This article presents the characteristics and results of the Rural Medical Education (RMED) Program which addresses medical workforce needs focused on reducing rural health disparities. The program is comprehensive in implementing a system of recruitment of candidates from rural backgrounds, offering a rural-focused curriculum, and instituting evaluative components to track outcomes. Distinctive program features include a Recruitment and Retention Committee of rural community members; special rural-focused topics and events during the first three years of undergraduate medical education; and a required fourth-year, 16-week rural preceptorship through which students work with primary care physicians and conduct community-oriented primary care projects. Since 1993, 216 students have matriculated. More than three quarters of candidates interviewed received offers into the program (overall acceptance rate of 75%). Comparisons between RMED and all other students on composite MCAT scores and United States Medical Licensing Examination (USMLE) Part 1 scores show a slightly lower MCAT average for RMED students, but USMLE scores are equal to those of non-RMED students. To date, 159 students have graduated, with 76% entering primary care residencies; 103 are currently in practice, with 64.4% in primary care practice in small towns and/or rural communities. RMED Program outcomes compare favorably with those of other rural medical education programs. RMED can serve as a model at many levels, including recruitment, collaboration, curriculum, and retention. Future challenges for program development and disparity reduction include recruiting students from the growing number of rural minority populations, expanding the number of program slots, and integrating the program with other health professions to address the needs of rural populations.

Background Medical student burnout can cause emotional and physical exhaustion and detachment. The objectives of this study were to evaluate burnout using the Maslach Burnout Inventory-Student Survey (MBI-SS), identify factors that may predict burnout, and assess wellness initiatives effectiveness at reducing burnout. Methods The MBI-SS was administered to all medical students (Classes 2019 to 2022) at the University of Illinois College of Medicine (UICOM) from February to May 2019. Factor analysis and internal consistency of the MBI-SS were assessed. Mean MSBI-SS subscale scores for burnout were calculated for cynicism (CY), emotional exhaustion (EE), and academic efficacy (AE). Multiple regression analysis was used to identify student factors that may predict burnout. Results A total of 273 (21.6%) UICOM students completed the survey and 110 (40.3%) respondents reported self-perceived burnout. MBI-SS subscale scores were significantly higher for CY and EE, and significantly lower for AE in students who reported suffering from burnout versus students who did not report burnout. Mean ± SD subscale scores for CY, EE, and AE in burnout students were 14.44 ± 5.59, 23.23 ± 4.74, and 24.81 ± 5.35, respectively. In comparison, mean ± SD subscale scores for CY, EE, and AE in non-burnout students were 7.59 ± 5.16, 14.96 ± 5.71, and 28.74 ± 3.21, respectively. Regression analysis denoted significant associations between burnout and being out-of-phase in the curriculum, the effectiveness of wellness initiatives, and strength of motivation for medical school (SMMS) in both the two- and three-dimensional MBI-SS models. Gender was significantly associated with burnout in only the two-dimensional model. Conclusions Self-reported burnout in medical students at UICOM was validated using the MBI-SS. Being out-of-phase in the curriculum, being female, rating wellness initiatives as less effective, and demonstrating lower motivation for continued medical school education may be used as predictors of medical student burnout. This investigation may act as a guide for measuring burnout in medical student populations and how the implementation of wellness initiatives may ameliorate burnout.

Recruitment of students combined with a rural-focused curriculum yielded positive outcomes related to primary care practice and decisions regarding practice location. RMED graduates were considerably more likely than non-RMED graduates to choose family medicine, choose a primary care specialty, and be currently practicing in a rural location.

Introduction: Regional or state studies in the USA have documented shortages of rural physicians and other healthcare professionals that can impact on access to health services. The purpose of this study was to determine whether rural hospital chief executive officers (CEOs) in the USA report shortages of health professions and to obtain perceptions about factors influencing recruiting and retention.Methods: A nationwide US survey was conducted of 1031 rural hospital CEOs identified by regional/state Area Health Education Centers. A three-page survey was sent containing questions about whether or not physician shortages were present in the CEO's community and asking about physician needs by specialty. The CEOs were also asked to assess whether other health professionals were needed in their town or within a 48 km (30 mile) radius. Analyses from 335 respondents (34.4%) representative of rural hospital CEOs in the USA are presented.Results: Primary care shortages based on survey responses were very similar to the pattern for all rural areas in the USA (49% vs 52%, respectively). The location of respondents according to ZIP code rurality status was similar to all rural areas in the USA (moderately rural, 29.3% vs 27.6%, respectively), and 69.1% were located in highly rural ZIP codes (vs 72.4% of highly rural ZIP codes for all USA). Physician shortages were reported by 75.4% of the rural CEOs, and 70.3% indicated shortages of two or more primary care specialties. The most frequently reported shortage was family medicine (FM, 58.3%) followed by general internal medicine (IM, 53.1%). Other reported shortages were: psychiatry (46.6%); general surgery (39.9%); neurology (36.4%); pediatrics

CEOs offer 1 important perspective on health professions needs, recruitment, and retention in rural communities. While expressing a range of opinions, rural hospital CEOs clearly indicate the need for more primary care physicians, call for an increased capacity in nursing, and point to community development as a key factor in recruitment and retention.

Introduction: A variety of studies have indicated that rural communities have fewer mental health services and professionals than their urban counterparts. This study will examine the shortages of mental health professionals in rural communities as well as the impact of inadequate mental health services access on rural hospitals. Methods: A sample frame of 1162 rural hospitals was compiled, and a two-page survey was mailed to each hospital Chief Executive Officer (CEO). Results: Of the 1162 surveys mailed, 228 were returned. The majority of CEOs agreed that there was a shortage of mental health professionals, that referral centers were too distant, and that there were many barriers to care including infrastructure, poverty, and substance abuse. Solutions offered by CEOs included telemedicine and residency training programs. Conclusions: This study shows that many rural areas have great need for more mental health professional recruitment and retention.

Similarities in shortages and attributes influencing recruitment in both states suggest that efforts and policies in health professions workforce development can be generalized between regions. This study further reinforces some important known issues concerning retention and recruitment, such as the importance of identifying providers whose preferences are matched to the characteristics and lifestyle of a given area.

Background: Medical student burnout can cause emotional and physical exhaustion and detachment. The objectives of this study were to evaluate burnout using the Maslach Burnout Inventory-Student Survey (MBI-SS), identify factors that may predict burnout, and assess wellness initiatives effectiveness at reducing burnout. Methods: The MBI-SS was administered to all medical students (Classes 2019 to 2022) at the University of Illinois College of Medicine (UICOM) from February to May 2019. Factor analysis and internal consistency of the MBI-SS were assessed. Mean MSBI-SS subscale scores for burnout were calculated for cynicism (CY), emotional exhaustion (EE), and academic efficacy (AE). Multiple regression analysis was used to identify student factors that may predict burnout.Results: A total of 273 (21.6%) UICOM students completed the survey and 110 (40.3%) respondents reported self-perceived burnout. MBI-SS subscale scores were significantly higher for CY and EE, and significantly lower for AE in students who reported suffering from burnout versus students who did not report burnout. Mean ± SD subscale scores for CY, EE, and AE in burnout students were 14.44 ± 5.59, 23.23 ± 4.74, and 24.81 ± 5.35, respectively. In comparison, mean ± SD subscale scores for CY, EE, and AE in non-burnout students were 7.59 ± 5.16, 14.96 ± 5.71, and 28.74 ± 3.21, respectively. Regression analysis denoted significant associations between burnout and being out-of-phase in the curriculum, the effectiveness of wellness initiatives, and strength of motivation for medical school (SMMS) in both the two- and three-dimensional MBI-SS models. Gender was significantly associated with burnout in only the two-dimensional model.Conclusions: Self-reported burnout in medical students at UICOM was validated using the MBI-SS. Being out-of-phase in the curriculum, being female, rating wellness initiatives as less effective, and demonstrating lower motivation for continued medical school education may be used as predictors of medical student burnout. This investigation may act as a guide for measuring burnout in medical student populations and how the implementation of wellness initiatives may ameliorate burnout.