Education and Training of the Rural Healthcare Workforce – Models and Innovations

Evidence-Based Examples

Thomas Jefferson University's Physician Shortage Area Program

Added March 2023

• Need: More rural doctors were needed in Pennsylvania, where nearly half of the state's physicians practice in just three large metropolitan counties.
• Intervention: Sidney Kimmel Medical College at Thomas Jefferson University established the Physician Shortage Area Program (PSAP) in 1974 to recruit and support students who are from rural backgrounds and who wish to practice in rural communities.
• Results: Approximately 80% of PSAP alumni have remained in rural family medicine for at least 20 to 25 years after graduation.

Effective Examples

OHSU Rural Surgery Training

Updated/reviewed October 2023

• Need: General surgeons are needed in rural communities.
• Intervention: Oregon Health & Science University (OHSU) is sending residents to complete a general surgery rotation in rural southern Oregon.
• Results: 39% of the graduates of the rural residency program are now practicing in a rural setting. The residents remain more likely than other OHSU residents to enter general surgery practice and to serve in a community of fewer than 50,000 people.

Rural Medical Education Program at University of Illinois College of Medicine Rockford

Added October 2023

• Need: To recruit and train medical students who are committed to choosing rural practice.
• Intervention: An add-on curriculum that includes seminars, field trips, and clinical rotations in rural and underserved areas.
• Results: 436 students have graduated from the RMED program between 1997 and 2023, with 65% of program graduates practicing in towns of less than 50,000 people.

MU AHEC Summer Community Program

Updated/reviewed September 2023

• Need: Lack of healthcare providers, specifically physicians, in rural Missouri.
• Intervention: Rising second-year medical students at University of Missouri's School of Medicine are given the opportunity to participate in a clinical program in a rural community setting.
• Results: Almost half of the participants from 1996-2010 chose to practice in rural locations upon graduation.

Promising Examples

TUSM-MMC Program Longitudinal Integrated Clerkship

Updated/reviewed April 2024

• Need: To fill vacant medical positions in Maine's rural medical facilities.
• Intervention: The Tufts Maine Track LIC program offers clerkships in rural medical facilities, exposing medical school students to the positives and possibilities that rural practices have to offer.
• Results: The program has seen an increase in students' interest in practicing in rural Maine. The majority of participants have pursued medical careers in one of the six core specialties studied during their clerkship.

Successfully Training and Educating Pre-medical Students (STEPS)

Updated/reviewed January 2024

• Need: To increase the number of primary care providers in northeast Kentucky.
• Intervention: STEPS provides support such as physician shadowing, mock interviews, and MCAT practice courses/exams for regional students applying to medical school.
• Results: More than 70% of participants have been accepted into medical school. The program has been replicated among most of Kentucky's regional AHECs.

Other Project Examples

Targeted Rural Underserved Track (TRUST) Program

Updated/reviewed March 2024

• Need: There is a shortage of rural physicians in the Northwestern United States.
• Intervention: University of Washington medical students are receiving training through the TRUST program in rural, underserved communities across a five-state radius.
• Results: Long-lasting connections have been formed among regional and underserved communities, medical students, and rural health professionals, with the goal of producing more rural physicians.

Pacific AIDS Education and Training Center-Nevada

Updated/reviewed February 2024

• Need: To improve and increase prevention and care services for HIV, STDs, hepatitis C, and other infectious diseases.
• Intervention: PAETC-NV provides clinical and didactic trainings, conferences, technical assistance, capacity building, webinars, and other services to providers and healthcare organizations statewide.
• Results: In 2023, PAETC-NV trained more than 1,600 healthcare providers across Nevada to increase clinical capacity in the care, screening, and prevention of HIV, other sexually transmitted diseases, and hepatitis C.

Hawai'i Island Family Medicine Residency

Updated/reviewed January 2024

• Need: Hawai'i is experiencing a severe shortage of family medicine physicians.
• Intervention: The Hawai'i Island Family Medicine Residency (HIFMR) program uses an interprofessional team-based approach so residents learn how to care for many types of patients in different healthcare settings.
• Results: Since 2017, HIFMR has graduated a class of 3 to 6 Board-certified family medicine physicians annually. Most graduates have remained in the state to practice medicine; those who have left have entered fellowship programs and plan to return to Hawai'i Island to practice.

Premera Rural Nursing Health Initiative at the University of Washington

Added January 2024

• Need: To create rural clinical placement and postgraduate fellowship opportunities for Doctor of Nursing Practice (DNP) students and recent Advanced Registered Nurse Practitioner (ARNP) graduates in Washington.
• Intervention: The Rural Nursing Health Initiative (RNHI), a program out of the University of Washington School of Nursing that created clinical placement opportunities for DNP students and a postgraduate fellowship program for ARNP graduates.
• Results: Rural clinical stipends have been awarded to 80 DNP students, and 12 ARNPs completed rural fellowships between 2021 and 2023.

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