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Influencing Residency Choice and Practice Location Through a Longitudinal Rural Pipeline Program

Quinn, Kathleen J. PhD; Kane, Kevin Y. MD, MSPH; Stevermer, James J. MD, MSPH; Webb, Weldon D. MA; Porter, Jana L. MS; Williamson, Harold A. Jr. MD, MSPH; Hosokawa, Michael C. EdD

doi: 10.1097/ACM.0b013e318230653f
Rural Medical Education

Purpose: The University of Missouri School of Medicine developed the Rural Track Pipeline Program (MU-RTPP) to increase the supply and retention of rural physicians statewide. The MU-RTPP features a preadmissions program for rural students (Rural Scholars), a Summer Community Program for rising second-year students, a six-month Rural Track Clerkship (RTC) Program for third-year students, and a Rural Track Elective Program for fourth-year students. The purpose of this study is to report the specialty choices and first practice locations of Rural Scholars, RTC-only participants, and Rural Track Clerkship Plus (RTC+) participants (students who participated in the RTC Program plus an additional MU-RTPP component).

Method: The authors compared the residency specialty choices of 48 Rural Scholars (tracked since 2002) with those of 506 nonparticipants and the residency specialty choices of 83 RTC participants and 75 RTC+ participants (tracked since 1997) with those of 840 nonparticipants. The authors calculated the relative risk (RR) for the likelihood of participants matching into primary care compared with nonparticipants and analyzed first practice location.

Results: Rural Scholars were more than twice as likely to match into family medicine (RR = 2.6; 95% confidence interval 1.5–4.4). RTC and RTC+ participants entered primary care, especially family medicine, at rates significantly higher than nonparticipants. Over 57% of students who participated in the RTC program (and potentially other MU-RTPP offerings) chose a rural location for their first practice.

Conclusions: The longitudinal MU-RTPP successfully recruits students for rural and primary care practice to address the health care needs of Missouri.

Dr. Quinn is program director, Area Health Education Center, Rural Track Pipeline Program, Department of Rural Health Programs, and assistant professor, Department of Family and Community Medicine, University of Missouri School of Medicine, Columbia, Missouri.

Dr. Kane is faculty director for curriculum for third- and fourth-year students and associate clinical professor, Department of Family and Community Medicine, University of Missouri School of Medicine, Columbia, Missouri.

Dr. Stevermer is medical director, Area Health Education Center, Rural Track Pipeline Program, Department of Rural Health Programs, and associate clinical professor, Department of Family and Community Medicine, University of Missouri School of Medicine, Columbia, Missouri.

Mr. Webb is associate dean, Department of Rural Health Programs, University of Missouri School of Medicine, Columbia, Missouri.

Ms. Porter is coordinator for program/project support, Area Health Education Center, Rural Track Pipeline Program, Department of Rural Health Programs, University of Missouri School of Medicine, Columbia, Missouri.

Dr. Williamson is vice chancellor for health sciences, University of Missouri School of Medicine, and professor, Department of Family and Community Medicine, University of Missouri School of Medicine, Columbia, Missouri.

Dr. Hosokawa is professor, Department of Family and Community Medicine, University of Missouri School of Medicine, Columbia, Missouri.

Please see the end of this article for information about the authors.

Correspondence should be addressed to Dr. Quinn, University of Missouri, School of Medicine, DC345.00, 2401 Lemone Industrial Blvd., Columbia, MO 65212; telephone: (573) 884-2024; fax: (573) 882-5666; e-mail: quinnk@health.missouri.edu.

First published online September 26, 2011

© 2011 Association of American Medical Colleges