In Nebraska, we have had great success with rural, primary care, and specialty services in many rural areas. Still we are totally dependent on medical programs from outside the state to provide mental health services in the state (Rural Doctor Survey). In all other specialties in rural Nebraska (FP, GP, Peds, IM, Surgery, OB), the state’s medical schools, (mostly UNMC) supply 70% or more of the physicians in that specialty.
The RHOP program has had incredible impact on much more than medicine. RHOP has drawn hundreds of top-notch students to Nebraska’s small colleges. Professors in the colleges have noted increased academics in both colleges. One professor noted a change from 2 poorly deserved A's per semester in Microbiology to 14 well deserved ones during the first few years of RHOP. The competition of these students has greatly enhanced the educational efforts at these schools. Another professor noted that the students in his microbiology class include now two populations at either end of the grading spectrum. This has challenged him to do more with those at the lower end.
The impact of RHOP may be more on the total professionals coming from rural areas, reversing a Centralization and Regionalization trend that has lasted for decades. Student efforts may be even more successful Hope: Students From the Underserved, For the Underserved. The efforts of students such as John Klein: PRIME Developer may greatly facilitate the work of admissions.
The Chadron State Rural Health Career Fair attracts hundreds of high schools students to the campus each year and gives even the most rural student a chance to explore health careers. The result of this career fair and RHOP has been that many students have gone to Chadron and Wayne, instead of going to more urban colleges. These students have chosen small town life, met small town spouses, and are much more likely to choose rural Nebraska locations.
At other small rural colleges across the nation the preprofessional courses have all but disappeared, obvious victims of education cutbacks Centralization and Regionalization Canada has few small colleges or rural schools and rural parts of Canada are highly dependent on doctors trained in other countries.
The result has been more rural students going to urban colleges, marring more urban spouses, and marrying spouses with highly specialized careers. One of the greatest deficits in rural Nebraska is Nebraskans age 25 – 44. These are the next generation of rural leadership, desperately needed to revitalize rural Nebraska (Breeding Young Professionals and Healthier Rural Communities). School consolidations, intended to improve education, have acted to disrupt the students bond with their town. Consolidated schools also train fewer leaders. Consolidation and Bonding
Rural schools have limited resources, less opportunities for gifted students, and tend not to ignore the more challenging students (Matthew Principle). Many rural students struggle with the college years. Despite starting at a disadvantage, these students catch and sometimes surpass their peers. Recently the top student at U of Illinois Rockford was a rural boy that started with a 6.7 average MCAT scores and finished at the top of the largest medical school class in the nation (Jeff Stearns). What about others that never had a level playing field from other rural and inner city locations?
In Nebraska the state deservedly gets failing grades on state standards and accountability and equity from the Education Week magazine (Omaha World Herald Editorial Sat Jan 11, 2003) Equal access to well-qualified teachers is a big part. Huge inner city schools struggle behind those with more money and fewer minorities, and small rural schools suffer the most, to as few as 50% of teachers qualified in certain key subjects such as science courses.
Best and Brightest vs Best Fit For the State