An approach to training and retaining primary care physicians in rural Appalachia

Abstract

The West Virginia School of Osteopathic Medicine (WVSOM) educated and retained more primary care physicians for practice in rural Appalachia than did any other U.S. medical school from 1978 through 1990. This article describes the most important methods used at WVSOM to place physicians in rural areas: (1) The school has a focused, achievable mission (to provide primary care physicians who are trained to meet the medical needs of rural Appalachia and to improve the health care of the rural Appalachian population) that is agreed upon by the administration, faculty, and students; (2) it participates in a multistate educational exchange program with a similar mission; (3) it emphasizes personalized and interactive recruiting, admission, and placement processes aimed to attract nontraditional, rural students; (4) it provides early and long-term clinical training in rural sites (both hospitals and physicians' offices); (5) it is dedicated primarily to the education of medical students rather than to research or other goals; and (6) it is a freestanding school in a rural environment. The authors state that although WVSOM is unusual in some respects, at least some of its methods may be useful to other medical schools as they seek to produce more primary care physicians for rural and other underserved areas.

A Comprehensive Medical Education Program Response to Rural Primary Care Needs

“…RMED is an evidence-based program that resulted from discussions among faculty and our understanding of other rural-oriented programs in place at the time. 10,22–26 A family physician with a background in rural medicine directs the RMED Program, which receives recurrent funding of about $550,000 per year from the state of Illinois. Funding covers major elements of the program including the identification and recruitment of potential RMED Program students; the development, implementation, and maintenance of a targeted rural curriculum; faculty development for rural preceptors; and program evaluation at multiple levels.…”

New Zealand rural primary health care workforce in 2005: More than just a doctor shortage

“…Australia has introduced more initiatives to address recruitment/retention shortages than NZ, including significant undergraduate medical training occurring in rural areas and more formalised postgraduate rural GP career pathways. 8,10 Intention to leave may not translate into leaving. Strategies should address issues likely to improve retention.…”

“…4,5 Other effective schemes focus on training: rural-orientated medical curricula, undergraduate teaching in community-orientated rural primary care and exposure to positive rural practitioner role-models. [6][7][8] Trainee doctors undergoing rural internships are more likely to consider rural practice. 9 Longterm rural rotations where medical students experience being part of the community, contributing to the health care team, increase numbers entering rural general practice.…”

Increasing Rural Activity and Curriculum Content in the Adelaide University Medical School

“…Medical schools clearly have a substantial impact on the career decisions of medical students through their selection, training and socialisation processes. 19,[22][23][24] Medical schools in North America vary greatly in the extent that their graduates select rural practice, with schools located in rural areas more likely to produce rural graduates. 25 However, interest in rural practice wanes as medical education progresses.…”