Institutional mandate - an absolute
Directors, funding (hospital, state), faculty, institution
Rural Experiences to guide residents for months or years in rural locations
Supportive rural locations for block or longitudinal rotations, includes support from community, doctors, facilities
Rural faculty to do programs, advising, helping residents deal with career issues, helping to identify strengths, anticipating resident weaknesses that may cause certain difficulties
Site visits to rural communities, residents on rural rotations, preceptors, community leaders, to maintain and develop sites and anticipate problems and direct solutions
Keeping up with the state and regional scene in rural health, health systems, recruitment and retention, recruiting facilitation - making sure residents have every opportunity to choose a rural rotation at an underserved location, a not-for-profit, or a training site through fairs and trips and tours and presentations that connect academic and rural sites. This means keeping up relationships with rural and primary care entities - health dept, office of rural health, rural docs, primary care assoc, fp orgs.
Keeping up with personal clinical efforts - patients, procedures, to maintain respect from rural physician colleagues
Research on rural practice, primary care, rural medical education programs, rural communities, etc.
A priority on recruiting residents who are interested in rural sets the pattern for the next years groups to come. Residents help develop rotations and procedural opportunities, recruitment efforts.
Curriculum prep and evaluation - A rural curriculum and schedule encompassing the entire three years
Orientation - overview, rural faculty and their programs and research, purpose of program is providing docs for rural areas, opportunities for experiences and consultation and income involving rural, site visit to a rural area, talk by a rural doc or organization
Noon conferences/teaching days
Rural electives, selectives, and moonlighting opportunities
Support groups by year, career advisement
Practice Assistance and practice management training that follows and anticipates residents needs through the three years such as talks on rural modes of practice, variety of rural, rural facilities, loan repayments, residents present their decision process, present their practice plan, highlight what it will take to adapt to the local rural site, receive advice from faculty and fellow residents in this process, faculty follow up on graduates to assist in their adaptation to the site, address needs that the program did not provide in the 3 years.
Moonlighting - good sites not above the level of the residents and supportive of their needs (place to stay, information access, consultants, backup, extras). Faculty go out to check out new or questionable sites.
Rotation objectives - more hands-on decision making and procedures
Use community medicine as a rural opportunity - schools, public health, focus groups, preventive medicine, role of the rural physician in the community, working with organizations in the community - indigent clinics, community work
Leadership opportunities as a resident at the local, state, national level
Procedural training in rotations, on site, off site, and at the clinic
Top notch training in computers/informatics and research - great info systems
Core Topics for Consideration for Discussions and Lectures
Personal Management Issues
Communication and time management - saying no, later, delegation skills, negotiation
Support/balance issues regarding family, career, spouse, anticipated location
Training in self evaluation - advisors, peers
Separating personal issues from problem solving when dealing with patients, personnel, practice, community leaders, bosses
Recognizing and dealing with individual characteristics that may lead to burnout
Training in group support
Institutional, facility, state, director, and faculty support - a commitment to work with and in rural communities
Leadership - Director and key faculty support and vision Directing Rural Programs - the big picture
Rural faculty and staff, faculty w/rural practice experience & personal commitment
Rural curricula
Rural community and physician support
Relationships with rural and primary care organizations
Rural-oriented residents
Procedural training
Rural practice management training
Good rural moonlighting sites
Address adaptation, personal management, balance/support issues