Dear colleagues and supporters,
Thank you for the work you do for your patients and as advocates for medical freedom in North Carolina. Here is a short update on rural health, life issues, and a few national items that need your attention.
Rural health: someone has been listening
North Carolina now has several 2026 incentives aimed at bringing and keeping physicians in rural and underserved areas.
- NC Primary Care Physician Incentive (NC PCPI): Up to $100,000, with a commitment of up to four years, for physicians in independent private practice in Tier 1 and Tier 2 distressed counties.
- North Carolina Loan Repayment Program (NC LRP): Up to $100,000 for physicians and dentists, and up to $60,000 for nurse practitioners and physician assistants, for a four-year service commitment.
- National Health Service Corps Loan Repayment Program: Up to $50,000 for a two-year commitment in a designated Health Professional Shortage Area.
- North Carolina High Needs Service Bonus: Taxable bonuses up to the NC LRP limits, including up to $100,000 for eligible physicians who no longer carry educational debt and begin service within five years of applying.
We are grateful for these tools. Rural patients still need physicians who will stay.
Medical Freedom Summit
On September 12, North Carolina Physicians for Freedom and the VA Medical Freedom Alliance co-sponsored a sold-out conference, Saving Life and Preserving Medical Freedom.
Dr. Paul Marik, co-founder of the Independent Medical Alliance, gave the keynote. Dr. Bose Ravenel, an NCPFF advisory board member, gave a strong presentation (attached) on vaccine efficacy. That talk will be posted on the NCPFF website.
Foreign physicians: still a concern
A state pathway now allows experienced international medical graduates who hold an active foreign license and meet set clinical requirements to obtain a temporary license in designated rural hospital areas (population density under 500 per square mile) without a U.S. residency or the usual exams. That temporary license can convert to a full license after four years. NCPFF continues to watch this closely.
New Match numbers sharpen the concern. In the 2026 Main Residency Match, 9,682 international medical graduates filled PGY-1 positions, about 23 percent of positions filled. Non-U.S. citizen IMGs alone accounted for 11,944 active applicants and 6,733 matched positions. The concentration is heaviest in primary care: about 40 percent of categorical internal medicine positions and about 28 percent of family medicine positions went to IMGs. U.S. MD and DO seniors still match at rates above 90 percent, but a growing share of the training slots that feed rural and underserved practice is going to physicians trained outside the United States. Opening a second door around residency, as this licensing pathway does, makes that imbalance harder to justify.
NC Right to Life scholarship
NC Right to Life will sponsor a fourth-year medical student planning a career in obstetrics and gynecology to attend the annual American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG) MEBEC Conference. The grant is valued at $3,000. The student may be asked to give a five-minute talk at the annual Prayer Breakfast and/or the NC Right to Life Rally and March for Life.
Students who are interested should contact Dr. Bill Pincus at Bill.Pincus@ncrtl.org.
Watch list: HB 410, medical aid in dying
HB 410 was debated again in the 2025–2026 session. Assisted suicide is now legal in 11 states. Supporters promise dignity, personal control, and a record free of coercion. That record does not hold.
NCPFF is disappointed that several Republican legislators support this bill, including Rep. Donny Lambeth, a key sponsor. This is not a slippery slope. It is a direct attack on the sanctity of life, and North Carolina should reject it.
National: say no to the new CDC COVID recommendation
On September 23, without a public announcement, the CDC updated its guidance to recommend a 2026–2027 COVID vaccine for all adults and, through “shared clinical decision-making,” for healthy children as young as 6 months: https://www.cdc.gov/covid/vaccines/stay-up-to-date.html
NCPFF joins Dr. Peter McCullough and the Independent Medical Alliance in calling for this guidance for healthy Americans to be withdrawn.
You are what you ate
A new report looks at how quickly junk food changes the brain: https://substack.com/home/post/p-217476895
HHS grant-review opportunity
NCPFF has been asked to recommend reviewers for Adolescent Sexuality and Reproductive Health grants. HHS prefers reviewers with a medical background, but that is not required. The review is remote, is likely to begin in late November, and should take about a month. The position is compensated.
If you are interested, contact Dianna Lightfoot at dlightfoot@ncphysiciansforfreedom.com.
Thank you for your partnership in this work. Your donations are appreciated and necessary for our work to continue. Please find our donation link here.
Emily Saunders
Network Director
NC Physicians For Freedom
