Purpose: Despite the efforts of numerous medical schools to produce rural physicians, many rural communities in the United States still experience physician shortages. This study describes the current landscape of rural efforts in US undergraduate medical education and catalogs medical school characteristics and activities that evidence has suggested, and that many experts in rural medical education believe, may result in more graduates choosing rural practice.Methods: This is a descriptive study of publicly available and rurally relevant characteristics of all 182 allopathic and osteopathic medical schools operating in the 50 states and the District of Columbia in 2016, with rural program information for these schools updated in 2019. The authors constructed a "rural program" definition in order to systematically catalog coordinated and strategic medical school efforts to produce a rural physician workforce.Findings: Few (8.2%) medical schools expressed an explicit commitment to producing rural physicians in public mission statements. However, most (64.8%) provided rural clinical experiences and many demonstrated their commitment in other ways. Only 39 (21.4%) did so through a formal rural program. Conclusions:In establishing an explicit rural program definition and documenting other markers of rural commitment, this paper provides a baseline for future studies of rural workforce production and medical school investment in these programs, activities, and personnel. Demonstrating the effectiveness of schools' rural physician education efforts will require collaboration across institutions and more intensive evaluations of programs involving students who, though relatively few in number, have great potential for contributing to the health of rural communities across the nation.

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Background and Objectives: Increased medical school class sizes and new medical schools have not addressed the workforce inadequacies in primary care or underserved settings. While there is substantial evidence that student attributes predict practice specialty and location, little is known about how schools use these factors in admissions processes. We sought to describe admissions strategies to recruit students likely to practice in primary care or underserved settings. Methods: We surveyed admissions personnel at US allopathic and osteopathic medical schools in 2018 about targeted admissions strategies aimed at recruitment and selection of students likely to practice rurally, in urban underserved areas, or in primary care Results: One hundred thirty-three of 185 (71.8%) US medical schools responded. Respondents reported targeted admissions strategies as follows: rural, 69.2%; urban underserved, 67.4%; and primary care, 45.3%. Nearly 90% reported some type of recruitment outreach to 4-year universities, but much less to community colleges. Student characteristics used to identify those likely to practice in targeted areas were largely evidence-based. Strategies to select students varied widely. Conclusions: Most responding US medical schools reported a targeted process to recruit and select students likely to practice in rural, urban underserved, or primary care settings, indicating widespread awareness of workforce challenges. This study also demonstrates varying approaches to and allocation of resources toward admissions targeting, especially the application and interviewing processes. Understanding how schools identify and admit students likely to practice in these fields is a first step in identifying best practices for selective admissions focused on addressing workforce gaps.

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