Do U.S. Medical Schools Nurture Rural Interest? A National Study of School-Specific Trends in Student Interest in...

Area of Science:

• Medical Education
• Rural Health Workforce
• Physician Distribution

Background:

• The United States faces a significant shortage and maldistribution of rural physicians.
• Students from rural backgrounds are underrepresented in medical schools.
• Rural practice interest among medical students decreases between matriculation and graduation.

Purpose of the Study:

• To understand the characteristics of medical institutions that successfully sustain students' interest in rural practice.
• To inform strategies aimed at supporting medical students' rural career aspirations.

Main Methods:

• Analyzed rural practice intent data from the Matriculating Student Questionnaire (MSQ: 2013-2015) and Graduation Questionnaire (GQ: 2017-2019) for U.S. medical students.
• Calculated and graphically displayed the change in rural practice intent from matriculation to graduation for each medical school.
• Identified characteristics of schools that matriculated and sustained a high proportion of students interested in rural practice.

Main Results:

• Rural practice interest declined among student cohorts at nearly all medical schools.
• The average percentage of students with rural practice intent decreased from 9.1% at matriculation to 7.7% at graduation (P < .001).
• Twenty-five medical schools successfully matriculated or graduated a high proportion of students interested in rural practice, often featuring large rural cohorts, rural admissions preferences, and defined rural programs.

Conclusions:

• The decline in rural practice interest exacerbates the existing U.S. rural physician workforce shortage.
• Medical schools should implement targeted strategies to foster rural interest throughout training.
• Strategies include building rural student cohorts and offering rural training opportunities through defined programs.