Efforts to Recruit Medical Students From Rural Counties: A Model to Evaluate Recruitment Efforts

Abstract

BackgroundOver the past 40 years, the physician supply of North Carolina (NC) grew faster than the total population. However, the distribution of physicians between urban and rural areas increased, with many more physicians in urban areas. In rural counties, access to care and health disparities remain concerning. As a result, the medical school implemented pipeline programs to recruit more rural students. This study investigates the results of these recruitment efforts. MethodologyDescriptive analyses were conducted to compare the number and percentage of rural and urban students from NC who applied, interviewed, and were accepted to the University of North Carolina's School of Medicine (UNC SOM). The likely pool of rural applicants was based on the number of college-educated 18-34-year-olds by county. ResultsRoughly 10.9% of NC's population of college-educated 18-34-year-olds live in rural counties. Between 2017 and 2019, 9.3% (n = 225) of UNC SOM applicants were from a rural county. An increase of just 14 additional rural applicants annually would bring the proportion of rural UNC SOM applicants in alignment with the potential applicant pool in rural NC counties. ConclusionsOur model of analysis successfully calculated the impact of recruitment efforts to achieve proportional parity in the medical school class with the rural population of the state. Addressing rural physician workforce needs will require multiple strategies that affect different parts of the medical education and healthcare systems, including boosting college completion rates in rural areas. This model of analysis can also be applied to other pipeline programs to document the success of the recruitment efforts.

Ten-Year Outcomes: Community Health Center/Academic Medicine Partnership for Rural Family Medicine Training

“…Over a 10-year period, the program recruited and trained a total of 25 family physicians at two sites: Prospect Hill CHC (RUCA 2.0, RUCC 8) and Siler City CHC (RUCA 7.0, RUCC 2). Among graduates, 76% (19) were female, 20% (5) Black/African American, 16% (4) Asian/Pacific Islander, and 12% (3) Hispanic; 72% (18) reported a rural background, and 84% (21) reported Spanish proficiency prior to residency. Eighty-four percent (21) attended a public medical school, and 64% ( 16) attended medical schools in the Southeast United States (Table 1 , Figure 1).…”

“…North Carolina has the second largest rural population in the nation and the highest proportion of persons living in rural areas (33%); 92 of its 100 counties encompass Health Professional Shortage Areas (HPSAs), and 38 fall short of the minimum 1:1500 primary care provider per capita target. [18][19][20][21][22] Given the effectiveness of rural residencies in physician placement, the University of North Carolina (UNC) Department of Family Medicine endeavored to expand its existing residency program through the addition of a rural pathway, aiming to increase postgraduation rural placement above a historical maximum rate of 25%. Expansion was limited by Medicare funding caps and ineligibility for THCGME funding as an academic institution.…”

Bridging the Urban-Rural Divide in Chronic Disease Through Community Engagement in Health Program Delivery

“…With nearly 65% of rural counties nationally having a designation as health professional shortage areas, place matters in the context of health outcomes [10]. In North Carolina, provider supply outpaced the total population in the past 40 years, but rural communities experienced maldistribution in the physician workforce during this same time period [11]. How we live, work, play, and age is predetermined by geographic locale (Figures 2-3) [12].…”