The UNMC Department of Family Medicine won the Outstanding Rural Health Program Award from the National Rural Health Association in May of 2001. See summary of this nomination for the reasons. Those who established specialized admissions that are more likely to admit "different" physicians and the efforts that improve the probability of rural student admissions (Rural Health Opportunities Program) share a big part of the success.
The integrated efforts of the medical school and residency deserve mention as well, with the Integrated Clinical Experience involving the first 2 years in small groups with heavy primary care emphasis, an M-1 rural 3 week experience at the end of the year, the required 2 month M-3 rural preceptorship (UNMC Celebrates 50th Year of Preceptorship, Why a Rural Preceptorship Is Best ), and then a variety of rural graduate programs (below). Rural Student Interest Groups, international programs, award winning service-learning opportunities (Sharing Clinic), and stellar community health projects Rural Nebraska Access to Health Care Report By Students also contribute. In fact, with the right admissions, it is difficult to keep students from excelling in service since they are Service Oriented. The presence of family medicine faculty is felt across all programs, curricula, mentoring, and leadership levels. Helping students, residents, and family medicine to fulfill potential is what it is all about.
Ten years ago, Nebraska graduates trained entirely in academic settings except for a two month rural rotations. They chose rural communities 40% of the time, slightly less than the 50% rural population of the state. Even though 40% was double the national average for rural graduation for FP, this was not enough for the needs of the state. Department leaders set out in new directions following research that stressed the importance of smaller training locations and more "hands-on decision-making" and procedural training. The result has been impressive.
Now the residency slots include 4 Accelerated Family Medicine Training positions and 8 Rural Training Track (RTT) positions each year. Some of the RTT positions are filled by residents who "become" residents in their 4th year of medical school via the Combined Primary Care Track. Each year 12 - 15 FP residents receive specific training for rural practice. All residents do 2 months in rural Nebraska in the PGY-2 year working closely with rural physicians through the The Combined Outstate Rural Experience (CORE). The remaining residency positions continue to address specific needs in the nation. They involve an urban underserved track, an MPH position, and an MBA position. The result has been more rural graduates, better graduates, and more grads to meet the needs of the state and the US in the most underserved areas. Those graduating locate in even the smallest towns - the kind of graduates most needed by Nebraska where there are 40 counties with less than 10,000 people but still a doctor and a hospital.
Feeder Programs for Students
Rural Health Opportunities Program
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"Physicians occupy an unusual spot in the social structure of rural communities. From an economic standpoint, they are successful entrepreneurs, well-paid business people similar to bankers and lawyers. On the other hand, they are also social servants like policemen or teachers, just as essential to the welfare and functioning of the community but paid for through a fee-for-service mechanism outside of local community control. This anomalous status requires some fairly innovative interpersonal and structural relationships to strike a workable balance." Rosenblatt and Moscovice, 1982