What community members can do. What rural faculty can do as facilitators at the local level.

Encourage and Prepare the Right Students

• We want students who are the best, not necessarily the brightest.
• We need students who want to return to rural communities, not escape for fun or profit or fame or fortune.
• We need teachers and counselors who encourage the right students and get them exposed to health practitioners and health careers.
• We need to encourage the teachers and counselors.
• We need small college health career advisors to push the right kind of students to prepare well and apply, even if they are marginal. Put the pressure on medical schools to select the right students and train them, even if it takes more effort. People in rural and underserved communities deserve this.

Work with Students and Residents who come to your town

• Do site development with practitioners and community leaders
• Set up a meeting with these folks and ask 3 questions:
• What should medical schools have done to train you better (or from community leaders what do you wish medical education did better)?
• What special assets do we have in our community that we would want students or residents to see (qualities or procedures from practitioners, family life in the community, key people in the community, special programs, recreational items, community events, community groups, info when people play basketball, involvement in the sports for the community, devoted people, chamber, newspaper)?
• How can we encourage these interactions when students and residents are hear (keep a list, have practitioners and community contact review these with incoming students and residents, do a mid course check to see how you are doing in these areas, keep track of students and residents over time and encourage them to return)?

Anyone can have clinical experience in any location. Only you can bring the experiences of an entire community into the awareness of a student or resident.

Fight Medical School Admissions Committees for Total Control of the process or at least a share of the control of the number of rural background and rural interested students that you need for your state. Do not settle for influence, go for control. Involve small college advisors and trained rural people as admissions members as they know the kids and they know who is really interested in rural practice versus those who just say they are interested to get in.

Fight for an entire generation We have forgotten what it takes to graduate more and better and longer rural physicians. We will need to fight for at least a generation or more to ensure that we do not forget. Studies have known what to do for 30 years, it is time to do it!

Work hard to retain current practitioners. It involves adjustments on both parts of this "marriage" to keep rural providers retained and enable them to best meet the needs of rural communities.

Robert C. Bowman, M.D.

Co-Chair of the Rural Medical Educator’s Group

UNMC Family Medicine Rural Programs

983075 Nebraska Medical Center

Omaha, NE 68198-3075 [email protected]