Alex Mostella drove by the construction site behind Cape Fear Valley Medical Center in Fayetteville every day for the past two years on his way to work as a medical scribe at an eye-care clinic.
When Mostella learned that the steel beams and paved lots would become the Methodist University Cape Fear Valley Health School of Medicine, his goal of becoming a doctor took shape.
Mostella was among more than 1,500 applicants for the school’s inaugural class that will start in July. He got in, along with 63 other students. Last month, as part of the school’s Accepted Students Day, Mostella toured the now-completed facility where he will spend the next four years working toward a medical degree.
“Being able to see, off in the distance, this being built and that’s where the next stop is for you, that’s where you want to go—it was an incredible experience being able to walk into that building,” Mostella said.
The new medical school is the sixth in North Carolina. But there could soon be a seventh: The University of North Carolina Wilmington plans to open a medical school in 2029. Meanwhile, Wake Forest University School of Medicine in Winston-Salem launched a campus in Charlotte last year.
University and health officials say the new schools are necessary because North Carolina does not have enough doctors to care for the 11 million people who live in the state, particularly those in rural communities. The state is predicted to be short more than 7,000 doctors by 2030, said UNC Wilmington Chancellor Aswani Volety.
While the state faces a doctor shortage, the number of medical school applicants far outpaces the spots available. More than 32,500 people applied last year to the medical schools at UNC-Chapel Hill, Duke University, East Carolina University, and Wake Forest, according to the AAMC, formerly known as the Association of American Medical Colleges. Only 637 were accepted.
The UNC School of Medicine admitted 230 students last year, its largest-ever class. ECU’s Brody School of Medicine will increase its first-year enrollment cap from 100 to 120 students in 2027, and eventually increase it to 160.
North Carolina isn’t the only state experiencing a medical school boom amid record-breaking enrollment nationwide. The number of accredited medical schools in the United States grew from 123 in 2006 to 163 this spring, according to the AAMC. At least five new medical schools or campuses have been announced this year, from Florida to Indiana, Becker’s Hospital Review reports.
“There is no question about the need or the deficit in the state,” Volety said. “While I can’t fix the entire state’s problems, at least I can address something in my region.”
Critical Need
Mostella, 33, didn’t always plan on becoming a doctor. After graduating from Village Christian Academy in Fayetteville in 2011, he enrolled in college courses on and off while working as a freelance apparel designer for Adidas and other companies.
He eventually earned an undergraduate degree in biology in 2024 from Methodist University, a private school with more than 2,300 students.
But when the COVID-19 pandemic began, Mostella said he felt called to help others in a new way. He applied to Campbell University’s Jerry M. Wallace School of Osteopathic Medicine in 2024, but didn’t get in. He took a job at Cape Fear Eye Associates to get medical experience.
Methodist University Cape Fear Valley Health School of Medicine is a short drive from Mostella’s home, where he lives with his wife and their two children.
“Growing up, I wouldn’t have thought that anyone would have seen merit in putting a medical school in a place like Fayetteville,” Mostella said. “Not because it didn’t need one, but because sometimes, when you’re from a place, you have a more narrow scope of it.”
Dr. Hershey Bell, the medical school’s founding dean and the Cape Fear Valley Health vice president and chief academic officer, said opening a medical school is a matter of pride. The health system is the eighth-largest in the state with eight hospitals in Bladen, Cumberland, Harnett, and Hoke counties.
“For the health system and the community, to realize that of the only 160 or so medical schools in the entire nation, one exists in our city, our county, our region, is awe-inspiring,” Bell said.
It’s also about meeting a critical need. Many counties in eastern North Carolina are among the least healthy in the state. Nearly every county east of Interstate 95 is considered a health professional shortage area by the U.S. Health Resources and Services Administration. Thirteen counties don’t have any general surgeons, according to the North Carolina Health Professions Data System. Eleven don’t have a single OB-GYN.
The region has disproportionately high death rates from conditions like heart disease, diabetes, and stroke. Residents born in eastern counties, including Robeson and Edgecombe, have some of the lowest life expectancies in the state, according to the N.C. Department of Health and Human Services.
“While I can’t fix the entire state’s problems, at least I can address something in my region.”
Aswani Volety, UNC Wilmington Chancellor
Volety said UNC Wilmington, 115 miles from Fayetteville, has long aimed to address the shortage of health care workers in the southeastern corner of North Carolina. He sees a new medical school as an effective way to meet the challenge. The UNC Board of Governors voted Thursday for the project to move forward.
“UNCW has spent decades building strength in the health sciences and forging deep community partnerships,” Wendy F. Murphy, chair of the board, said in a news release. “This is a thoughtful, future-focused opportunity to expand students’ access to medical education, strengthen the healthcare workforce in the region, and create lasting impact across North Carolina.”
UNC Wilmington predicts that more than 2,000 students will apply to the school’s inaugural class. Sixty will be accepted and will work toward a traditional four-year medical degree or finish on an accelerated three-year track.
Currently, an inadequate number of medical school spots is hindering qualified students from becoming the state’s next crop of doctors, Volety said. “You have to grow your own. Expanding access locally helps retain the talent locally, and also strengthens the future physician workforce where it is needed the most.”
Geoffrey Young, who leads AAMC’s Transforming the Health Care Workforce Unit, described the nation’s medical school applicant pool as strong. The average applicant in 2025 had an undergraduate GPA of 3.67 and an MCAT admission test score of 506.3 out of 528, slightly higher than in prior years, according to the nonprofit organization.
While North Carolina’s medical school applicant pool grew by 58% and became more competitive over the last 12 years, the number of seats increased by less than 22%, according to UNC Wilmington’s proposal.
Keeping Doctors Close to Home
But is it possible for eastern North Carolina to have too many medical schools?
Bell said there is “room and need for multiple institutions.”
“Health care workforce shortages are not challenges one institution can solve alone,” he said.
Fayetteville is the sixth-largest city in the state, and Wilmington has experienced major growth in recent years. Nearby Brunswick County is one of the fastest-growing counties in the nation; its population increased 4.7% between 2024 and 2025.
But much of the region is home to farmland and small communities. It can be tough to recruit and retain medical professionals to rural areas, where salaries typically lag behind those in bigger cities, and some hospitals lack cutting-edge technology.
“If I can continue my training over the course of my career here and then begin my career as a physician here—in a perfect world, that would be what I would want.”
Alex Mostella, incoming medical student
Officials with North Carolina’s medical schools say they want to enroll in-state students who will hopefully stick around to serve their own communities. Methodist University offers two scholarships for students from southeastern North Carolina who want to pursue a medical degree. It has another scholarship for Cumberland County residents.
ECU opened its medical school seats to out-of-state applicants for the first time last year. But North Carolinians still make up 100% of its incoming 91-person class, according to the AAMC.
“The Brody School of Medicine has a very specific mission that appeals to those who go into the profession—to heal and care for people who need us most, often the most vulnerable communities in any place, including right here in North Carolina, rural communities and residents who are historically underserved by medicine,” said Dr. Jason Higginson, dean of the medical school and chief health officer for ECU Health.
Thirty-nine percent of North Carolina’s medical school graduates remain in the state, according to 2015 research from UNC-Chapel Hill’s Cecil G. Sheps Center for Health Services Research.
“By training physicians in the communities they serve—both urban and rural—we increase the likelihood they will remain in the state, helping improve access to high-quality care statewide,” said Dr. L. Ebony Boulware, Wake Forest University School of Medicine’s dean and chief academic officer at Advocate Health.
Post-Graduate Training
On average, North Carolina’s five medical schools that offer doctor of medicine degrees saw almost 37% of graduates stay in-state for post-graduate residency training this year.
UNC School of Medicine had the highest percentage with about 45%, according to the school’s Match Day results, followed by ECU’s Brody School of Medicine with 42%. Wake Forest University School of Medicine had the lowest, about 28.5%. Match Day is the annual day in March when medical students learn where they will go for residency.
About 21% of last year’s Brody School of Medicine graduates accepted jobs at ECU Health in Greenville, according to Higginson. He said half of them chose primary care specialties, which are severely lacking in the region, according to the North Carolina Health Professions Data System.
“Our school was started in the 1970s with a very specific mission—to raise the number of primary-care physicians for the state of North Carolina,” Higginson said, particularly in rural and underserved areas.
Young, with the AAMC, said the cap on the number of residency positions funded through Medicare “remains a major bottleneck” to producing more doctors.
Medicare is the largest federal funder of graduate medical education, according to the U.S. Government Accountability Office. In 1997, Congress set a per-hospital cap on the number of Medicare-funded residencies to prevent a physician surplus. Now, there aren’t enough residencies to fill the nation’s projected shortfall of up to 86,000 physicians by 2036, Young said.
“Without expanding graduate medical education capacity, additional graduates do not translate into additional practicing physicians,” he said.
This year, nearly 90% of the 1,134 available residency positions in North Carolina were filled, according to data from the National Resident Matching Program. The state is creating more residency programs through funding from the UNC System Office and the federal Rural Health Transformation Program.
Nearly 65% of physicians who complete both medical school and residency in North Carolina stay in the state to practice, Sheps Center research shows.
Since UNC Wilmington does not have an affiliated hospital, it will likely rely on Novant Health, Goshen Medical Center, and other partners to offer residency positions. They will also provide students with clinical placements during medical school.
“My goal is that southeastern North Carolina will be a net exporter of doctors versus the net import of doctors that we currently are,” Volety said.
Laurie Whalin, president of acute care operations for the Novant Health Coastal Region, is optimistic UNC Wilmington’s medical school students will stay in the area to practice. That’s been the case with the university’s nursing program. Novant Health retained more than half of the program’s nurses last year, up from about 25% in previous years, according to Whalin.
Cape Fear Valley Health has about 75 residency positions for doctors available annually, Bell said. More are in the works.
Mostella said he’s especially interested in the ophthalmology program the health system is considering. Ultimately, he said, he hopes to stay in Fayetteville.
“If I can continue my training over the course of my career here and then begin my career as a physician here—in a perfect world,” he said, “that would be what I would want.”