Rural physician 1951 - 1971
Accomplishments as Rural Medical Educator 1971 - 1991
RPAP director until 1991, Distinguished Rural Medical Educator
Dr. Verby was the 1991 winner of the Thomas W. Johnson Award at the AAFP annual meeting. Dr. Johnson was a long-time member of AAFP who joined the education division staff in 1969 and served as its director from 1971 to 1973. The annual award recognizes physicians who have made outstanding contributions to family practice undergraduate, graduate, and continuing medical education.
Verby Articles Listing and Summaries
A SPECIAL EXAMPLE - THE MINNESOTA RURAL PHYSICIAN ASSOCIATE PROGRAM
In 1971 the Minnesota Legislature told the medical school to develop programs that would address the needs of the state or face reduced funding. This created an immediate institutional mission. The state supported the program with funding. John Verby developed a model program for 10% of the class (20 - 30 students a year). The program involves rural preceptor training for nine to twelve months in the third year. It also involves training in doctor-patient relationships, psychiatry, and other areas. The program addresses many of the principles mentioned previously. The location and the duration of the RPAP program greatly influence students. The clinical years are the key ones in deciding for primary care. The longer duration allow more comfort with primary care. RPAP students escape each other and the medical school environment. The funding allowed a critical mass of faculty for program development. The program has graduates in every legislative district and RPAP grads train new RPAP students. Each new generation is more familiar with the program.
The program is one of the most learner-centered in the nation. Instead of the usual new attending and resident each month, the student has a preceptor for the entire time. This preceptor gets to know each student's strengths and weaknesses. The student learns much more than medicine in these interactions. RPAP students do as well or better in board scores and far outperform the urban students in behavioral and procedural objectives. The evaluation of the RPAP is among the most extensive in all of medical education. The funding structure favors the student and rural training.
All of his articles and efforts have largely been forgotten, except for the rural medical educators and programs that he has influenced. Searches of the internet and medical education and family medicine documents only reveal one notation on Dr. Verby, a $500 donation to the AAFP Foundation. www.aafpfoundation.org/2001ar.pdf
RPAP has influenced medical schools to establish replications in New York, West Virginia, Illinois, Tennessee, and Florida in addition to Canada and Australia.
Blueprint documents Canada
http://www.srpc.ca/librarydocs/blueprint1.html
http://www.srpc.ca/librarydocs/blueprint2.html
“Medical schools in West Virginia, Arkansas, the Dakotas, and others are asking for more information in implementing the RPAP (MN) model. The massive transition in clinical undergraduate, graduate, and postgraduate medical education as proposed here would help to cut medical education costs and upgrade medical care and education throughout the state. It will produce a more humanistic physician with a broader knowledge base and steeped in primary care and family medicine experience, as recommended by the New York State Commission on GME and the AAMC. The hostile polarization of people towards hospitals and physicians will be reduced, eventually helping to alleviate the current malpractice crisis and producing more of the right physicians for the right place.” Verby, et al 1989
Dr. Verby’s articles are profiled with other key rural medical education articles in
http://www.futurehealth.ucsf.edu/pdf_files/biblio.pdf
And also in Florida State’s extensive consultations and preparation for the new medical school at http://www.fsu.edu/~medicine/pdf/summaries.pdf
Dr. Verby’s comments appear in numerous publications in this and other English-speaking nations. Here is one in Family Practice Management in Nov-Dec 1996 High demand for well-trained docs. http://www.aafp.org/fpm/961100fm/letters.html
To the Editor:
Managed care organizations will continue to seek competent family physicians because we are cost-effective compared to subspecialists. Family physicians who are trained to do obstetrics, uncomplicated minor surgical procedures and simple, uncomplicated fractures and who are capable of relating to people of all cultures and ages will be held in high esteem by the medical profession and U.S. citizens. Those residencies that teach these skills will produce physicians who can go anywhere (rural or urban settings) and be in the highest demand.
John Verby Jr., MD
Illinois RMED is but one of the replicants of the RPAP program. http://www.stfm.org/fmhub/Fullpdf/Jan00/Sa1.pdf
RPAP (MN) builds bridges of good will between the University and rural doctors. Many physicians recall the days when the hapless and hopeless referring LMD was dismissed with scorn at the professor's grand rounds. Times have changed! Monthly University visits have done much to dispel the doubts. When men of professional stature… come out to the rural hospital, make rounds, break bread, and discuss common problems with the local medical staff, new bonds of understanding grow quickly between small town and gown. JK Heid
http://www.aamc.org/data/aib/camcam/vol4_no2.htm
March 2000 AAMC Fact Sheet Vol. 4 No.2
Examples of Medical School Programs for Rural Communities
The University of Minnesota Medical School has established a community-based education project called the Rural Physician Associate Program (RPAP) in order to address the shortage of primary care physicians in Minnesota. Since 1971, the RPAP has involved a total of over 100 teaching sites and 900 medical students. During the program, each medical student typically performs 250 history and physical exams, assists on 200 general surgical procedures, and delivers 32 babies. The program, which involves video and distance learning technology to enhance students' educational experiences, has proven effective throughout the years. Of the former students now in practice, 61% are in rural communities and 64% remain in Minnesota. In addition, 76% of these students are in primary care, with 67% choosing family practice.
Research in Rural Medical Education