Background Report: Strengthening Higher Education and Tomorrow’s Workforce Town Hall

CH 5: Healthcare Workforce

Overcoming Barriers to Rewarding Careers

A career in healthcare has long been valued by our society. For most people it is a rewarding line of work, one in which a person can support a family, be a respected member of the community, and make a difference. Unfortunately, New Mexico is not producing or recruiting enough healthcare providers to serve the critical health needs of our state. For those aspiring to be healthcare professionals, a lack of educational preparation or funds to pay for additional education present substantial barriers for most New Mexico students. New Mexico and its higher education institutions continue to invest in health career degree and certificate programs that are supportive and inclusive of students from all communities. This chapter offers a foundation to expand the healthcare workforce pipeline, thereby improving the health and economic opportunity in all New Mexico communities.

Key Considerations

Given the high demand for healthcare professionals, and the existence of a broad range of healthcare education and training programs, what more can be done to increase the number of providers? How can we scale-up successful education programs that cultivate our own New Mexico students and also bring in students and providers from out-of-state? What policies are needed to support increasing consumers’ access to healthcare providers throughout the state?

Higher Education Institutions Healthcare Programs

The healthcare industry is an important part of the New Mexico economy, a recognition that is built into most New Mexico higher education institutions that offer a variety of health-related certificates and degree programs. For example, bachelor’s, master’s and doctorate programs include:

  • Physician (MD)
  • Physician residency programs
  • Nursing (RN-Bachelor of Science)
  • Nurse-Midwifery (Master of Science in Nursing or Post-Master’s Certificate)
  • Nurse practitioner – family, pediatric, psychiatric, and adult-gerontological acute care
  • Nutrition and dietetics (Bachelor of Science)
  • Physician Assistant (PA – Master of Science)
  • Occupational therapy
  • Osteopathic medicine (DOM)
  • Pharmacist (PharmD)
  • Physical therapy

Certificate and associate programs

  • Certified nursing assistant
  • Community health worker
  • Dental assistant
  • Dental hygienist
  • Emergency medical technician, paramedic
  • EKG technician
  • Health information technology - medical coding, cyber security, electronic health information
  • Home health aide
  • Licensed practical nurse (LPN) (dual credit programs available with some high schools)
  • Medical assisting
  • Nursing (RN), and Pre-nursing
  • Occupational therapy assistant
  • Personal care attendant
  • Pharmacy technician, clinician
  • Phlebotomy
  • Radiologic technology
  • Respiratory therapy
  • Surgical technology
  • Vision care technology

Healthcare and the Economy

Healthcare is the predominant, well-paying industry on the rise in the state and accounted for two-thirds of the state’s job growth from 2014-2016.[1] It was one of the few New Mexico industries that saw a rise after the 2008 recession. The state’s Veterans Administration Health Care System, Lovelace Health Systems, Presbyterian Healthcare Services and UNM Health System are among the state's industry leaders. Healthcare jobs provide New Mexico families the promise of economic security and stability, offering higher average salaries than other growing sectors such as the service industry.[2] Healthcare practitioners enjoy a mean salary of about $73,000.[3]

The greatest number of new healthcare jobs are for ambulatory healthcare services (i.e. outpatient medical services that take place at dialysis clinics, ambulatory surgical centers, hospital outpatient departments, and the offices of physicians and other health professionals).[4] Other related sectors include social assistance, long-term and residential care nursing, home health and hospitals. The increase in healthcare sector is due to multiple factors including the number of aging baby boomers, the expansion of Medicaid and other insurance coverage under the Affordable Care Act, and consequent increased demand for medical services.[5] The healthcare industry both brings in and relies on federal dollars through Medicare, Medicaid and other federal healthcare programs.

Healthcare Workforce Gaps

While the promise of jobs in healthcare fields exist, vacancies persist. On any given day there are over 228 unfilled physician openings in New Mexico, with an average of 75 family physician, 25-30 pediatric physician and 60 nurse openings.[6] These vacancies represent only those healthcare employers who are actively seeking assistance in filling the positions. It does not account for the many other standing vacancies in which employers have given up.[7] The state cannot fill these openings from its population alone. Therefore, the state must continue efforts to grow its own healthcare providers and actively recruit and retain providers from outside the state.

The shortfall, coupled with uneven distribution of providers throughout the state, is impacted by the number of people who became newly insured in 2014 through the Affordable Care Act.[8] In the near-term, the lack of supply will result in longer wait times to providers and more difficulty accessing specialists. As New Mexico’s population expands and becomes proportionately older, the state can expect even greater healthcare access problems.

Reasons for New Mexico’s vacancies and provider shortage include:[9]

  • The overall low high school graduation rate, as well as students’ math, science and reading performance: Healthcare jobs require math and reading competency and education beyond a high school degree.
  • Brain drain: There is a growing number of young and working age New Mexicans who seek education and/or work elsewhere. In rural communities, one source of providers is local young people who return home after college. However, brain drain can also describe these people choosing to live in metropolitan areas instead.
  • High Medicaid and Medicare populations: A substantial portion of New Mexico healthcare dollars come from Medicaid and Medicare, which pay less than other insurers. Therefore, employers cannot offer as competitive salaries as out-of-state employers. This issue matters to young professionals paying off student loan debt.
  • High percentage of people with complex health problems: New Mexico’s healthcare professionals treat many patients with complex and chronic conditions, placing a substantial daily strain on primary care practitioners. They often burn out, choose to practice elsewhere, or switch to a specialty practice. Primary care providers in community clinics commonly see 25 patients a day, often resulting in more than a 12-hour workday.
  • Lack of adequate staffing to support higher level providers: Provider vacancies for healthcare providers at all levels mean those practicing must carry a heavier load.
  • Shortage of available slots in education programs for qualified applicants: New Mexico healthcare programs must often turn away qualified applicants due to lack of faculty and funding.

Increasingly, medical assistants, technicians and home health aides are called on to provide more frontline patient work. Twenty-nine percent of healthcare jobs require only a certification or industry credential.[10] To better determine staffing ratios and provider gaps, it would be useful to quantify the number of students graduating from community colleges with medical assisting or technician certificates or degrees, and where they are working.[11]

Quantifying the Workforce Gaps

Each year the New Mexico Health Care Workforce Committee, a voluntary group of experts, analyzes substantial gaps in the state’s healthcare workforce and makes recommendations for addressing the problem. The committee uses data collected by state licensure boards including where providers practice, their status (i.e. active or inactive), demographics, education, practice activities, hours and weeks worked and future practice plans.[12]

According to the committee, the healthcare workforce is well below national benchmarks for provider-to-patient ratios in many areas of the state for physicians, psychiatrists, dentists, nurses, emergency medical technicians and other providers.[13] Improvements have occurred in the number of registered nurses and physician assistants, though the shortages remain. Even if New Mexico was meeting benchmarks for providers, the committee reports that all residents still would not necessarily have adequate healthcare access. For example, the estimates do not account for: whether providers see Medicare and Medicaid patients (many do not); wait times that can range from a month or over six months for primary and specialty care; or substantial health disparities related to poverty such as access to transportation and other social determinants of health. All these challenges prevent residents from accessing services. Suggestions that New Mexico could solve its shortages by relocating providers from better-served counties to lower-served ones are not considered realistic.

Estimated Number of N.M. Providers Compared to National Benchmarks

Provider type

Estimated number in NM

Total below national benchmark

NM counties below national benchmark

Registered nurses (RNs)

17,219

3,361

30

Emergency medical technicians (EMTs)

6,101

475

12

Primary care physicians (PCPs)

2,076

139

22

Pharmacists

2,013

257

26

Certified nurse practitioners/nurse specialists

1,379

142

18

Dentists

1,171

55

18

Physician assistants

746

119

22

Psychiatrists

332

106

26

Obstetrics and gynecology physicians (OB-GYNs)

273

31

9

General surgeons

188

14

7

Certified nurse-midwives (CNMs)

156

12

9

Licensed midwives (LMs)

48

4

4

Source: N.M. Health Care Workforce Committee, 2017

The state’s shortage of physician specialists impacts families and our state’s economy. For example, the state does not have a pediatric neurosurgeon. Patients and their families are sent to Denver and Phoenix for treatment. This displaces families from their support systems, costs a great deal of money, and sends dollars to competing states.[14] Physicians who want local access to specialty services decline to work in New Mexico and existing higher-income providers are recruited out-of-state.

The one exception to New Mexico’s provider shortage is in dental hygiene. Each year, New Mexico higher education institutions produce more dental hygienists than can find full-time positions. The number of newly graduated hygienists who remain unemployed or underemployed means some programs risk losing their accreditation.[15] At the same time, thousands of New Mexicans need basic services dentists provide but hygienists cannot. Other states, tribal communities, and over 50 countries around the world, have established dental therapist practices to help resolve this challenge. Dental therapists are mid-level dental providers who work under the direction of dentists, and who have been shown in a global literature review to provide quality, routine dental care services in the range between a hygienist and dentist.[16] The New Mexico dental therapist proposal would capitalize on the existing hygienist workforce, using current higher education facilities and dental clinics to train and educate dental hygienists to be dental therapists, earning about $60,000 per year.[17] The New Mexico bipartisan legislative proposal is supported by a coalition of New Mexico higher education institutions, nonprofit organizations and healthcare providers.[18] The New Mexico Dental Association remains opposed to the proposal.

“Of any avenue, New Mexico has to prioritize higher education if we are going to overcome the social determinants of health. All it takes is providing students the social and emotional support they need, and we can flourish!” – Ariel Scott, MD, Family physician, Lovington, NM, Former UNM BA/MD student

Workforce Demographics

Workforce planning requires analysis of three key demographics: gender, race/ethnicity and age.[19] These factors demonstrate whether the workforce is reflective of New Mexico’s diversity, whether students from all walks of life have opportunities to enter health careers, and how many positions will open due to an aging workforce.

In comparison with New Mexico’s population, our physicians are more likely to be male, while our nurse practitioners, clinical nurse specialists and physician assistants are more likely to be female. [20] Professionals in all those fields are less likely than the state’s population to be people of color. Looking at these professional in terms of their mean age, they average late 40s to mid-50s, which essentially means New Mexico needs more younger providers in our professional pipeline.

Why We Need More Healthcare Professionals: Human and Economic Costs

Workforce challenges translate to patient challenges. The day-to-day impact of New Mexico’s shortage in healthcare providers means that most New Mexicans will experience gaps in services throughout all stages of their lives, with people living in rural, frontier and tribal areas encountering the problem more acutely. These gaps can mean months of waiting for a necessary appointment, a delayed diagnosis that is more difficult and expensive to treat if at all, or a protracted arrival to an emergency department that is hours away. Ultimately, the shortage can mean the difference between life and death.

For example, many assume that pregnant women can continue to count on their community hospital to deliver their children. However, the erosion of the availability to obstetrics services is a statewide and ongoing concern especially in rural areas, and is a “canary in the coal mine” when it comes to assessing adequate access to necessary healthcare services.[21] Rural hospitals are having difficulty recruiting and retaining at least one obstetrician and one pediatrician, a requirement for hospitals and nurse-midwives to provide delivery care. Only larger communities have the population to meet the 20 or more births per month requirement for a physician to be certified in obstetrics or pediatrics. [22] Pregnant women in some communities must travel long distances many times in at-risk state for special monitoring, regular checkups, delivery and follow-up care all of which put themselves and their child in danger resulting in the death of one pregnant woman.[23]

From an economic perspective, healthcare dollars normally spent in the local community are now traveling with the patients, and are spent and invested elsewhere. In addition, the lack of access to healthcare providers also effects New Mexico businesses’ bottom line. Employers spend over $255.8 billion each year due to worker absenteeism caused illness and chronic diseases for themselves and family members, and sick employees who return to work before getting well.[24] Lack of access to healthcare providers also negatively impacts our children’s success in school and their academic future.

New Mexico’s Behavioral Health Workforce Crisis

New Mexico mental and behavioral health providers, and their patients, have arguably suffered most from the provider shortage. In 2013, the New Mexico Human Services Department halted funding to 15 behavioral health providers in response to allegations of Medicaid fraud. Since then, all of the providers have been cleared. During the investigations, the fiscal implications of being shut down meant that behavioral health providers had to either settle for a hefty amount or close their doors, leaving regions around the state scrambling to fill gaps in mental health and substance abuse treatment programs. [25] Some clinicians lost their jobs or relocated, and thousands of patients experienced a disruption in services.[26]

Since that time, to attempt to ameliorate the shortage of mental health professionals, the UNM School of Medicine has established a dedicated track that helps prepare and attract psychiatry residents to practice in rural areas.[27] The program spans all four years, with senior residents working at tribal clinics and community mental health centers two days a week for at least six months. Nearly 40 percent of these rural-track psychiatry residents ultimately practice in rural New Mexico, compared with 10 percent of other UNM psychiatry residents, according to a study published in 2014.[28] In 2017, UNM also received a $7 million National Institutes of Health grant to open a new behavioral health research center. The goal of the center is to make a measurable impact in preventing youth suicide, alcohol and drug misuse, and depression in vulnerable populations, while also improving access to behavioral health services and growing a diverse behavioral health workforce.[29]

Financial Aid for Healthcare Students

Students aspiring to become healthcare professionals must contend with the cost of higher education and especially for more advanced degrees. The average medical school debt of $166,750, repaid in 30 years at 7.5 percent interest, ultimately costs $419,738.[30] The state offers a variety of student loan programs to help make attaining a health professions degree possible.[31] In FY17, advanced practice nurses, clinical psychologists and other mental health providers were considered the priority professions for funding distributions. Medical professionals, dentists and allied providers also received awards. Loan for service and repayment programs have been shown to be the most effective in retaining health professions students in New Mexico.[32] However, the loans amounts have not kept pace with rising education costs.[33] In addition, current loan amounts leave little if any remaining funds for students to cover housing, food and other living expenses.[34]

Examples of loan programs include:

  • Loan for Service programs for allied health professions, medical, nursing, teaching or minority doctoral students (Allied Health is a term used to describe the broad range of health professionals who are not doctors, dentists or nurses.)
  • State loan repayment programs that help students repay outstanding student loan debt
  • Health Professional Loan Repayment Program (HPLRP) providing assistance for practicing health professionals in exchange for service in underserved communities including rural areas
  • Western Interstate Commission on Higher Education (WICHE) loan-for-service program that reduces out-of-state tuition for New Mexico dentistry and veterinary students, since our state does not offer those degrees

The good news is that there are many eligible applicants for these programs. Unfortunately, there are not enough funds to provide awards to all eligible applicants, and the value is diminishing due to rising higher education costs. During the FY17 application cycle 29 of the 114 eligible applicants for the state loan repayment program were offered awards, which benefited 15 of the state’s counties.[35] For the state Loan for Service Programs, only 55 percent of eligible applicants received awards. In addition, six years ago, some loan programs generally covered 40-50 percent of costs now cover only 20-25 percent.[36]

Best Practices and Recommendations

Our state has available jobs, a high demand for healthcare professionals, and healthcare education and training programs, so how do we keep and bring students here fill those positions?

While it would be helpful to increase New Mexico’s Medicare and Medicaid reimbursement rates and reduce restrictions on residency programs, the state has little control over these federally controlled items and this is unlikely to change.

Next, support programs and efforts that are working. For example, loan repayment programs are by far the most effective way to recruit and retain students and graduates of health professions.[37] To recruit physicians, offering a 1:5 staffing ratio of physician to mid-level and allied health providers, and limiting “on call” requirements to a maximum of every third weekend can also be very effective. Healthcare services entities in New Mexico are able to successfully recruit out-of-state providers using various recruitment strategies some of which include loan repayment opportunities. For example, New Mexico Health Resources, a nonprofit healthcare recruitment agency, is able to recruit approximately 65 out-of-state providers each year using a number of strategies.[38]

NM Health Care Work Force Committee Recommendations

The New Mexico Health Care Workforce Committee developed a number of recommendations:[39]

  • Support further exploration of Medicaid as an avenue for expanding residencies in New Mexico.
  • Position the Higher Education Department to take full advantage of the next opportunity to reinstate the U.S. Department of Health and Human Services matching grant to support New Mexico’s state loan
  • repayment program.
  • Continue funding for primary and secondary care residencies in New Mexico.
  • Increase funding for state loan-for-service and loan repayment programs, and consider restructuring them to target the professions most needed in rural and underserved areas rather than prioritizing those with higher debt.
  • Request that the Department of Health add pharmacists, social workers and counselors to the health care professions eligible for New Mexico’s Rural Healthcare Practitioner Tax Credit program.
  • Provide funding for the New Mexico Health Care Workforce Committee to continue its work and better identify true access gaps allowing limited funds to be better prioritized.
  • Develop reimbursement mechanisms through Medicaid for services delivered by behavioral health interns in community settings.
  • Expedite direct services via telehealth by participating in interstate licensing compacts when available

Sun Path Consortium Recommendations[40]

To strengthen, sustain, and expand college career pathways after SUN PATH TAACCCT funds expire, college and workforce leaders from across the consortium recommend the following:

  1. Strengthen the focus on the critical role community colleges plays in meeting the state’s workforce needs through the following state and individual college strategic plans:
    • Expand capacity to deliver additional workforce training programs at community colleges.
    • Sustain and expand the strategic partnerships among higher education, the Department of Workforce Solutions (DWS) and community and regional employers.
  2. Partner with Adult Education programs to expand the Integrated Education Training (IET) model to entry-level certificates. IET programs support academically under prepared adults to obtain industry credentials in high demand occupations.
  3. Embed entry level certificate programs into associate degree programs to create career pathways with stacked credentials.
  4. Ensure that core industry competencies and assessments are included in academic curricula that prepare students to obtain industry recognized credentials.
  5. Expand partnership/collaboration between Institutes of Higher Education and Department of Workforce Solutions (DWS), regional workforce boards, and college campuses in the following ways:
    • Continue and expand the role of Job Development Career Coaches (JDCC) on campuses to serve as a link between colleges, workforce connection offices, and regional employers.
    • JDCCs train career services staff to use workforce readiness support services including the Workforce Connections online system (WCOS).
  6. Increase college student enrollment in and usage of Workforce Connections Online System (WOCS) resources.
  7. Expand sector specific employer advisory councils that meet regularly to ensure the relevance of workforce training programs.
  8. Train financial aid staff and advisors to access alternative financial resources for adults who lack a high school diploma or equivalency. Examples include Workforce Innovation and Opportunity Act (WIOA), Temporary Assistance for Needy Families (TANF), or demonstrating the Ability to Benefit to receive financial aid.
  9. Adopt a unified statewide career pathways system that aligns with industry sectors in the state and leverages existing resources, systems, and structures.
  10. Commit resources to the alignment of courses, course numbers, and CIP codes for programs that lead to the same industry credential across institutions. (Currently, they are inconsistent and all over the map which causes much confusion for students and systems in general).

Recommendations from Other Sources

Recommendations from other sources for strengthening the health professions pipeline include the following:

  • Recruit and train business and personnel managers who can implement innovative ways, beyond salary and benefits, that maintain and keep their healthcare workforce happy. Nationally, newly recruited providers stay an average of only 28 months.[41]
  • Better train health professions students in soft skills, providing more experience with patients throughout their education. This would help graduates better adjust to communities they serve and patient and providers overcome social barriers they may face.
  • Better prioritize state funds so that they also support a strengthened pipeline. (e.g. State funding for buildings does not inherently translate to more providers and improved access.)
  • Improve and expand marketing to students and families promoting existing health professions education programs and available funding.[42]
  • Expand the number of healthcare-focused early college high schools. As noted in Chapter 1, these schools aim to graduate students with both a high school diploma and an associate degree or credential.
  • Increase New Mexico Higher Education Department (HED) funding for nursing faculty.
  • Support expansion of the New Mexico Nursing Education Consortium’s efforts in bringing the Bachelor of Science in Nursing (BSN) to community colleges.

Faculty and Preceptorships

Recruiting and retaining healthcare professions faculty and preceptors remains a challenge. Two options include allowing our growing number of retired or near-retired nurses and physicians to more easily earn faculty status and better compensating provider preceptors. Currently, preceptors must manage their own heavy caseloads in addition to mentoring students.

Veterans - an Underutilized Workforce

Better transitioning veteran military medics into civilian healthcare jobs and education programs could alleviate rural provider shortages. New Mexico is home to over 46,000 veterans between the ages of 18-54, 64 percent of whom have high school through college degrees, and many already reside in underserved rural communities.[43] But veterans pursuing a career in healthcare often face significant obstacles including translating military training into college credit, having to retake classes or exams to meet state credentialing requirements, and navigating veteran education benefits.[44] (See Chapter 1 about Credit for Prior Learning programs for veterans in New Mexico.) Similar opportunities might also exist to better transition practitioners with international degrees and credentials into healthcare jobs.[45]

SUN PATH Consortium: A Community College Health Professions Best Practice

New Mexico could consider expanding the work of the New Mexico Skill UP Network Pathway Acceleration in Technology and Healthcare (SUN PATH) Consortium. Over the past three years SUN PATH, comprised of higher education and industry leaders, has developed programs throughout the state that accelerate students through community college healthcare training programs and directly into the workforce.[46] SUN PATH has served close to 3,400 students with over 2,300 credentials earned.

UNM Pipeline Programs: A Four-Year College and Beyond Best Practice

The University of New Mexico Health Sciences Center Office for Diversity coordinates educational pipeline programs focused on growing our own diverse healthcare workforce. These programs prepare underrepresented, underserved, and economically disadvantaged middle school through college students for health professions programs.[47] The programs provide health careers awareness and exploration opportunities, testing preparation and the chance to develop and hone critical thinking skills.

One of the most well-known pipeline programs is the UNM BA/MD program. Under the BA/MD program students earn a baccalaureate degree in a challenging four-year curriculum specifically designed to prepare them for medical school and to practice medicine in New Mexico. Upon graduation eligible students transition to the UNM School of Medicine to complete their doctor of medicine degree.[48] After completing their medical residency, many of these students return to practice in New Mexico.[49] (See Appendix H for a detailed listing of UNM programs.)

Collaborative Pipeline Programs:

Our state could also look to the examples of collaborative programs in which New Mexico higher education institutions are working together, sharing and coordinating resources to strengthen the state’s healthcare workforce. Some of these collaborative efforts include:

  • American Indians into Nursing Collaborative Grant, which prepares nurses to practice at Indian Health Centers
  • New Mexico Nursing Education Consortium, which advances a common, sustainable statewide nursing curriculum, increased numbers of bachelor and graduate nursing degrees in New Mexico, and a qualified, diverse and professional nursing workforce for rural areas
  • UNM/NMSU Cooperative Pharmacy Program, which aims to increase the number of pharmacy students from southern New Mexico to practice in the region

See Appendix H for additional details on these and other healthcare pipeline programs.

Student Case Study: Preparing for a Health Career

Fabiola Perez, UNM College of Pharmacy


Fabiola Perez’s parents instilled in her the value of education from an early age. Because of her family support, planning and initiative, today Fabiola is a first-generation graduate student at the UNM College of Pharmacy. During her undergraduate program she majored in biology with a minor in chemistry, knowing that those courses would prepare her for pharmacy school. Her career inspiration stemmed for her family’s unique challenges. “When my mom was pregnant my parents were in a car accident. My dad hurt his spine and I never saw him walk. I grew up helping my dad, and I wanted to help other people. That's why I chose to go into healthcare.”

Fabiola chose pharmacy because she loved chemistry and has since put her passion into practice with multiple internships and volunteer positions. Though Fabiola is used to figuring things out on her own, she recalls her educators always being a great help. In high school, teachers sat down with her and helped Fabiola come up with a plan for college and connected her with scholarships. She still seeks support from campus resources and takes advantage of more tutoring now then she did before. She recommends that higher education institutions offer plenty of these types of support systems. These include: in-the-field learning opportunities, faculty that make themselves available to guide students, and scholarships specifically for underserved students.

Intersections and Conclusion

Overall, the most successful health career pipeline programs strengthen services available to New Mexicans, foster in students a robust understanding of community needs and public health, and provide students with the tools, skills, knowledge and support they need to serve communities. The chapter points out that out-of-state provider recruitment and retention efforts are also important. It may be worthwhile to consider examples from other industries, and Chapters 4 and 6 offer examples. Regarding New Mexico’s own health professional programs, this chapter offers a snapshot of good examples. (See Appendix H for more.) These programs demonstrate a marked change in how New Mexico continues to evolve math and science education. Rather than educating students that “math and science are important” these programs are making the core curriculum relevant by integrating these courses directly into a program of study that leads to a career. This content connects with important data on STEM education in Chapter 6.

Fundamentally, New Mexico’s healthcare community, educators, students and policymakers can continue to map a path toward a more robust pipeline of health professionals, enriching our lives today and tomorrow.

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[1] (Krasnow, 2018)

[2] (N.M. Department of Workforce Solutions Economic Research and Analysis Bureau, 2015)

[3] (Russell, 2015)

[4] (Grassberger, 2017)

[5] (Krasnow, 2018)

[6] (N.M. Health Resources, 2018)

[7] (Harrison, 2018)

[8] (N.M. Department of Health and Allied Agencies, 2015)

[9] (Harrison, 2018), (N.M. SUN PATH Consortium, 2018)

[10] (UNM Bureau of Business and Economic Research, 2017)

[11] (Harrison, Jerry. NM Health Resources. Interview 2-12-18)

[12] (N.M. Health Care Workforce Committee, 2017)

[13] (N.M. Health Care Workforce Committee, 2017)

[14] (Dupont, 2018)

[15] (Harrison, 2018)

[16] (The Pew Charitable Trusts, n.d., Nash, 2013)

[17] (The Associated Press, 2017)

[18] (Albuquerque Journal, Roch, Shendo, 2017)

[19] (N.M. Health Care Workforce Committee, 2017)

[20] (N.M. Health Care Workforce Committee, 2017)

[21] (Dye, 2018)

[22] (Harrison, 2018)

[23] (Matlock, 2016)

[24] (Centers for Disease Control, n.d.)

[25] (Public Health New Mexico, n.d.)

[26] (Rashad, 2015)

[27] (Weiner, 2018)

[28] (Weiner, 2018)

[29] (Haederle, 2017)

[30] (Kristof, 2013)

[31] (N.M. Higher Education Department, 2017)

[32] (Harrison, 2018)

[33] (Harrison, 2018)

[34] (Hawker, 2018); (N.M. Higher Education Department, n.d.)

[35] (N.M. Higher Education Department, 2017)

[36] (Harrison, 2018)

[37] (Harrison, 2018)

[38] (Harrison, 2018)

[39] (N.M. Health Care Workforce Committee, 2017)

[40] (N.M. SUN PATH Consortium, 2017)

[41] (Harrison, 2018)

[42] (New Mexico First, 2008)

[43] (N.M. Department of Workforce Solutions, 2015)

[44] (Healthcare Daily Online, n.d.)

[45] (Baier, 2015)

[46] (N.M. SUN PATH Consortium, 2017)

[47] (UNM Health Sciences Center Office for Diversity, 2017)

[48] (UNM Health Sciences Center, School of Medicine, n.d.)

[49] (Romero-Leggott, 2018)

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