Rural Medicine Realities: The Impact of Immersion on Urban-Based Medical Students.

PURPOSE: The purpose of our study was to determine what effect a rural-based 8-week surgical clerkship during the third year of medical school in a rural setting has on students' opinions about rural living and practice. METHODS: Thirty-three third-year medical students completed a rural health opinion survey at the beginning and end of their 8-week rural rotation and a survey measuring their interest in rural practice after the rotation. The setting was a rural hospital with an average acute care census of 100 that is a regional referral center for 5 rural counties. FINDINGS: Urban campus-based students had a statistically significant positive change in opinions about rural comfortable living, availability of quality services, community support, and medical resources. The urban campus-based students also showed a significantly increased interest in small town practice after the rotation. CONCLUSIONS: Our hypothesis that urban-based students would report an increased level of rural community support at the end of the rotation was confirmed. These urban-based students also reported positive opinions about rural living and practice. The students primarily based at the urban campus also showed a statistically significant more positive attitude toward pursuing a career in a small town after the 8-week experience. This suggests that brief rural immersion experiences may make the larger student pool at an urban campus available to address rural workforce challenges. Future studies at multiple rural sites with a larger sample size are needed to confirm this possibility.

Just what are rural premedical students thinking? A report of the first 6 years of a pathways program.

PURPOSE: To assess outcomes of the first 6 years of a program designed to facilitate medical school admission for rural premedical students. METHODS: Students completing the University of Louisville School of Medicine Trover Rural Scholar program were surveyed using a 23-item survey. FINDINGS: Twenty-two of the 24 (92%) students responded. Overall, 12 (55%) were in the physician pipeline (medical students or re-applying to medical school) and 10 (45%) had left the physician pipeline for other careers (7 were pursuing other health care careers). Differences between the 2 groups included income expectations and perceptions of intellectual challenges and physicians' job satisfaction. CONCLUSIONS: Attrition can be explained by student interests, maturation and influences of pre-professional advisors and practicing physicians. Successful pipeline programs should address these issues.