Frontier And Rural Medicine: A 10-Year Review

South Dakota's largely rural and frontier population faces significant barriers to healthcare access, including a high prevalence of Health Professional Shortage Areas (HPSAs). To address these gaps, the University of South Dakota Sanford School of Medicine (USD SSOM) launched the Frontier and Rural Medicine (FARM) program in 2014. FARM provides longitudinal rural clinical training and community immersion to medical students, aiming to increase the number of physicians entering primary care and practicing in South Dakota. Residency match outcomes (2016-2025) and practice locations of FARM graduates were reviewed. Placement and practice location data were obtained from FARM program records, the SSOM Department of Student Affairs, the National Resident Matching Program, and the AAMC Workforce Data Dashboard. Using a sample of 86 FARM graduates, Chi-Square Goodness of Fit testing compared FARM outcomes with USD SSOM and national rates for primary care match and in-state retention. Results indicated that FARM graduates matched into primary care at a 68% and 48% higher rate than SSOM and national rates, respectively. In-state retention rates were significantly greater than national rates, but not for SSOM rates, with differences of 50% and 33%, respectively. The program demonstrates measurable impact on the rural physician workforce and offers a model for addressing primary care shortages in underserved states.