Medical School Programs to Increase the Rural Physician Supply: A Systematic Review and Projected Impact of Widespread Replication

Rabinowitz, Howard K.; Diamond, James J.; Markham, Fred W.; Wortman, Jeremy R.

doi:10.1097/acm.0b013e318163789b

Cited by 191 publications

(207 citation statements)

References 22 publications

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“…Students from rural areas and underrepresented minorities have demonstrated a predisposition to serve underserved populations. [18][19][20] Some medical schools have expanded efforts to target these populations. Undergraduate and graduate medical training should include exposure to underserved urban and rural populations, and graduates should be trained in the skills needed to serve such populations.…”

Section: Resultsmentioning

confidence: 99%

Geographic Maldistribution of Primary Care for Children

et al. 2011

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OBJECTIVES: This study examines growth in the primary care physician workforce for children and examines the geographic distribution of the workforce. METHODS: National data were used to calculate the local per-capita supply of clinically active general pediatricians and family physicians, measured at the level of primary care service areas. RESULTS: Between 1996 and 2006, the general pediatrician and family physician workforces expanded by 51% and 35%, respectively, whereas the child population increased by only 9%. The 2006 per-capita supply varied by >600% across local primary care markets. Nearly 15 million children (20% of the US child population) lived in local markets with <710 children per child physician (average of 141 child physicians per 100 000 children), whereas another 15 million lived in areas with >4400 children per child physician (average of 22 child physicians per 100 000 children). In addition, almost 1 million children lived in areas with no local child physician. Nearly all 50 states had evidence of similar extremes of physician maldistribution. CONCLUSIONS: Undirected growth of the aggregate child physician workforce has resulted in profound maldistribution of physician resources. Accountability for public funding of physician training should include efforts to develop, to use, and to evaluate policies aimed at reducing disparities in geographic access to primary care physicians for children.

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Section: Resultsmentioning

confidence: 99%

Geographic Maldistribution of Primary Care for Children

et al. 2011

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“…[17][18][19][20] Six research teams from 4 countries have provided literature reviews 4,[21][22][23][24][25] that help judge the relative potency of these influences. Table 1 summarizes the focuses of these reviews and factors considered; "X" indicates factors stressed as "established" or "important" and "x" indicates those factors acknowledged as "probably influential."…”

mentioning

confidence: 99%

The Rural Medical Scholars Program Study: Data to Inform Rural Health Policy

Wheat¹,

Leeper²,

Brandon³

et al. 2011

The Journal of the American Board of Family Medicine

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Introduction: Medical education to produce rural physicians hinges on the characteristics of students, educational programs, and rural experiences. Family physicians are key components of rural medicine. This study tested the effectiveness of multiple, combined strategies of the Rural Medical Scholars Program to produce family medicine residents.Methods: We compared the relative effectiveness of the Rural Medical Scholars Program, family medicine-oriented branch campuses, and a traditional urban campus to produce family medicine residents using a prospective quasi-experimental design. Logistic regression was used to account for covariates.Results: The relative effectiveness of 3 educational modalities to produce family medicine residents was examined: Rural Medical Scholars Program (44.0%; odds ratio [OR], 15.6), family medicine-oriented branch campuses (18.9%; OR, 5.8), and a traditional urban campus (3.9%; OR, 1). These differences were significant (P < .05) after controlling for sex, race, Medical College Admission Test scores, and graduation rate.

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“…In addition, although the absolute number of physicians in the PSAP is small, our previous study showed that, if all medical schools developed (or expanded) small comprehensive medical school rural programs similar to the PSAP (with 10 students per class), the overall production of rural physicians in the United States would double. 18 A limitation of this study is that it took place at one medical school. However, the large size of the study (more than 2100 graduates over 11 years), that these physicians have taken residency training in more than 343 different hospitals in 44 states and practice in 47 states, and the similar ratio of JMC men:women physicians practicing in rural areas as for the entire United States 6 all support the generalizability of these outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…23,28 Both programs have also had very high long-term rural family medicine retention rates (79% to 87%). 18 This suggests that identifying and preferentially admitting women who grew up in a rural area and who are committed to practicing in a rural area, along with supporting these students during medical school to help them achieve their career goals, represents an important policy for increasing the supply of rural women physicians. 29 This is similar to the effect of this policy on men, and it addresses the recommendations of the Council on Graduate Medical Education and the Robert Graham Center regarding increasing the supply of women who practice in rural areas.…”

Section: Discussionmentioning

confidence: 99%

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Increasing the Supply of Women Physicians in Rural Areas: Outcomes of a Medical School Rural Program

Rabinowitz¹,

Diamond²,

Markham³

et al. 2011

The Journal of the American Board of Family Medicine

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Results: Women PSAP graduates were more than twice as likely as non-PSAP women to practice in rural areas (31.7% vs 12.3%; relative risk, 2.6; 95% CI, 1.6 -4.2). This was similar to the PSAP outcomes for men (51.8% vs 17.7%; relative risk, 2.9, 95% CI, 2.2-3.9; relative risk ratio, 0.9, 95% CI, 0.5-1.5). PSAP outcomes were also similar for women and men practicing rural family medicine and rural primary care.

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Medical School Programs to Increase the Rural Physician Supply: A Systematic Review and Projected Impact of Widespread Replication

Cited by 191 publications

References 22 publications

Geographic Maldistribution of Primary Care for Children

Geographic Maldistribution of Primary Care for Children

The Rural Medical Scholars Program Study: Data to Inform Rural Health Policy

Increasing the Supply of Women Physicians in Rural Areas: Outcomes of a Medical School Rural Program

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