Timetable for Developing a Series of Rural Medical Education Programs

Timetable for Developing a Series of Rural Medical Education Programs (or underserved in rural and urban areas)

Start early, address childhood development (see Education or State By State Education Status)
Build on existing programs in middle school and high school
Develop feeder operations with small colleges
Work with small college advisors see RHEN for example
See Statewide Continuous Efforts for what must be in place

Be sure that the medical school is ready to do RME for the long haul
The Dean of Admissions must be fully capable of admitting students with connections outside of major medical centers in birth and life
The Dean of Admissions must be fully willing to admit different students with connections outside of major medical centers in birth and life
The Dean and Chancellor and faculty must be patient and committed to the preparation, education, support, and graduation of those who are different who distribute Distributional Medical Schools

In the first few months it will take time for rural students to adjust to urban surroundings and medical school
In the first few years, it will take time for the medical school to adjust to medical students who are strong on service and communication and dedication, but a bit weaker academically. Sometimes this is a function of a few years for feeder small colleges to become more competitive (see RHOP). Sometimes this may take some remedial programs. Perhaps even a program based on quarters would be appropriate, rather than one that forces students to repeat an entire year if any segment is failed.

It is helpful to get students out to visit rural physicians during the first year
Rural student interest groups and other contacts with rural and family practice faculty (for advisors, counselors, small group leaders, student health, international missions)
International service efforts and service-learning - the right students will be chomping at the bits for these programs. These programs also help develop leadership, management skills, career development, and a broader view of their role in communities, also the opportunity to meet some incredible role models

The M-4 year is often wasted, so why not use it as transition year to residency. Again, the right students know what they want to do and are ready for focused rural primary care efforts. Also specific rural training can prepare residents more specifically for rural practice. For update on Accelerated Rural Training Program see NE Grad Programs 2000
There are many ways to bridge the gap between residency and rural practice, including specialized moonlighting programs, resident experiences such as The CORE Program, having faculty take residents on tours, having communities come to the residency to do presentations, service learning projects or community medicine projects in rural areas, require residents to prepare a practice plan for a practice in a rural area and use consultants to educate the resident.
The focus is on the learner specific to rural and underserved location, not the comfort of faculty or medical education

Some elements must be in place from the start. These include:

Significant planning and coordination to ensure that the right students are selected and programs are ready when these students are ready
Offices of Rural Health that work at all levels in training from scholarships, shortage area, health systems, loan repayments, educating students and residents, tracking and evaluation, close contact with communities that are recruiting, personal knowledge of the residents involved, active recruitment of those who have left the state for residency or recent practice
Rural Faculty who facilitate at all levels and Family Medicine leaders who support the above and provide excellent education to all levels from basic doctor-patient skills to advanced practice management and procedures.

Nebraska

Statewide plan developed, loans and scholarships in place
Feeder programs set up, state functions improved for recruitment, retention, and tracking
Bridging and graduate programs
Results now support the entire effort, with some programs seeming to work, but too early to evaluate 8 years later. It takes time and patience and commitment to do RME