Glasser Michael, Hunsaker Matthew, Sweet Kimberly, MacDowell Martin, Meurer Mark
National Center for Rural Health Professions, University of Illinois, Rockford, Illinois 61107, USA.
Acad Med. 2008 Oct;83(10):952-61. doi: 10.1097/ACM.0b013e3181850a02.
This article presents the characteristics and results of the Rural Medical Education (RMED) Program which addresses medical workforce needs focused on reducing rural health disparities. The program is comprehensive in implementing a system of recruitment of candidates from rural backgrounds, offering a rural-focused curriculum, and instituting evaluative components to track outcomes. Distinctive program features include a Recruitment and Retention Committee of rural community members; special rural-focused topics and events during the first three years of undergraduate medical education; and a required fourth-year, 16-week rural preceptorship through which students work with primary care physicians and conduct community-oriented primary care projects. Since 1993, 216 students have matriculated. More than three quarters of candidates interviewed received offers into the program (overall acceptance rate of 75%). Comparisons between RMED and all other students on composite MCAT scores and United States Medical Licensing Examination (USMLE) Part 1 scores show a slightly lower MCAT average for RMED students, but USMLE scores are equal to those of non-RMED students. To date, 159 students have graduated, with 76% entering primary care residencies; 103 are currently in practice, with 64.4% in primary care practice in small towns and/or rural communities. RMED Program outcomes compare favorably with those of other rural medical education programs. RMED can serve as a model at many levels, including recruitment, collaboration, curriculum, and retention. Future challenges for program development and disparity reduction include recruiting students from the growing number of rural minority populations, expanding the number of program slots, and integrating the program with other health professions to address the needs of rural populations.
本文介绍了农村医学教育（RMED）项目的特点与成果，该项目旨在满足医疗劳动力需求，重点是减少农村地区的健康差距。该项目在实施方面具有综合性，包括从农村背景招募候选人、提供以农村为重点的课程以及设立评估环节以跟踪成果。该项目的独特之处包括由农村社区成员组成的招生与留用委员会；本科医学教育前三年中特别设置的以农村为重点的主题和活动；以及必修的为期16周的四年级农村实习，学生在此期间与初级保健医生合作并开展以社区为导向的初级保健项目。自1993年以来，已有216名学生入学。超过四分之三接受面试的候选人收到了该项目的录取通知（总体录取率为75%）。RMED学生与所有其他学生在医学院入学考试（MCAT）综合成绩和美国医师执照考试（USMLE）第一部分成绩上的比较显示，RMED学生的MCAT平均成绩略低，但USMLE成绩与非RMED学生相当。迄今为止，已有159名学生毕业，其中76%进入初级保健住院医师培训项目；103人目前已从业，64.4%在小镇和/或农村社区从事初级保健工作。RMED项目的成果与其他农村医学教育项目相比具有优势。RMED可以在多个层面成为典范，包括招生、合作、课程设置和留用。项目发展和减少差距未来面临的挑战包括从不断增加的农村少数族裔人口中招募学生、增加项目名额，以及将该项目与其他卫生专业相结合以满足农村人口的需求。
