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University of Missouri

The Nearest Doctor

Mizzou educates rural students to practice medicine in rural areas.

Dr. James Stevermer and medical student Amanda Shipp examine an elderly female patient

James Stevermer, MD, and medical student Amanda Shipp examine a patient in Fulton, Mo., a town of approximately 13,000 people. After growing up on a farm, Stevermer decided to practice medicine in a small community due to a shortage of rural physicians and his family’s preference for rural life. He is a medical education director at MU and co‐author of a new article in Academic Medicine that describes MU’s success in producing physicians for rural areas. Photo courtesy of MU School of Medicine.

America’s shortage of physicians is worsening, especially for rural patients, one of the nation’s largest underserved populations. About 20 percent of the U.S. population is rural, but only 9 percent of physicians practice in the countryside, a disparity that harms the health of rural people and their economies. There’s no end in sight because just 3 percent of medical students want to practice in rural areas.

But through MU’s longitudinal Rural Track Pipeline Program, the situation in Missouri is much brighter, according to a November 2011 article in Academic Medicine. Many programs throw money at the problem by offering financial incentives to physicians willing to work in rural areas for a few years. “Those doctors usually move back to cities, where they can get a Starbucks coffee when they want it,” says lead author Kathleen Quinn, who directs the program. Instead, MU’s pipeline program recruits interested rural students and trains them in rural areas to help foster long‐term commitments.

Quinn says students from rural backgrounds are more likely to practice in rural areas. So, the pipeline program is replenished annually when the medical school’s Bryant Scholars Pre‐Admission Program admits up to 15 students from rural backgrounds who want to practice in such areas. After the first year of medical school, Bryant Scholars and other interested students join the Summer Community Program, where they work in rural practices to learn about the lifestyle and practice possibilities. During the third year of medical school, Bryant Scholars and interested third‐year students really dive in by participating in the 6 month Rural Track Clerkship Program. They live at one of 10 sites across Missouri and work alongside community‐based faculty members, many of whom are MU graduates. In the final year of medical school, students can return to those rural centers and delve into specialty practice.

Students gradually visualize themselves professionally and personally living and working in these areas,” Quinn says. “But they have to see and experience it over time as they mature and develop clinical expertise. Then they can say, ‘This is right for me, this is what I’m good at and here’s why.’ But without the training they may not know enough to make informed choice.”

MU’s students are making the choice. More than half (57.4 percent) of medical students who participate in some part of the pipeline program began their careers practicing in rural areas.

More: Care for Missouri