The Rural Medical Scholars Program Study: Data to Inform Rural Health Policy

摘要

id="p1">Introduction: Medical education to produce rural physicians hinges on the characteristics of students, educational programs, and rural experiences. Family physicians are key components of rural medicine. This study tested the effectiveness of multiple, combined strategies of the Rural Medical Scholars Program to produce family medicine residents. id="p-2">Methods: We compared the relative effectiveness of the Rural Medical Scholars Program, family medicine–oriented branch campuses, and a traditional urban campus to produce family medicine residents using a prospective quasi-experimental design. Logistic regression was used to account for covariates. id="p-3">Results: The relative effectiveness of 3 educational modalities to produce family medicine residents was examined: Rural Medical Scholars Program (44.0%; odds ratio [OR], 15.6), family medicine–oriented branch campuses (18.9%; OR, 5.8), and a traditional urban campus (3.9%; OR, 1). These differences were significant (P .05) after controlling for sex, race, Medical College Admission Test scores, and graduation rate. id="p-4">Conclusions: The findings are consistent with the literature, which recommends multiple strategy interventions to produce rural physicians (e.g., admit rural students who have an interest in family medicine, use family medicine faculty, and provide rural experiences). Further study will determine whether rural practice follows training in family medicine among Rural Medical Scholars. class="kwd-group KWD">

>class="kwd-search" href="/search?fulltext=Evaluation&sortspec=date&submit=Submit&andorexactfulltext=phrase">Evaluation

>class="kwd-search" href="/search?fulltext=Family+Medicine&sortspec=date&submit=Submit&andorexactfulltext=phrase">Family Medicine

>class="kwd-search" href="/search?fulltext=Health+Policy&sortspec=date&submit=Submit&andorexactfulltext=phrase">Health Policy

>class="kwd-search" href="/search?fulltext=Residency+Choice&sortspec=date&submit=Submit&andorexactfulltext=phrase">Residency Choice

>class="kwd-search" href="/search?fulltext=Rural+Medical+Education&sortspec=date&submit=Submit&andorexactfulltext=phrase">Rural Medical Education

>class="kwd-search" href="/search?fulltext=Rural+Medicine&sortspec=date&submit=Submit&andorexactfulltext=phrase">Rural Medicine id="p-5">Current health policy deliberations have emphasized the shortage of primary care physicians in the United States, id="xref-ref-1-1" class="xref-bibr" href="#ref-1">1 which is a great concern in rural locales. Massachusetts created a sentinel event in health care policy by enacting universal health insurance that exposed the inadequate supply of primary care physicians needed to meet public demand.id="xref-ref-2-1" class="xref-bibr" href="#ref-2">2 Nine percent of physicians are located in rural areas where 20% of the population resides, id="xref-ref-3-1" class="xref-bibr" href="#ref-3">3 and only 3% of current medical school graduates plan to enter rural practice.id="xref-ref-4-1" class="xref-bibr" href="#ref-4">4 The increasing demand for primary care in populous areas brought about by broader insurance coverage promises to exacerbate this rural disparity. In 2005, Whitcombid="xref-ref-5-1" class="xref-bibr" href="#ref-5">5 forecasted the challenge to rural medical education (RME), while urban primary care physicians were also in short supply. RME includes purposeful efforts to produce rural physicians or an understanding of rural practice through adaptations in administration, policies, structures, faculty, and students, as well as programs of admission, financial aid, teaching, research, service, and outreach. A current policy question is: To what degree can RME be expected to alleviate the shortage of rural primary care physicians?