scholarly journals Using rural training tracks to encourage rural practice careers and enhance training in family medicine

1998 ◽  
Vol 73 (5) ◽  
pp. 599 ◽  
Author(s):  
J R Damos ◽  
C Christman ◽  
C Gjerde
Keyword(s):  
Family Medicine ◽  
Rural Practice ◽  
Rural Training

scholarly journals An Exploratory Study of a Novel Approach to Improve Readiness for a Rural Family Medicine Residency

PRiMER ◽  
2021 ◽  
Vol 5 ◽  
Author(s):  
Dwight Smith ◽  
Nellie Wirsing ◽  
Joyce C. Hollander-Rodriguez ◽  
Tracy Bumsted ◽  
Eric Wiser ◽  
...  
Keyword(s):  
Family Medicine ◽  
Medical School ◽  
Rural Areas ◽  
Exploratory Study ◽  
Rural Practice ◽  
Family Medicine Residency ◽  
Novel Approach ◽  
Field Notes ◽  
Curricular Elements ◽  
Rural Training

Background and Objectives: Transitioning from medical school to residency is challenging, especially in rural training programs where a comprehensive scope of practice is needed to address rural health disparities. Oregon Health & Science University partnered with Cascades East Family Medicine Residency in Klamath Falls, Oregon to create an integrated fourth-year medical student experience (Oregon Family medicine Integrated Rural Student Training (Oregon FIRST). Participants may then enter this residency to complete their training with the intention to practice in rural underresourced settings.  Methods: In this exploratory study, we conducted key informant interviews with 9 of ten Oregon FIRST participants to determine how Oregon FIRST contributed both to their readiness for residency training and their choice to practice in rural underserved locations. Interviews were conducted between June 10, 2020 and July 8, 2020. We analyzed field notes taken during interviews for emergent themes using classical content analysis. Results: Emergent themes included logistical ease, relationship development, key curricular elements, and commitment to rural practice. Overwhelmingly, Oregon FIRST participants reported the experience had many challenging and demanding components because they served as subinterns for their entire fourth year of medical school, but this prepared them very well for internship. When asked if they would choose to enroll in Oregon FIRST again, given what they now know about physician training and patient care, all nine (100%) said they would. Conclusions: This study demonstrated that Oregon FIRST students felt better prepared for the rigors of residency and are committed to practicing in rural areas. 

scholarly journals Rural exposure during medical education and student preference for future practice location - a case of Botswana

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Tonya Arscott-Mills ◽  
Poloko Kebaabetswe ◽  
Gothusang Tawana ◽  
Deogratias O. Mbuka ◽  
Orabile Makgabana-Dintwa ◽  
...  
Keyword(s):  
Family Medicine ◽  
Student Perceptions ◽  
Rural Areas ◽  
Structured Interview ◽  
Rural Practice ◽  
Public Institution ◽  
Practice Location ◽  
Rural Training ◽  
The Impact ◽  
Future Practice

Background: Botswana’s medical school graduated its first class in 2014. Given the importance of attracting doctors to rural areas the school incorporated rural exposure throughout its curriculum. Aim: This study explored the impact of rural training on students’ attitudes towards rural practice.Setting: The University of Botswana family medicine rural training sites, Maun and Mahalapye.Methods: The study used a mixed-methods design. After rural family medicine rotations, third- and fifth-year students were invited to complete a questionnaire and semi-structured interview. Data were analysed using descriptive statistics and thematic analysis.Results: The thirty-six participants’ age averaged 23 years and 48.6% were male. Thirtythree desired urban practice in a public institution or university. Rural training did not influence preferred future practice location. Most desired specialty training outside Botswana but planned to practice in Botswana. Professional stagnation, isolation, poorly functioning health facilities, dysfunctional referral systems, and perceived lack of learning opportunities were barriers to rural practice. Lack of recreation and poor infrastructure were personal barriers. Many appreciated the diversity of practice and supportive staff seen in rural practice. Several considered monetary compensation as an enticement for rural practice. Only those with a rural background perceived proximity to family as an incentive to rural practice.Conclusion: The majority of those interviewed plan to practice in urban Botswana, however, they did identify factors that, if addressed, may increase rural practice in the future. Establishing systems to facilitate professional development, strengthening specialists support, and deploying doctors near their home towns are strategies that may improve retention of doctors in rural areas.Keyords: rural health, student perceptions

scholarly journals Family Medicine Rural Training Track Residencies: Risks and Resilience

2019 ◽  
Vol 51 (8) ◽  
pp. 649-656 ◽  
Author(s):  
Davis G. Patterson ◽  
David Schmitz ◽  
Randall L. Longenecker
Keyword(s):  
Family Medicine ◽  
Health Care Providers ◽  
Local Population ◽  
Rural Practice ◽  
Local Health ◽  
Care Providers ◽  
Teaching Resources ◽  
Program Support ◽  
Multiple Challenges ◽  
Rural Training

Background and Objectives: Family medicine rural training track (RTT) residency programs produce a higher proportion of graduates who choose rural practice than other programs, yet RTTs face continuing threats to their existence. This study sought to understand threats to RTT sustainability and resilience factors that enable RTTs to thrive. Methods: In 2014 and 2015, the authors conducted semistructured interviews of 21 RTT leaders representing two closed programs and 22 functioning programs. Interview topics included program strengths providing resilience and sustainability, risk factors for closure or vulnerabilities threatening sustainability, and advice for other RTTs. The authors performed a content analysis, coding pertinent themes in all interview data. Results: From the top three assets, risks, and advice that respondents offered, the following nine themes emerged, in order from most to least mentioned: leadership, faculty and teaching resources, program support, finances, resident recruitment, program attributes, program mission, political and environmental context, and patient-related clinical experiences. Interviewees frequently reported multifactorial causes for RTT sustainability or closure. Conclusions: Numerous factors identified, such as distance, can operate as positive or negative influences for program resilience, depending on place and context. Resilience depends on multiple forms of social capital, including robust networks among individuals and various communities: the local population and patients, local health care providers, residency faculty, and RTTs in general. The small size and remoteness of RTTs make them vulnerable to multiple challenges in finances, regulations, and accreditation, requiring program adaptability and suggesting the need for flexibility in the policies that govern them.

scholarly journals It is time for rural training in family medicine in Brazil!

2018 ◽  
Vol 13 (40) ◽  
pp. 1-4
Author(s):  
Magda Moura Almeida ◽  
Mayara Floss ◽  
Leonardo Vieira Targa ◽  
John Wynn-Jones ◽  
Alan Bruce Chater
Keyword(s):  
Family Medicine ◽  
Low Income ◽  
Rural Areas ◽  
Human Resources For Health ◽  
Health Indicators ◽  
Health Needs ◽  
Rural And Remote ◽  
Barriers To Access ◽  
The Social ◽  
Rural Training

The gap between health needs and the training of human resources for health is much more evident in rural areas. In Brazil, a country of continental dimensions, these differences become more challenging. The diversity of geographical and administrative barriers to access makes the health indicators of rural and remote populations worse than those of the urban population. Family Medicine could address the social determinants of health through the provision of human services and play an important role in low-income rural residents’ health status. This essay is an urgent call for the debate on models for projecting heath workforce supply and requirements for rural areas in Brazil.

scholarly journals Factors perceived to influence rural career choice of urban background family physicians: a qualitative analysis

2019 ◽  
Author(s):  
Olga Szafran ◽  
Douglas Myhre ◽  
Jacqueline Torti ◽  
Shirley Schipper
Keyword(s):  
Family Medicine ◽  
Career Choice ◽  
Rural Areas ◽  
Role Models ◽  
Rural Practice ◽  
Training Experience ◽  
Urban Background ◽  
Practice Location ◽  
Telephone Interviews ◽  
Physician Role

Background: Urban background physicians are the main source of physician supply for rural areas across Canada. The purpose of this study was to describe factors that influence rural career choice and practice location of urban background family medicine graduates. Methods:  We conducted a qualitative, descriptive study employing telephone interviews with 9 urban background family medicine graduates. Those who completed residency training between 2006 and 2011 and were in rural practice, but who had an urban upbringing were asked about: when the decision for rural practice was made; factors that influenced rural career choice; and factors that influenced choice of a particular rural location.  Emerging themes were identified through content analysis of interview data.  Results:  We identified four themes as factors influencing rural career choice - variety/broad scope of rural practice, rural lifestyle, personal relationships, and positive rural experience/physician role models.  We also identified factors in four theme areas as influencing the choice of a particular rural practice location - having lived in the rural community, spousal influence, personal lifestyle, and comfort with practice expectations.  Conclusion:  Decisions for rural career choice and rural practice location by urban background family medicine graduates are based on clinical practice considerations, training experience, as well as personal and lifestyle factors.

Effects of compulsory rural vocational training for Australian general practitioners: a qualitative study

2011 ◽  
Vol 35 (1) ◽  
pp. 81 ◽  
Author(s):  
Sarah A. Bayley ◽  
Parker J. Magin ◽  
Jennifer M. Sweatman ◽  
Catherine M. Regan
Keyword(s):  
Qualitative Study ◽  
General Practitioners ◽  
Vocational Training ◽  
Learning Experience ◽  
Rural Practice ◽  
Clinical Learning ◽  
Negative Experience ◽  
Positive Effects ◽  
Medical Undergraduates ◽  
Rural Training

Background. Increasing the recruitment of doctors, including general practitioners (GPs), to rural areas is recognised as a health priority internationally. Australian GP trainees (registrars) complete a mandatory minimum of 6 months training in a rural area. The rationale for this includes the expectation of increased likelihood of a future choice of rural practice location. Method. A qualitative study employing semistructured in-depth interviews and a modified grounded methodology. Participants were 15 registrars from an Australian GP postgraduate training program. Results. Though generally a rewarding clinical learning experience, negative aspects of the rural placement included the disruption to personal lives of rural relocation and the stresses involved in higher levels of clinical responsibility. These stressors could undermine rather than enhance clinical confidence. Anxiety and depression were accompaniments for some registrars. Intention to practice rurally was little influenced by this compulsory placement. Conclusions. Findings of positive effects on rural practice destination in studies of medical undergraduates should not be generalised to GP registrars. The positive clinical learning experience of most registrars in rural terms must be balanced with the social dislocation involved in rural relocation and the adverse effects of the rural experience, for some registrars, on professional confidence and psychological well being. What is known about the topic? The rationale for compulsory rural placements during general practitioner vocational training includes an assumption that this will increase rural GP workforce. Undergraduate training in rural environments is known to enhance recruitment to rural practice. What does this paper add? Despite considerable positive educational and training outcomes for many registrars, compulsory rural training placements cause significant social dislocation for many registrars and were in this study associated with psychological morbidity in some registrars. Placements are unlikely to significantly increase rural GP workforce. What are the implications for practitioners? Compulsory rural placements can be a negative experience for GP registrars. Findings of positive effects of rural training experience on career intentions and rural workplace destination in studies of medical undergraduates should not be generalised to compulsory rural placements for general practice registrars.

scholarly journals Impact of the Rural Physician Associate Program on Workforce Outcomes

2021 ◽  
Vol 53 (10) ◽  
pp. 864-870
Author(s):  
Logan Butler ◽  
Mark E. Rosenberg ◽  
Yeng M. Miller-Chang ◽  
Jacqueline L. Gauer ◽  
Emily Melcher ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Rural Practice ◽  
Data Sets ◽  
University Of Minnesota ◽  
Rural Workforce ◽  
Primary Care Specialty ◽  
Longitudinal Integrated Clerkship ◽  
Practice Methods ◽  
Rural Physician

Background and Objectives: The Rural Physician Associate Program (RPAP) at the University of Minnesota Medical School (UMMS) is a 9-month rural longitudinal integrated clerkship (LIC) for third-year medical students built on a foundation of family medicine. The purpose of this study was to examine the relationships between participation in the RPAP program and the desired workforce outcomes of practice in Minnesota, primary care specialty (particularly family medicine), and rural practice. Methods: We analyzed workforce outcomes for UMMS graduates who completed postgraduate training between 1975 and 2017, comparing RPAP participants (n=1,217) to noparticipants (n=7,928). We identified graduates through internal UMMS databases linked to the American Medical Association (AMA) Physician Masterfile and the National Provider Identifier (NPI) registry. We identified workforce outcomes of rural practice, practice in Minnesota, primary care specialty, and family medicine specialty based on practice specialty and practice location data available through the AMA and NPI data sets. Results: Proportionally, more RPAP graduates practice in state (65.7% vs 54.4%, P<.01), in primary care (69.0% vs 33.4%, P<.01), in family medicine (61.1% vs 17.3%, P<.01), and rurally (41.2% vs 13.9%, P<.01) than non-RPAP graduates. Conclusions: We demonstrate a significant association between participation in RPAP and a career in family medicine, rural practice, and primary care, all outcomes that promote meeting urgent rural workforce needs.

scholarly journals Preparing Physicians for Rural Practice: Availability of Rural Training in Rural-Centric Residency Programs

2019 ◽  
Vol 11 (5) ◽  
pp. 550-557 ◽  
Author(s):  
Davis G. Patterson ◽  
C. Holly A. Andrilla ◽  
Lisa A. Garberson
Keyword(s):  
Health Care Systems ◽  
Core Competencies ◽  
Rural Practice ◽  
Full Time ◽  
Specific Content ◽  
Residency Programs ◽  
Rural Clinic ◽  
Rural Residency ◽  
Care Systems ◽  
Rural Training

ABSTRACT Background Exposing residents to rural training encourages future rural practice, but unified accreditation of allopathic and osteopathic graduate medical education under one system by 2020 has uncertain implications for rural residency programs. Objective We describe training locations and rural-specific content of rural-centric residency programs (requiring at least 8 weeks of rurally located training) before this transition. Methods In 2015, we surveyed residency programs that were rurally located or had rural tracks in 7 specialties and classified training locations as rural or urban using Rural-Urban Commuting Area (RUCA) codes. Results Of 1849 residencies in anesthesiology, emergency medicine, general surgery, internal medicine, obstetrics and gynecology, pediatrics, and psychiatry, 119 (6%) were rurally located or offered a rural track. Ninety-seven programs (82%) responded to the survey. Thirty-six programs required at least 8 weeks of rural training for some or all residents, and 69% of these rural-centric residencies were urban-based and 53% were osteopathic. Locations were rural for 26% of hospital rotations and 28% of continuity clinics. Many rural-centric programs (35%) reported only urban ZIP codes for required rural block rotations; 54% reported only urban ZIP codes for required rural clinic sessions, and 31% listed only urban ZIP codes in reporting rural full-time training locations. Programs varied widely in coverage of rural-specific training in 6 core competencies. Conclusions In multiple specialties important for rural health care systems, little rurally located residency training and rural-specific content was available. Substantial proportions of training locations reported to be rural were actually urban according to a common rural definition.

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