Family practice residency programs and the graduation of rural family physicians

Family practice residency programs graduate about 600 rural physicians each year. Increases in resident positions have not increased the numbers who choose rural practice. This study examines the relationship between program characteristics and the graduation rate of rural physicians.

From 1994-1996, we sent an annual survey to the directors of all nonmilitary family practice residency programs; 353 programs (96% response rate) returned questionnaires. Weighted least-squares regression was used to analyze the relationship between program factors and the percentage of graduates who chose practices in 1992, 1993, and 1994 in towns of less than 25,000 not adjacent to a larger metropolitan area.

Family practice residency programs that graduated more rural physicians had more required rural and obstetrical training months, had a full or partial rural mission, were located in more rural states, had the program director as the rural contact, had a procedural emphasis, had fewer residents who were minorities or female, and used fewer types of other major graduate programs for rotations.

This study outlines the important contribution of rural emphasis and training in family practice residency programs. Future studies should explore rural, procedural, and obstetrical training interventions and examine gender, minority, and program location issues.