Nearly a third of medical graduates at the University of North Dakota continue in primary care, down from nearly half just two years ago. This is the university that leads the nation for the percentage of students (about 20%) choosing family medicine.
North Dakota overall will be short about 160 physicians by 2025, and the need is now affecting urban areas as well as rural ones, said Joshua Wynne, FACP, dean of the university's School of Medicine and Health Sciences.
Keeping medical students interested in practicing primary care in rural America depends upon whom medical schools choose to admit. For example, one-fourth of the University of North Dakota's student population hails from small towns, and 80% are in-state.
More and more medical schools are looking at locally grown talent to fill their residencies, believing that these students are more likely to stay after graduation. Bruce Pitts, FACP, president of Sanford Clinic Fargo in North Dakota, tells local news source Inforum that he uses "trap lines" to cull physicians who grew up locally, or have a spouse or friend who did. Once he finds a recruit, he then expands the network a little further.
These programs also use more familiar means, such as loan forgiveness for service in areas of medical shortage, such as the RuralMed Scholarship at the University of North Dakota.
In Kansas, the University of Kansas School of Medicine-Wichita accomplishes similar recruiting and retention efforts via its Scholars in Rural Health program, which identifies promising potential medical students raised in small towns. During their undergraduate freshman and sophomore years, they shadow a rural doctor at least 40 hours each semester as well as during the summer months between their junior and senior years, and complete reports and projects. With good grades, the students are guaranteed acceptance into med school.
Garold O. Minns, FACP, professor and program director in the department of internal medicine at the medical school, said, "We are concerned about where we are today because we are just barely meeting the needs for rural Kansas. The pipeline of doctors is not as full as we would like it to be for the future."
And, programs in Maine, Arizona and New York have tried similar methods to great success by dangling half-tuition scholarships and condensed study programs to students interested in staying close to home. For the most part, students are interested, even if they haven't seen the opportunities.
Said Robert G. Bing-You, FACP, at the Maine Medical Center, "We want to show the students they can have a very productive career in a community or rural site."