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Rural Track Training Based at a Small Regional Campus: Equivalency of Training, Residency Choice, and Practice Location of Graduates

Crump, William J. MD; Fricker, R. Steve MPA; Ziegler, Craig MA; Wiegman, David L. PhD; Rowland, Michael L. PhD

Academic Medicine:
doi: 10.1097/ACM.0b013e31829a3df0
Research Reports
Abstract

Purpose: Ten years of data for the rural-based Trover Campus (ULTC) were compared with data for the main campus of the University of Louisville School of Medicine to determine whether educational outcomes were equivalent and whether this method of optimizing the affinity model was effective in placing graduates in rural practice.

Method: Demographic data and academic measures were compared for 1,391 graduates (60 from ULTC) for 2001–2010. A noninferiority model was developed to compare clinical experiences for each campus cohort. Residency match lists were examined for specialty choice. Graduates from 2001 to 2006 were matched to the American Medical Association Masterfile to determine practice site.

Results: ULTC students scored lower on United States Medical Licensing Examination (USMLE) Step 1 and Step 2 Clinical Skills (CK) but tended to close this gap after clinical training when compared with Louisville graduates. The noninferiority model indicates that ULTC students’ scores were noninferior to Louisville students’ on adjusted shelf exams for obstetrics–gynecology, pediatrics, and surgery, and Step 2 CK (P < .001). ULTC graduates were 4.5 times more likely to choose family medicine (P < .001) and over 6 times more likely to choose a nonmetropolitan area as a practice site (P = .001).

Conclusions: These data support the value of a small regional rural clinical campus in optimizing the affinity model to place rural students into rural practice. The ULTC students showed equivalent adjusted test scores and slightly narrowed the gap in unadjusted USMLE scores compared with the main campus students.

Author Information

Dr. Crump is associate dean, University of Louisville School of Medicine Trover Campus at Baptist Health Madisonville, Madisonville, Kentucky.

Mr. Fricker is director of rural health/student affairs, University of Louisville School of Medicine Trover Campus at Baptist Health Madisonville, Madisonville, Kentucky.

Mr. Ziegler is a biostatistician, Office of Graduate/Undergraduate Medical Education, University of Louisville School of Medicine, Louisville, Kentucky.

Dr. Wiegman is associate vice president for health affairs, vice dean for academic affairs, and professor of physiology, University of Louisville School of Medicine, Louisville, Kentucky.

Dr. Rowland is assistant professor, University of Louisville School of Medicine, Louisville, Kentucky.

Funding/Support: None.

Ethical approval: Ethical approval has been granted for this study by the University of Louisville School of Medicine institutional reviewboard.

Other disclosures: None.

Correspondence should be addressed to Dr. Crump, ULSOM Trover Campus at Baptist Health Madisonville, 200 Clinic Dr.–3rd Center East, Madisonville, KY 42431; telephone: (270) 824-3515; fax: (270) 824-3590; e-mail: wcrump@trover.org.

© 2013 by the Association of American Medical Colleges