; and (bb) submits an application to the Secretary during such period containing such information as the Secretary may specify. (II) Shortage specialty program The term shortage specialty program means, with respect to a hospital located in a geographic area (as defined by the Secretary), any approved residency training program in a specialty for which the Secretary determines that there is a shortage of physicians practicing such specialty in such area at the time such program is established. In making such a determination, the Secretary shall take into account whether such hospital is located in an area— (aa) without adequate health care resources (such as in a rural area or a medically underserved area (as defined by the Administrator of the Health Resources and Services Administration)); (bb) experiencing primary care or specialty physician shortages (such as in a health professional shortage area (as defined in section 332(a) of the Public Health Service Act ( 42 U.S.C. 254e(a) ))); (cc) without an adequate number of approved residency training programs; (dd) struggling to expand or keep approved residency training programs operational; (ee) lacking existing medical training infrastructure or in the process of building such infrastructure; (ff) with a low resident-to-population ratio; (gg) with few full-time equivalent resident positions; or (hh) with a low physician-to-population ratio for physicians practicing in the same specialty as the shortage specialty program concerned. .