Models of Rural Medical Education

Community Medical Outreach Model Why wait, develop the physician servant leaders that we most need even before medical school.

Defining Rural Graduate Medical Education - some background for rural comparisons

 

Rural Curricula, Strategies, Guidelines

Rural Curricula         Rationale for Rural Programming        Strategies for Rural Medical Educators

Checklist for Rural Program Development   Guidelines for Rural Medical Education    

Objectives for National Organizations for More and Better Rural Physicians     Foundations of Continuous Programs

Statewide Objectives and Examples

Pre-Professional     

Examples of Pre-Professional Programs To Identify and Encourage a Rural Career     Health Advisors

Admissions

Admissions Summary

Best Models Admissions or Complete Rural School

Admit More      The Pitfall of the Brightest Students      Admit Older Students

Service Orientation

Medical School

Rural Student Interest Groups                   Rural Preceptorships, short and long term         

Rural Coordinators

Special Needs   

Community Service and Interdisciplinary

Minnesota's Rural Health School 

Nebraska's SEARCH program 

Wisconsin Rural Ambassadours http://www.medsch.wisc.edu/ahec/progachiev/ra.html

Faculty Development with a Rural Flavor

Rural Faculty Development: Facilitating Town Plus Gown  The Minifellowship in Rural Family Medicine

Faculty Development                              

Rural Faculty Meetings Agenda            

Rural Medical Fellowship

Rural Health Info Clearinghouse, Mercer, Georgia.

To Graduate Programs

Rural Workforce and Health Policy in the United States

 

Admissions significant with continuation beyond - Perennials vs Annuals

Physician Shortage Area Program Jefferson/Rabinowitz  - down to 7 a year from 14 average

Duluth consistent 40 50% FP choice across student birth origins from most urban born to rural born

Rural Scholars Programs

            Alabama 

            Dartmouth

            U Mass at Worcester

Nebraska Rural Health Opportunities Program RHOP - slight increase to 10 - 12 a year admitted from rural high schools (since rural admissions are otherwise decreasing)

Florida State University Students Get Started   focus on rural, minority, geriatrics throughout

Virginia Commonwealth University School of Medicine's Dept of Family Medicine - see below also in rural plus minority

Osteopathic schools admit rural born and older at highest levels, clinical and hands on early, family medicine focus

North Texas Osteo with special rural track

West Virginia Osteopathic entire rural focus in location, training, and outcomes, backed by 36.9% of 1112 graduates in rural locations in 2005.

MedStep: students jointly accepted at WVU School of Medicine and Shepherd University. While undergraduates, students participate in clinical experiences and select educational experiences at the WVU Rural Family Medicine Residency Program.

ETSU

Brody/East Carolina

Tulane new

LSU New Orleans new for 10 students a year

RMED U of Ill Rockford admissions, branch, rural clinical

Mercer - reaching out to rural regions, networks http://www.mercer.edu/publications/Medicine/fall99/pg6.html
WWAMI overview http://www.washington.edu/medical/som/wwami/

A study of the best models for training and retaining physicians for underserved areas from MGT to FSU http://med.fsu.edu/pdf/02_train_retain_phys.pdf also saved in private file

Western Australian Center for Remote and Rural Medicine

Rural plus minority

Most critical need as these are the areas in greatest shortage, also the least likely to gain admission. With the exception of natives, 90% of underrepresented minorities are born in areas of over 1 million, rural has a tough enough time at 1 in 360 admitted, 1 in 500 for rural males, 1 in 400 for blacks, even higher for black males, Hispanic, and Mexican American. Rural plus minority probability of admission basically falls to near zero while distribution of the lowest income most different students to rural and poverty primary care approaches 100% (for those who do manage admission and choose FP).  Whites, urban born, Natives admitted at 1 out of 200. Asian Indian is 1 medical student admitted out of 20 who are age 18 24 according to the 2000 census. Asian Indian includes the highest income levels, the most educated parents with the greatest attainment of professional degree, the most urban origins, and likely the least previous contact with rural or family medicine. It is likely that whites of the same parameters have the same choice and those in elite allopathic schools have similar choices.

Rural Scholars Programs - Alabama
Duluth Native Americans
North Dakota Native Americans
Morehouse - only school to hold its own with rural born admissions or even slight increase, all other osteo and allo schools have decreased with worst decreases among those in states with 40 50% of their population rural, slightly less decline for schools with a rural mission, but still decline, total decline from 27% decades ago to 9.6% born in nonmetro locations in recent years (Masterfile has 97% of allopathic birth origins, less in black, Puerto Rican, osteopathic, Caribbean).
See also First Annual Community Award for Morehouse

Virginia Commonwealth University School of Medicine's Dept of Family Medicine sponsors the Inner City/Rural Preceptorship Program. We have 10 students from each year, 40 all together involved in electives, learning activities, and preceptorships all four years of medical school. Of the graduates from this program 1/2 have chosen family medicine, 3/4 primary care. We are now beginning to work on securing seats in each class for these students, for the last several years we recruit from the incoming class. We have requested to be considered as a certificate program which would be granted at the time of graduation to all who completed the program goals. We are also building a pipeline with community colleges, rural colleges, and HBC's. michelle whitehurst-cook predoc director  Michelle Whitehurst-Cook mwcook@hsc.vcu.edu
 

Addressing the Needs for Rural Minorities
Challenges to Primary Care: Serving the Underserved
Impact of Academic Distancing
Going Global - Student Efforts in International Health

Minority Data: Entry, Faculty,Title VII

Older student admissions (have 50 100% greater choice FP and rural)
    U of New Mexico - 1 year prep course with guaranteed admission 

Required rural clinical

            Nebraska 2 months rural FP in M-3,  3 wks M-1but more escaping this

            Mercer rural FP is first clinical rotation

            Upper Peninsula

 

Rural Preceptorships

            Wisconsin

            Nebraska Rural Family Practice Preceptorship

            Texas

            Georgia

            South Dakota

            North Dakota

 

Branch Campus/Integrated Decentralized

            Upper Peninsula

            Terre Haute

            Trover/ U Louisville

            Rockford Rural Health Needs Challenge Doctors

            U Washington

            NC AHEC efforts

            Arkansas AHEC efforts

            West Virginia partnerships

            North Dakota

            Binghampton

            Tuscaloosa

            West Virginia U Eastern Campus

 

Elective rural early

            RUOP Long Term Effect of FP Curric Pathway U Washington - down in numbers

 

Longitudinal Elective rural track

 

Rural Campus

            ETSU Mountain City and Rogersville

            Trover Madisonville U of Louisville

            Upper Peninsula Michigan

            Med College of Georgia Faculty without walls

            North Carolina

            Edward Via

            West Virginia Osteopathic

            Worchester U Mass

            U of New England Osteopathic

            Dartmouth

            North Dakota

            South Dakota

            West Virginia U Eastern Campus

            Interdisciplinary Efforts such as Shiprock NM and U of New Mexico

            WWAMI Rural Locations   WWAMI overview http://www.washington.edu/medical/som/wwami/

            Numerous FP Residency sites in rural areas used for student training

 Statewide Focus

Preprofessional health careers

Accelerated Rural Track in Nebraska Begin in medical school, focus on rural prep, final year is rural/procedural fellowship year, 7 years of total training     Meeting the Needs of Underserved Rural and Inner City Areas with Accelerated Graduate Training

Rural Scholars: special intensive MS IV curriculum + stipend for students committed to WV FM residency program and practice. Program operating on all 3 WVU clinical campuses. Since inception 3 awardees 2004, 6 awardees year 2005.

Graduate Consortia

 

Graduate rural tracks

The Family Medicine Residency in Spokane offers student rotations both in Spokane and also our RTT sites in Colville and Goldendale WA. Students can spend a few days up to a few weeks in any or all of these sites. These experiences are coordinated by our Residency Coordinator, Deanna McRae in Spokane. Of course all FMS residents spend 1 of their 2 rural months in either Colville or Goldendale and the RTT residents spend 2 years in either Colville or Goldendale

"Maudlin, Robert K." <MaudliR@fammedspokane.org>

            Rural focus
            Rural location
            Rural Training Track
            Accelerated Rural Track
            The CORE Program - using graduate rotations to meet rural needs, and train

Integrated Rural Training Track in Ohio ("2-2-2" where residents are based in the rural location, and go to the urban center for specific immersion experiences for 7 months over 3 years)

WVU Rural Family Medicine Residency Program: in 10th year of accreditation.

WVU Rural Geriatric Medicine Fellowship: Part of WVU Rural FMRP and accredited in 2004 with 1st fellow starting Oct 2005. First Geriatrics fellowship program in the state.

WVU Rural Family Medicine Fellowship Program: created in 2004 to provide a longitudinal distance learning + on campus rural residency program delivered curriculum to new practitioners whose first practice site is at a rural FQHC or private clinic in the eastern panhandle of WV.
 

Physician Workforce Studies

 

www.ruralmedicaleducation.org

 

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