Characteristics to look for include rural background, more mature candidates. This puts a premium on quality rural education. Educational programs must overcome problems in some urban and rural populations where expectations of peers, parents, and schools are not high.
Candidates need premedical career experiences in high school and college, especially for those with non-professional parents or from disadvantaged backgrounds.
Not currently in operation, but a long term goal is to force medical students to do primary care practice for at least four years after residency graduation before specialization is allowed. This helps all of the priorities to fall into place. Students desiring subspecialization will think twice. Faculty will know primary care is the priority. Pick a date in 3 - 4 years and begin notifying high school and college students and colleges. Might as well add fluency in a Spanish or another useful language while you are at it.
Reverse current thinking where academic performance is king and rural and primary care are tracked separately. Prioritize rural and primary care (sometimes rural alone for some states) and give the separate small rural admissions tracks for the gifted individuals - Ten AHOPS (Academic health opportunity program students) instead of ten Rural HOPs per class.
Try a new process. Might as wll be generous and choose the 25% that are exceptional as potential leaders, clinicians, and researchers. For the rest then make a pool of acceptable candidates that have less than a 30% risk of academic failure. Of these, choose first those most likely to serve the rural and disadvantaged. Go down the line and stop when you become concerned whether candidates have exceptional interpersonal skills and service motivation.
Anything that you want, you got to get up early for it!
The right candidates will be frustrated if they don't get to do service, teaching, or some form of care. Make sure this is brought in early and often. Link it to studies to avoid class rebellions and poor socialization.
Rural experiences are key. Also need hands on responsibility for real patients in ambulatory and hospital practice. This may mean work away from the medical center or overseas. This should develop comfort with decision-making and procedural skills. Lots of ambulatory emphasis and training is advisable.
Curricula, rural experiences (preferably residency in rural area), practice management, procedures, hands-on, faculty, advisors
Ready access to key information about the types of rural practices available. Choice of a good "matching" rural practice. State, medical institution, rural community partnership. Lots of visits going on to rural communities, lots of moonlighting.
The task of many in the community, including physician role models, community people and others. The big challenge is adjusting to the workload. Also understanding the community, the practice, and changes in self and family.
Comfort with the role, expectations of self, expectations of peers, expecations of community
physician, manager, lead physician or not, overcoming grass is always greener thoughts
Becoming truly effective as a physician - developing skills of delegation, personnel, information, keeping up
Accepting financial responsibility and risk
Best accomplishing last steps - strong local rural health system in partnership with state. Physician is part of an effective rural health system with acceptance by locals of need for own efforts and responsibility, rather than blaming externals for problems. State/med center supportive
If defective system, physician can be sucked into other roles and more easily overwhelmed. Attention to mental health, public health, economic development, community leadership - physicians are not out there alone.
For a step by step approach to obtain more rural physicians, try this page.