A summer in the country can inspire physicians to practice in rural areas, MU study finds

(Press-News.org) COLUMBIA, Mo. — According to a recent study, the Summer Community Program offered by the University of Missouri School of Medicine has made a significant impact on physician access in rural communities. The 15-year study showed medical school graduates involved in the program not only entered family practice residency training at higher rates than nonparticipants, but nearly half began their medical careers in rural locations. "In the United States, only about 10 percent of physicians practice in rural areas, and less than 3 percent of entering medical students nationally plan to practice in a rural community or small town," said Kevin Kane, M.D., a professor of clinical family and community medicine at the MU School of Medicine and lead author of the study. "We developed the Summer Community Program in 1995 to address this issue. The outcome of our study shows that not only is our program working here in Missouri, but replicating it throughout the country may increase interest in rural medicine and address rural physician workforce needs elsewhere." The Summer Community Program is part of the MU School of Medicine's Rural Track Pipeline Program. It provides students with four to eight weeks of clinical training in a rural community during the summer between their first two years of medical school. The program accepts 20 to 30 participants each year. In the study, researchers questioned 229 participants from 1996 to 2010, and asked them about pre- and post-program perceptions related to rural practice and lifestyle. The researchers then calculated how many chose to become family medicine physicians, and tracked the locations of their first practices. The findings indicated that student perceptions concerning rural practice and lifestyle changed favorably, with 72 percent agreeing they were more interested in rural medicine than they were before. Compared to nonparticipants, those involved in the summer program were also 30 percent more likely to enter primary care residency training, and twice as likely to choose family medicine specifically. Of the participants, 46 percent chose rural settings for their first practice locations following their postgraduate training. "Early rural clinical training experiences can have a positive influence on the students' interest and perception of rural medicine and lifestyle," said Kathleen Quinn, Ph.D., assistant professor of family and community medicine at the MU School of Medicine and co-author of the study. "For those who show an interest or may be on the fence about practicing in a rural community, giving them this real-world experience has been a factor in that decision-making process." John Krumme, a fourth-year MU School of Medicine student who is completing a rotation in orthopaedic surgery at the University of Pittsburgh Medical Center, is considering a rural practice after his involvement with the Summer Community Program. "I feel that practicing in a small town is a real possibility for me," Krumme said. "I have always been interested in sports medicine, but I did not consider practicing in a small community before going through the program because I didn't think they could sustain a specialty like that. Having had that experience, I am definitely considering it now." ### The study, "Summer in the Country: Changes in Medical Students' Perceptions Following an Innovative Rural Community Experience," was published in the August 2013 edition of Academic Medicine, the Journal of the Association of American Medical Colleges.