Form 2 Survey of NHSC Clinicians in Service (LPR)

2011 Survey of Current and Recent NHSC Loan Repayment Participants
This questionnaire is intended for clinicians of all disciplines who were serving (providing clinical work) in the National
Health Service Corps on September 1, 2010. If you were not serving in the NHSC on September 1st, please check the
appropriate box below and mail the questionnaire back to us in the enclosed envelope.
1. □ I was never in the NHSC—you have the wrong person
2. □ I had not yet begun serving in the NHSC as of September 1, 2010
3. □ I completed my NHSC service prior to September 1, 2010
Any explanation/elaboration? __________________________________________________________________
__________________________________________________________________

All others please complete the questionnaire. Thank You!

Use of identifiers and Reporting Burden
The information you provide will not be revealed to the NHSC or others in any way that can be linked to you, your community or
practice. All information provided will be handled anonymously and reported in aggregate. The identification number with this
questionnaire allows us only to keep track of the questionnaires as they are returned.
Public reporting burden for this collection of information is estimated to average 8 minutes. The OMB control number for this project is
XXX, expiration XX.

I. TRAINING AND EXPERIENCES PRIOR TO NHSC SERVICE
1a. In what state did you live most of your years before college?

State: ____________________

□ check if
no one place

b. In what type of community was this? (circle one)
1. urban

2. suburban

3. small town or rural

0. N.A., no principal place

c. In which state and year did you graduate professional school (e.g., medical or dental school)?
1. State: ________________________

2. Year of graduation: _______

d. For physicians and others who completed a residency:
In which state and year did you complete your residency? If more than one residency, report the last.
1. State: ________________________

2. Year of graduation: _______

2a. Did you have any formal training experiences with medically underserved populations during your professional
training? (circle number of all that apply)
0. No  If “no”, skip to 2c
1. Yes, as student
2. Yes, during residency or fellowship
b. How many weeks cumulatively were spent in these experiences?

___________ weeks

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c. Did you participate in the NHSC’s SEARCH Program as a student?

1. Yes

d. During your training, how much exposure did you have to:
(circle one number on each line)
None

0. No

Moderate
Exposure

Extensive
Exposure

1. community and/or migrant health centers?

1

2

3

4

5

2. rural health care?

1

2

3

4

5

3. inner city health care for the poor?

1

2

3

4

5

4. past and/or current NHSC clinicians?

1

2

3

4

5

3. What was your approximate outstanding educational debt when you completed your training? $ ___________

II. JOINING THE NHSC AND SELECTING YOUR FIRST NHSC SERVICE SITE
4a. When did you begin your Loan Repayment Program service? Month: _____ Year: _____
b. Were you serving an “amendment” (renewal/extension) contract with
the Loan Repayment Program on September 1, 2010?

1. Yes

0. No

c. Were you serving in the NHSC’s Half-Time Loan Repayment Program
on September 1, 2010?

1. Yes

0. No

d. How much do you agree or disagree with each statement below about your reasons for initially applying to the
NHSC Loan Repayment Program. (circle one response for each question.)
Strongly
Disagree
a. I needed financial assistance to pay off educational
debt.
b. I wanted to provide care to an underserved
population or area.

Neutral

Strongly
Agree

1

2

3

4

5

1

2

3

4

5

5. Where was your first practice/site where you began working as part of your NHSC Loan Repayment
Program service?
Practice/Organization name:

_____________________________________

City: __________________________ State: _________________________ Zip: _____________

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6. When did you begin working in this practice/site? Month: ____________ Year: ______

7. Were you already working in this practice/site when you applied for NHSC Loan Repayment?
0. No
1. Yes

 If “yes” a. about how many months had you worked
there before applying for loan repayment?

__________ months

b. when you decided to work in this practice, did
you know that you might be eligible for NHSC loan repayment?

1. Yes

0. No
8. Where would you likely have worked if you had not participated in the NHSC?

(circle all that apply)

a. in the same practice

d. in an underserved area

b. in a rural practice

e. in a community or migrant health center

c. in an inner city practice

f. other (specify): ___________________________

9. How important to you and your family were each of the following considerations when choosing to work in your
first NHSC practice/site? Did the practice and community you chose meet your needs?
(circle responses for both” importance” and “need met” on each line)
Importance
Not
important
a. Working with a specific socioeconomic or ethnic
population
b. Working at a specific, known site that you already
had in mind
c. Working in a specific area (e.g., near family or
in a particular state)
d. Having ready access to specific activities
like fishing, hiking, fine dining or theater

Need met at your
first NHSC practice?

Somewhat
important

Very
important

Yes

No

1

2

3

4

5

Y

N

1

2

3

4

5

Y

N

1

2

3

4

5

Y

N

1

2

3

4

5

Y

N

III. ABOUT YOUR FIRST NHSC SERVICE SITE
10. Which one of the following best describes your first NHSC practice/site? (circle one letter)
a.
b.
c.
d.
e.
f.
g.

community or migrant health center
rural health center
other primary care practice
Indian Health Service (IHS) site
tribal site
prison
city or county health department

h. dental practice—group or private
i. mental health or substance abuse facility
j. nursing home
k. university-based clinic or service
l. hospital-based clinic or service
m. Other (specify): ________________________

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11. How many patient/client visits or encounters do you have on
a typical day in all settings (e.g., office & hospital)?

__________ total visits per day

12. How many weekday evenings and weekend days on average per week
are you on call (apart from scheduled clinic hours)?
(respond “0” if you do not take call)

__________ days and nights
(maximum = 7)

13. How much do you agree or disagree with the following statements about your work in your first NHSC practice/site
while you are/were serving in the NHSC? (circle one number on each line)
Strongly
Disagree
a.

Neither Agree
nor Disagree

Strongly
Agree

I have good clinical back-up from more senior and/or
supervising clinicians at my practice.

1

2

3

4

5

I am able to provide the full range of services for which
I was trained and wish to perform.

1

2

3

4

5

c.

The practice has an effective administrator.

1

2

3

4

5

d.

Work rarely encroaches upon my personal time.

1

2

3

4

5

e.

I feel a strong personal connection to my patients.

1

2

3

4

5

f.

I feel I am doing important work in this practice.

1

2

3

4

5

g.

I feel a sense of belonging to the community where I work. 1

2

3

4

5

h.

Overall, I am pleased with my work.

1

2

3

4

5

i.

Overall, I am satisfied with my practice.

1

2

3

4

5

b.

14. How satisfied have you been with the following aspects of your first NHSC practice/site during the years you
are/were serving in the NHSC?
(circle one number on each line)
Very
Dissatisfied

Very
Satisfied

Neutral

a. your relationship with the practice administrator

1

2

3

4

5

b. financial stability of the site / practice organization

1

2

3

4

5

c. physical condition of the healthcare facility

1

2

3

4

5

d. your salary or income from your practice

1

2

3

4

5

e. availability of cross coverage to allow you to leave town

1

2

3

4

5

f. mission and goals of the practice

1

2

3

4

5

g. your access to specialist consultations for your patients

1

2

3

4

5

h. support by other clinicians working at the site

1

2

3

4

5

4

15. a. What was your annual salary or income when you began working in your first NHSC practice/site? $___________
b. What was your most recent or last annual salary or income in this practice?

$ ___________

□ no change; I am still in my first year there

16. Do you teach students or residents while working at your first NHSC practice/site?
1. Yes.  If yes, about how many half-days per month do you teach?

___________ half-days

0. No
17. How much do you agree or disagree with each of the following statements about the community where you lived
while working in your first NHSC practice/site? (circle one number on each line or “NA”)
Strongly
Disagree

Strongly
Agree

Neutral

Not
Applicable

a. My spouse/partner is happy in the community.

1

2

3

4

5

N/A

b. Satisfactory professional opportunities for my spouse/partner
are available in the community.

1

2

3

4

5

N/A

c. My children are happy in the community.

1

2

3

4

5

N/A

d. Satisfactory educational opportunities for my children are
available in the community.

1

2

3

4

5

N/A

1

2

3

4

5

N/A

e. My family is concerned about personal safety in the
community.

IV. JOB CHANGES AND YOUR FUTURE
18. Are you still serving in the National Health Service Corps?
A. Yes  If yes, when will you complete your current contract?

Month: __________

Year: __________

B. No  If no, did you . . . (circle one letter below)
a. satisfactorily complete your NHSC contract/obligation with service?
 If so, when did you complete your service?

Month: __________

Year: __________

b. defer your obligation?
c. go into default?
d. other: Explain: ______________________________________________________________

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19. Did or will you apply for a renewal (“amendment”) contract to extend your NHSC service?
1. Yes

0. No

2. Uncertain

20. Are you still working in the same practice where you first served in the NHSC?
1. Yes  Skip to question 22 below.
0. No

 If no, when did you leave your first NHSC site? Month: ______________ Year: ___________

21. Where do you now work and what kind of position is it?
□ Outside the U.S. (check the box only if outside the U.S.)
a. City: ____________________________ b. State: ______________________ c. Zip: _____________
b. Type of position: (circle one number)
1. Clinical work
 a. If clinical, approximately what proportion of your patients are covered under: (Numbers may
not total to 100%)
1. Medicaid ____%

3. IHS or tribal coverage ____%

2. Medicare ____%

4. uninsured

_____%

b. Does this organization focus on care for the underserved?

Yes _______ No ________

2. non-clinical work
3. in training (e.g., residency)
4. teaching
5. not working
6. other

22. The following questions are about your current career plans. Please provide a response on each line below.
Respond with a single year estimate if able, otherwise a range of years. Check “NA” when not applicable.
Looking ahead, how many more years do you think you will:
Single year estimate

Range of years estimate

a. remain in your current practice/site?

_____________

OR

_____ to _____

b. remain practicing in your current community?

_____________

OR

_____ to _____

c. remain in rural practice?

_____________

OR

_____ to _____

□ NA

d. continue practicing with a medically underserved
population?
_____________

OR

_____ to _____

□ NA

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V. YOUR BACKGROUND AND FAMILY
23. Year of birth:__________________
24. Your gender:

1. Male

2. Female

25. Are you of Hispanic origin?

1. Yes

2. No

26. Race: (circle all that apply)
1. White

4. Asian

2. Black or African American

5. Native Hawaiian or other Pacific Islander

3. American Indian or Alaska Native

6. Other: ________________________

27. Were you married or did you have a partner at any point while working in your first NHSC practice site?
0. No  If no, skip to question 28 below.
1. Yes
b. In what state did your spouse/partner live growing up? State:_______________ □ or check if no principal state
□ or check if outside the U.S.
c. In what type of community did your spouse/partner grow up? (circle one)
1. urban

2. suburban

3. small town or rural

0. Not applicable, no principal place

VI. YOUR RECOMMENDATIONS
28. What can the NHSC leadership and staff do to make the NHSC a better program for its clinicians?
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
29. What can the NHSC do to make it more likely that its alumni would continue to serve needy populations?
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________

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