In family medicine residency programs, this is a most challenging approach as many programs operate in the here and now with little time for the future needs of the nation. Recruiting residents, retaining faculty, and maintaining funding are major concerns. Curriculum committees struggle to deal with changes in the availability of training resources, expansions in medical knowledge, and advances in technology.
It is a time of great challenge to family medicine. Health care crises continue to give opportunities to those who are prepared. The basic financing of medical education is being shaken with changes in reimbursement, graduate medical education, research, and other areas. If family medicine fails to respond, other entities can and will surely make the most of these same opportunities.
Family medicine organizations strain to deal with internal priorites. Rural physicians and rural practice were once at the core of the discipline. Rural values still elect AAFP Presidents and Doctors of the Year, but little substantive change in family medicine paves the way for more rural physicians. Program directors feel that they do a good job preparing residents for rural practice (AAFP Survey for Dr. Jane Murray), but others disagree. National committees have nearly excluded obstetrics in FP curricula in the past and even today. Rural is an afterthought in committees and conferences, despite the large number of rural family physicians in practice.
Although many residencies face an easy time in matching residencies, programs in the midwest and southeast, the most rural regions, still have difficulty in this key area. These programs must decide whether to widen their nets or concentrate in certain areas. These decisions all affect the residency's ability to train for rural practice.
Rural programs can be a major asset to FP programs. Rural programs can help with recruiting faculty and residents. They can help programs train residents more effectively. Rural programs can improve the funding base and broaden the political support for family medicine training, especially programs that emphasize obstetrics training.
Departments and residencies with the commitment, the faculty, and the resources can prepare physicians for rural practice. Rural program directors can make the difference in this effort. This information is for those who plan rural programs and those who will assist them.
See Table regarding different Rural Graduate Programs
Varieties of Graduate Programs By Program Type