Higher local income and farm scale are associated with greater odds of veterinary loan repayment program rural shortage situation placement

Objective: To identify nomination-level and contextual factors associated with whether USDA Veterinary Medicine Loan Repayment Program (VMLRP) shortage situation nominations are filled by an awardee veterinarian. Methods: Type I (at least 80% food animal practice) and Type II (at least 30% food animal practice in a rural area) VMLRP shortage situation nominations submitted from fiscal year 2010 through fiscal year 2021 (n = 2,163) were analyzed in a retrospective observational study; Type III (public practice) nominations were excluded. Logistic regression models were estimated to predict fill status (filled vs unfilled). Nomination-level predictors included shortage type (Type I vs Type II) and carryover status (unfilled in prior year). County-level agricultural and economic factors were also included. Results: Annual fill rates ranged from 19.3% to 36.8%. Carryover nominations were less likely to be filled. Higher per capita income, greater number of farms, and larger cow and heifer inventory were positively associated with fill. Type I nominations had modestly higher fill odds than Type II. Conclusions: VMLRP nomination areas with higher local per capita income, number of farms, and cow and heifer inventory and that do not have a carryover nomination status are more likely to be filled. Regional differences in fill rates persisted after adjustment for measured covariates. Clinical Relevance: Loan repayment incentives were most effective where local market conditions support practice viability, suggesting that greater incentives would be needed to recruit veterinarians to low-income or small-scale agricultural areas. These findings can inform how VMLRP shortage situations are designated and prioritized to improve veterinary workforce placement in underserved rural areas.