Growing a rural family physician workforce: The contributions of rural background and rural place of residency training

Patterson, Davis G.; Shipman, Scott A.; Pollack, Samantha W.; Andrilla, C. Holly A.; Schmitz, David; Evans, David; Peterson, Lars E.; Longenecker, Randall

doi:10.1111/1475-6773.14168

Cited by 11 publications

(4 citation statements)

References 33 publications

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“…There is a significant body of research on the impact of residency training on the choice to practice in rural areas [ 41 , 42 ] Since this study was conducted in Spain, the results can contribute to a better understanding of whether there are other important factors that have not been previously studied. Most of the residents defined the training programme as rewarding and having significant learning opportunities.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with the attraction and retention of family and community medicine and nursing residents in rural settings: a qualitative study

Tort-Nasarre,

Vidal-Alaball,

Pedrosa

et al. 2023

BMC Med Educ

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Background The current shortage of primary care doctors and nurses is causing difficulties in replacement, and this shortage is expected to increase. This situation is more pronounced in rural environments than in urban ones. Family and community care specialty training is a key component of both the transition to clinical practice and the retention of new professionals. The aim of this study is to explore the attitudes and perceptions of internal medicine residents and internal nurse residents trained in a rural teaching unit on factors associated with recruitment and retention, including the role of the specialty training programme. Methods A qualitative study was conducted. Purposive sampling was used, and thirteen residents from the central Catalonia teaching unit who were in their final year of training participated in semistructured interviews. The data were collected during 2022 and were subsequently analysed with thematic analysis. The study is reported using the COREQ checklist. Results Six themes emerged from data related to perceptions and attitudes about the factors associated with recruitment and retention: training programme, characteristics of the family and community specialty, concept of rural life, family and relational factors, economic and resource factors, and recruitment and job opportunities. Conclusions Family and community medicine and nursing residents trained in rural settings expressed satisfaction with the specialty programme and most features of primary care, but they experienced a wide range of uncertainties in deciding on their professional future in terms of living in rural areas, family support, financial support and recruitment. This study identifies individual and structural factors that could be of great use to retain doctors and nurses in rural areas.

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Section: Discussionmentioning

confidence: 99%

Factors associated with the attraction and retention of family and community medicine and nursing residents in rural settings: a qualitative study

Tort-Nasarre,

Vidal-Alaball,

Pedrosa

et al. 2023

BMC Med Educ

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“…While uneven geographic distribution of oncology specialists has been established, more needs to be done to understand disparities for specific cancer types and oncology specialties . These rural disparities may be influenced by fewer training programs in rural areas, debt and salary concerns, or simply by limited access to specialized equipment to conduct complex therapy …”

Section: Discussionmentioning

confidence: 99%

“… 10 , 16 , 17 These rural disparities may be influenced by fewer training programs in rural areas, debt and salary concerns, or simply by limited access to specialized equipment to conduct complex therapy. 10 , 18 …”

Section: Discussionmentioning

confidence: 99%

Comparison of US Oncologist Rurality by Practice Setting and Patients Served

Cornelius,

Shaefer,

Wong

et al. 2024

JAMA Netw Open

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ImportanceStudies of the oncology workforce most often classify physician rurality by their practice location, but this could miss the true extent of physicians involved in rural cancer care.ObjectiveTo compare a method for identifying oncology physicians involved in rural cancer care that uses the proportion of rural patients served with the standard method based on practice location.Design, Setting, and ParticipantsThis cross-sectional study used retrospective Centers for Medicare &amp; Medicaid Services encounter data on medical oncologists, radiation oncologists, and surgeons treating Medicare beneficiaries diagnosed with breast, colorectal, or lung cancer from January 1 to December 31, 2019. Data were analyzed from May to September 2023.Main Outcomes and MeasuresThe standard method of classifying oncologist physician rurality based on practice location was compared with a novel method of classification based on proportion of rural patients served.ResultsThe study included 27 870 oncology physicians (71.3% male), of whom 835 (3.0%) practiced in a rural location. Physicians practicing in a rural location treated a high proportion of rural patients (median, 50.0% [IQR, 16.7%-100%]). When considering the rurality of physicians’ patient panels, 5123 physicians (18.4%) whose patient panel included at least 20% rural patients, 3199 (11.5%) with at least 33% rural patients, and 1996 (7.2%) with at least 50% rural patients were identified. Using a physician’s patient panel to classify physician rurality revealed a higher number and greater spread of oncology physicians involved in rural cancer care in the US than the standard method, while maintaining high performance (area under the curve, 0.857) and fair concordance (κ, 0.346; 95% CI, 0.323-0.369) with the method based on practice setting.Conclusions and RelevanceIn this cross-sectional study, classifying oncologist rurality by the proportion of rural patients served identified more oncology physicians treating patients living in rural areas than the standard method of practice location and may more accurately capture the rural cancer physician workforce, as many hospitals have historically been located in more urban areas. This new method may be used to improve future studies of rural cancer care delivery.

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“…3,4,8,9,11,13 There is substantial evidence for other health care professionals, particularly physicians, that rural training experiences are effective in recruiting, appropriately preparing, and retaining clinicians. [13][14][15][16][17] A few studies have demonstrated that rural and underserved communityfocused training for behavioral health trainees can increase interest in and actual recruitment to work in rural and underserved settings 11,18 ; however, there is a dearth of research investigating the effects of training on behavioral health clinicians' preparedness, successes, and retention in rural underserved communities.…”

Section: Introductionmentioning

confidence: 99%

Preparing behavioral health clinicians for success and retention in rural safety net practices

Pathman,

de Saxe Zerden,

Gingras

et al. 2024

The Journal of Rural Health

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PurposeThis study assesses how, among behavioral health clinicians working in rural safety net practices, the amount of exposure to care in rural underserved communities received during training relates to confidence in skills important in their work settings, successes in jobs and communities, and anticipated retention.MethodsThis study uses survey data from Licensed Clinical Social Workers, Licensed Professional Counselors, and Psychologists working in rural safety net practices in 21 states while receiving educational loan repayment support from the National Health Service Corps, from 2015 to April 2022.FindingsOf the 778 survey respondents working in rural counties, 486 (62.5%) reported they had formal education experiences with medically underserved populations during their professional training, for a median of 47 weeks. In analyses adjusting for potential confounders, the estimated amount of rural training exposure was positively associated with a variety of indicators of clinicians’ integration and fit with their communities as well as with longer anticipated retention within their rural safety net practices. The amount of training in care for rural underserved populations was not associated with clinicians’ confidence levels in various professional skills or successes in their work, including connection with patients and work satisfaction.ConclusionsFormal training in care for underserved populations is a large part of the education of behavioral health clinicians who later work in rural safety net practices. More training in rural underserved care for these clinicians is associated with greater integration and fit in their communities and longer anticipated retention in their practices, but not with skills confidence or practice outcomes.

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Growing a rural family physician workforce: The contributions of rural background and rural place of residency training

Cited by 11 publications

References 33 publications

Factors associated with the attraction and retention of family and community medicine and nursing residents in rural settings: a qualitative study

Factors associated with the attraction and retention of family and community medicine and nursing residents in rural settings: a qualitative study

Comparison of US Oncologist Rurality by Practice Setting and Patients Served

Preparing behavioral health clinicians for success and retention in rural safety net practices

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