Rural Versus Urban Family Medicine Residency Scope of Training and Practice

Area of Science:

• Medical Education
• Family Medicine
• Rural Health

Background:

• Limited understanding of differences between rural and urban family medicine residency training.
• Comparison of physician preparedness and postgraduation scope of practice (SOP) is needed.

Purpose of the Study:

• To compare perceived practice preparedness and actual SOP of rural versus urban family medicine residency graduates.
• To identify differences in skills and practice breadth based on residency location.

Main Methods:

• Analysis of survey data from 6,483 early-career and 44,325 later-career physicians.
• Bivariate and multivariate regression analyses comparing rural and urban graduates on 30 practice areas and overall SOP.

Main Results:

• Rural graduates reported greater preparedness in hospital-based care and certain procedures.
• Rural graduates were less prepared in some gynecologic and HIV/AIDS management areas.
• Only later-career rural graduates demonstrated a significantly broader SOP after adjustments.

Conclusions:

• Rural training enhances preparedness in hospital care and leads to a broader scope of practice for later-career physicians.
• Findings underscore the value of rural residency programs for physician training and practice.
• Establishes a baseline for future research on the long-term impact of rural training on health outcomes.