About Site & Author
Robert C. Bowman, M.D.
World of Rural Medical Education Web site
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Most active and updated area: Physician Workforce Studies
This web site is not affiliated with any institution of higher education or medical association.
The World of Rural Medical Education Meets Distributional Medical Education
More and better physicians that stay longer where they are most needed...
Family Medicine Central: National Comparisons of Workforce
Launching a Not For Profit - Infrastructure America Website
Dedicated to rebuilding Human Infrastructure in America - teachers, nurses, public servants, family physicians
Our nation, by its policies in nurturing, child development, education, admissions, higher education, college, education funding, medical education, insurance, and health - is a market forces machine for concentrating physicians. Those admitted and entering the nation as physicians are the most likely to be found in zip codes that already have 400 - 1500 physicians per 100,000, levels already above the 300 physicians per 100,000 that is the national average.
About 50% of the physicians entering the United States have origins outside of the United States or have a parent who was born outside.
Serious problems exist in birth to admission in America, yet we hear nothing. Child developers, those involved in secondary education, those who test American children, and those who study higher education agree that there are serious problems, and still we hear nothing. Medical education experts claim that medical school debt impairs career choice. Actually birth to admission changes have prevented lower and middle income children, rural children, and children born in America from a reasonable birth to age 6, education with opportunity, and higher education with medical school only the final barrier. Barriers to medical school, for those that do manage to overcome lowest probability of admission, are best reflected in age at medical school entry. Those without barriers are the youngest, age 21 - 22 at admission. Those with increasing barriers are 28, 29, 30... Those most likely to be found in rural locations, underserved locations, primary care, family medicine, and psychiatry are older at admission. Medical schools have yet to discover that those with more life and health experiences are a very good choice. The best graduate business schools have known this for decades.
Any medical school can graduate subspecialists and physicians for zip codes with 75 - 1000 physicians.
Few medical schools have success with physician distribution but their success is consistent.
The Historically Black, osteopathic, and distributional allopathic public schools have followed the principles of physician distribution for over a century - admit medical students born and raised outside of concentrations, focus training away from concentrations of physicians, specialists, and health resources, graduate more of the family physicians that double or triple practice location outside, and focus on the coordination of policy to support health care for the 65% of the population outside of current concentrations and outside of the current health care design.
Distributional medical students, distributional medical schools, and distributional policies lead to distribution.
Distributional medical schools are capable of graduating every type of physician that top ranking MCAT schools can muster, in addition to the full range of physicians by specialty, location, and patient population. The top ranking schools are incapable of meeting even the most basic health care needs - primary care, care of the rapidly growing age 65 and up population, urban underserved primary care, women's health, rural specialties, rural pediatrics, rural general surgery, rural primary care, and other areas that rank at the top of current deficiencies of physician workforce.
Exclusive admission, exclusive training, and exclusive policy make health care access most difficult.
Distributional schools are capable of meeting the needs of over 90% of the population.
Top ranking schools are incapable of meeting the needs of the 65% of the population in most need of health care.
Distributional schools admit based on the best physician with a wide range of normal admissions, in other words those with slightly lower scores, those who are older who took time to overcome barriers of income and education, those who are older because they had life experiences and health experiences that can shape them into better physicians, those of lower and middle income levels with more service orientation that also match up to those in need of health care better, and those from lower and middle population density levels that are comfortable living outside of extreme concentrations of people. Distributional medical schools do not admit diverse students. They admit the least different students. Their students are normal medical students most representative of the full range of Americans. Graduates of Distributional Schools also have greater choice of family medicine, primary care, rural careers, and underserved locations.
Even elite schools can set up programs that admit, train, and graduate differently, but this is not a current focus. They have been warned. It is not a good idea to promote the current health care design to the elderly that are rapidly growing in numbers and percentage of the population, that have 70% or more living beyond physician concentrations that are left out in the physical plant design, that find it more and more difficult to find any physician for their basic health needs, or that have difficulty finding any physician in their area that will take Medicare. There are no easy solutions in sight. Billions invested in health access have been wasted.
Nurse practitioners and physician assistants are making the same departures from areas with concentrations of elderly in rural, lower income, and middle income America. They are following the came health policy that concentrates physicians.
The answers are not primary care, family medicine, or more physicians. The answers are about a basic health, education, and development plan for the entire nation, not the 35% doing well.
Education - the pipeline begins at the earliest ages for physicians and for better health care
Rural Medical Education index page
Best Works on Site Birth Origins Articles
Most frequent keyword - Getting into Medical School Advice About Getting Into Medical School, Also Teaching Quotes Holiday Quotes
Top Rated Google sites other than this page at Physician Workforce Studies, Rural Family Physicians, also family physician workforce studies, rural physician workforce, rural medical education, underserved physician workforce, and rural medical
Author's Favorites
The Invisible Faculty by Joseph Hobbs, M.D. - by permission from STFM
Academic Medicine's Season of Accountability and Social Responsibility, Butler - by permission from AAMC
Pendulum or Vortex - will we return, or have we taken out important foundations for health
Rural Interested Senior Medical Students 1995 from AAMC GQ data
On the Passing of Dan Marien, who continues to inspire me and much on this web site. Other Heroes in Medicine
To those who endure and overcome to gain admission, distribution, and service!