—entered primary care residency programs, the highest number in the state.
Health workforce experts note that primary care shortages are among the most pressing challenges facing rural health systems nationwide. Many states have invested heavily in recruitment incentives, loan forgiveness, and residency expansion, with mixed results.
Nemitz said the report confirms the long-term value of a mission-driven approach to medical education.
“This data supports what we already know—that the school is a great place to learn to become a compassionate, highly skilled physician,” he said. “As a result, communities in West Virginia and beyond are seeing the benefits.”
Broader implications for rural health
The West Virginia Higher Education Policy Commission, which oversees the state’s public colleges and universities, uses the annual report to guide workforce planning and policy decisions. Its Division of Health Sciences works with hospitals, universities, and government agencies to address physician shortages and improve access to care.
While the report focuses on West Virginia, its findings resonate beyond state borders. Rural states nationwide face similar challenges in retaining medical graduates, particularly in primary care and underserved regions.
As policymakers seek sustainable solutions, the experience of a small medical school in the Appalachian Mountains provides a data-driven example of how targeted training, affordability, and rural immersion translate into real-world workforce outcomes.
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