Superselection is a term I use that represents the ability of an admissions process to choose students that not only will choose rural practice, but will stay in rural practice for years beyond the average 6 or 7. Superselection requires special dedicated admissions. Superselection is a concept that runs contrary to the standard recruitment and retention literature. The usual studies demonstrate no rural vs urban background differences in retention (Don Pathman studies).
Superselection is more than just generic rural, more than generic low income, and more specific for family medicine characteristics.
Superselection is aboutTop Workforce Outcomes Rankings
Duluth comes closest to the attempt to pick all of its students for rural family medicine. Even so only about 45% do this upon graduation. You probably saw the Boulger Duluth screening questions but even more important is the training of the admissions personnel and the dedication to this mission. Students are well schooled in what to say and do to get admitted. Duluth also has a 1 point less MCAT score across the board, a reflection of choice by dedication to the right stuff rather than dedication to intellect and research.Duluth Plus RPAP Duluth 20 Questions
Rabinowitz in PSAP in Pennsylvania chooses 10 - 15 students a year to attend Jefferson in superurban Philadelphia with little in the way of curricula or pressure or support. He works with small college advisors. His 1% of students now makes up 21% of the rural FP docs in PA.
Both of the above programs have been able to superselect, choose students that go rural and stay rural. The only other program that can likely say this is Rockford, we are only partially able to claim this.
Our Rural Graduate programs do superselect, a reason for their success. Most RTT programs superselect. This is obviously an easier process for graduate compared to medical school admissions.
Unfortunately there are only 1000 students interested in rural practice that graduate each year. My studies demonstrated that the senior students interested in rural practice in towns of less than 10,000 knew this at matriculation in 30%, as compared to only 15% of their peers knowing their career path. Being older, meeting and marrying a spouse before medical school and other factors contribute. Characteristics of Rural Interested Students
Rabinowitz has demonstrated that 78% of the choice of a rural location is rural background plus fp interest at matriculation. More PSAP Links and info
Few do so much to really make sure students are actually rural and actually FP interested as Duluth.
1. Fact - There is data regarding rural docs coming from rural background students Characteristics of Rural Interested Students and many other sources, Wigton, others
2. Fact - There are established programs with certain practices in admissions that have verified such approaches.
Centralization and Regionalization
Medical Schools for the Underserved
Physician Workforce Studies
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