The initial impact of a surgical AHES program on medical students' career decisions

Since 1974 the University of Louisville has sent medical students to a rural area to receive their core surgical clerkship experience as part of an area health education system (AHES) program. This report reviews the first five years of the program and its effect on residency selection. Seventeen percent of the 679 students who graduated from the School of Medicine between 1976 and 1980 participated in this rural program. These students were similar to their urban university-based peers as a group in preclerkship evaluation criteria. Test scores on surgery examinations and examinations of the National Board of Medical Examiners did not differ between the two groups. Residency programs chosen by participants showed a similar distribution to those chosen by the university group, except in family practice. Twenty-six percent of the rural group chose family practice residencies, compared with 16 percent of the urban group. The early impact of the surgical AHES program is evaluated, and the need for continued follow-up is emphasized.