A program that enrolls students interested in rural health care and provides training in rural communities produces graduates who will practice in rural areas.
To our knowledge this represents a first effort to define and develop a medical curriculum for teaching resiliency in rural predoctoral and residency education.
Discussion about these 5 elements can provide program guidance to neophyte rural medical education programs. Five recommendations are presented in an effort to continue discussion about the essential elements and identify actions that rural medical educators can take to further assist developing programs.
The use of rural training tracks (RTTs) in family practice residencies is a new strategy (beginning in the late 1980s) to increase the number of residents selecting rural careers. The authors describe the four residencies (in Washington, Nebraska, New York, and Kentucky) that have established RTTs. The first residency year is completed in an urban tertiary care center, and the second and third years are completed in a distant rural community wherein the primary faculty are the members of a rural family practice group. Inpatient experience for the residents is provided by community hospitals that offer obstetrics, emergency room care, and first-line critical care. The residents' training is supplemented by specialty faculty practicing in the rural communities. The curricula are highly structured and are evaluated to ensure training experiences of high quality. The RTTs' financial support comes from state initiatives, hospital reimbursement, recruitment budgets, and outpatient care revenues. The authors conclude that the RTT concept has the potential to lessen the shortage of rural physicians.
Spirituality is an essential aspect of a patient's health that can and should be integrated into routine health care. Despite recommendations of accrediting organizations such as the Association of American Medical Colleges, the National Association of Social Workers, and the Association of Professional Chaplains, there is little well defined curriculum focusing on interprofessional spiritual assessment. This article explores one program's use of an interprofessional approach in teaching spiritual assessment to students from medicine, social work, and chaplaincy. Learning objectives were adapted from the Association of American Medical Colleges Medical School Objectives Project. Workshop evaluations show that students can learn key concepts of spirituality and the basics of spiritual assessment while developing an understanding and respect for the role of chaplains, social workers, and physicians.
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