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Educating generalist physicians for rural practice: how are we doing?

J P Geyman1, L G Hart, T E Norris

  • 1Department of Family Medicine, School of Medicine, University of Washington, Seattle 98195, USA. jgeyman@u.washington.edu

The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association
|August 1, 2000
PubMed
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Despite efforts, a significant physician shortage persists in rural areas. Effective strategies require a multifaceted approach to overcome complex barriers in the rural medical pipeline.

Area of Science:

  • Health Services Research
  • Medical Education
  • Rural Health

Background:

  • Only 9% of physicians practice in rural areas, despite 20% of Americans living there.
  • Physicians disproportionately settle in urban and suburban locations.
  • Millions still reside in health professions shortage areas, particularly in small rural communities.

Purpose of the Study:

  • To review the successes and failures of medical education and government programs aimed at increasing rural physician practice.
  • To identify effective strategies for placing generalist physicians in rural settings.
  • To understand the complexities of the educational pipeline for rural medical practice.

Main Methods:

  • Comprehensive literature review of MEDLINE and Health STAR databases.

Related Experiment Videos

  • Content review of over 125 relevant articles and additional materials.
  • Focused analysis on "small rural" communities (population < 10,000).

    • Main Results:

    • Progress has been made in stabilizing physician numbers in some rural communities.
    • A significant number of people (22 million) still lack adequate health professions access.
    • The educational pathway to rural practice is long, complex, and has many points of attrition.

    Conclusions:

    • While much is known about selecting, training, and placing physicians rurally, challenges remain.
    • Effective strategies must address the multifaceted barriers to rural practice.
    • Continued multifaceted initiatives are necessary to improve rural physician distribution.