Based on advice given to a student from New York interested in the best rural training available.
You can become a rural doctor from any medical school in the US or overseas, but some are a bit better in selections and also in environment and preparation. Most students do not have the luxury of selecting a school from many, but if you do...
Some of these schools and school programs will prefer rural background students, but nearly all will be willing to take the extra steps to identify true rural primary care interest in an urban candidate.
Regarding medical school type and location, the public medical schools and those with a mission for rural health and rural curricula are best (WAMI paper in JAMA). There is also the advantage of a group effect, rural student interest programs, and better faculty and administration attitudes toward your career (Bowman anecdotal). Wish I could say that medical schools were more open minded about career choices, but even in many of these schools, faculty finding out about your rural pc interest will still tell you or imply that you are wasting your life. If you are a strong-willed person, this will not matter and may even disgust you, hopefully. Even in the following medical schools, those desiring rural practice will have to cut their own career course. Otherwise you will find yourself a typical subspecialist, costing the nation an additional $400,000 a year and adding to the burden of health care on the nation.
Given from your western location preference, the schools with the best training for a rural practitioner would be noted below. The following have special rural selections, group effect, rural electives, interest group, rural experiences, mission:
For those interested in a more national rating, see Rural Ranking 1981 for a listing of the % of students choosing rural practice.
University of Washington, WWAMI system
University of Nebraska, especially the Accelerated Rural Training Program - selections, group effect, electives, interest group, rural experiences, mission
University of Minnesota, Duluth then Rural Physician Associate Program (RPAP) in the M-3 year
University of Illinois, Rockford, RMED program
Michigan State Upper Peninsula program Local link at Upper Peninsula Program
East Tennessee State rural primary care track
Medical Scholars Program in Alabama
West Virginia Partnerships
Mercer University in Georgia - keeps causing problems with link
Syracuse, do the 4th year RMED program - not as certain about other rural items in environment and curriculum here, RMED is top notch prep.
University of New Mexico - also has international focus
Jefferson Physician Shortage Area Program - much of the above, but group effect and selections strong, very urban
BA/MD Rural Track Homepage for Indiana - example of some programs involving branch campuses and combined activities. Alabama, New York and other states have similar examples
I would also rank several osteopathic schools in this group, including Kirksville, Des Moines, TCOM in Fort Worth, Michigan State, and Oklahoma State
Although not an osteopath, I have a great respect for osteopathic training. They truly train for rural primary care. They have hands on training from day one of medical school. They are willing to take the students who want to serve and do primary care, rather than bowing to the intellectual gods as other medical schools do. Osteopathic education has few obstacles for those truly interested in rural primary care. Many if not most osteopaths take allopathic graduate residencies in Family Medicine. Considering these number of good quality rural training programs, it is a marriage that I hope to see more and more. Recent efforts by osteopathic medicine to improve graduate training, increase the number of programs, extend to 3 years, and work with allopathic training have all been positive. Osteopathic residents and physicians make great contributions to their training programs.
Given your New Your residency status, Syracuse might move up on your list. Students who do RMED are outstanding candidates for residency and rural practice. Obviously selection depends upon medical school performance, but most of the time the number of candidates taking the rural tracks is about equal to the number available. Few are turned away. This varies in some locations.
I know very little about you, but given your residency status and willingness to travel and status outside their typical catchment areas, the Jefferson and Rockford programs and some others might rank you less likely for their group. Rural selections tend to prefer people in their own state who are more likely to return to practice in these locations. At the Rockford program, you are screened by GPA and MCAT to be sure that you can make it in medical school, and then are selected by a jury of rural people as the ones most likely to continue in a rural pathway. Their track record for primary care choice is nearly 100%. The program will need a few more years before rural locations are known. Your service activities would be important. Padding the application for service is also considered, so this would be ill advised. All of the usual medical school admission tricks seem to be accounted for such as saying you are interested in being a small town doctor. It is more difficult to fool several people who have the inclination and training to detect false statements. One drawback is that some people have the appearance of being cosmopolitan without actually being that way. I guess when you are breaking new ground to select the right candidates, there should be some tolerance in the early years of such programs. On the other hand, your pursuits in the area to find the best rural medical school are an advantage. You might be too polished for this group, but I would not exclude it.
More about Recruitment and Retention - Two different species without the same factors involved.
Recruitment to a rural location involves background and interest, but retention in a rural location is no better for any of these factors. Rural background students are 4 – 6 times more likely to choose rural practice (30 – 40% at some locations). Urban students choose rural practice less often (2 – 8 %). Selecting a true rural background candidate with true family practice interest is the key to rural recruitment. Unfortunately admissions committees usually do not understand this.
Retention is dependent on some factors that we do not understand well. Don Pathman at UNC Chapel Hill is the national expert in this area. My favorite factor to explore for retention is the dedication of the physician to service or mission. Next likely is better preparation, including training that involves decision-making, confidence building, procedures, rural locations as much as possible. These are difficult to find because most medical schools have learning environments that do not involve such hands-on training, given the concentration of more senior learners and liability excuses. Frankly one of the main problems is that physicians who train students and residents do not know their patients and their patients do know know them. Physicians that have a close relationship with patients allow students and residents to do more. This training then is better in the more rural locations for training. Inner city and other locations with good continuity over several years can also provide this type of training if they choose to do so and see the need to train for care of the underserved. Locations where practice monetary concerns dominate can compromise the teaching also. It takes time and dedicated practitioners to assist students in a career of service to the underserved. They are willing to make small sacrifices to achieve greater long term goals.
Robert C. Bowman, M.D, Co-Chairman
Rural Medical Educators Special Interest Group of the National Rural Health Association
UNMC Department of Family Medicine Director of Rural Health Education and Research
983075 Nebraska Medical Center
Omaha, NE 68198-3075
(402) 559-8873 or fax at -8118
Email: rbowman@unmc.edu
Main web page entry at
http://www.unmc.edu/Community/ruralmeded/ for World of Rural Medical Education
PreProfessional Advice and Information
Education - the entire pipeline