Castro Maria Gabriela, Roberts Caroline, Hawes Emily M, Ashkin Evan, Page Cristen P
Maria Gabriela Castro, Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Fam Med. 2024 Mar;56(3):185-189. doi: 10.22454/FamMed.2024.400615.
The widening gap between urban and rural health outcomes is exacerbated by physician shortages that disproportionately affect rural communities. Rural residencies are an effective mechanism to increase physician placement in rural and medically underserved areas yet are limited in number due to funding. Community health center/academic medicine partnerships (CHAMPs) can serve as a collaborative framework for expansion of academic primary care residencies outside of traditional funding models. This report describes 10-year outcomes of a rural training pathway developed as part of a CHAMP collaboration.
Using data from internal registries and public sources, our retrospective study examined demographic and postgraduation practice characteristics for rural pathway graduates. We identified the rates of postgraduation placement in rural (Federal Office of Rural Health Policy grant-eligible) and federally designated Medically Underserved Areas/Populations (MUA/Ps). We assessed current placement for graduates >3 years from program completion.
Over a 10-year period, 25 trainees graduated from the two residency expansion sites. Immediately postgraduation, 84% (21) were in primary care Health Professional Shortage Areas (HPSAs), 80% (20) in MUA/Ps, and 60% (15) in rural locations. Sixteen graduates were >3 years from program completion, including 69% (11) in primary care HPSAs, 69% (11) in MUA/Ps, and 50% (5) in rural locations.
This CHAMP collaboration supported development of a rural pathway that embedded family medicine residents in community health centers and effectively increased placement in rural and MUA/Ps. This report adds to national research on rural workforce development, highlighting the role of academic-community partnerships in expanding rural residency training outside of traditional funding models.
城乡健康结果差距不断扩大，而医生短缺问题使农村社区受到的影响尤为严重，这进一步加剧了这种差距。农村住院医师培训是增加农村及医疗服务不足地区医生配置的有效机制，但由于资金问题，其数量有限。社区卫生中心/学术医学伙伴关系（CHAMP）可作为一个合作框架，用于在传统资金模式之外扩展学术初级保健住院医师培训。本报告描述了作为CHAMP合作一部分而制定的农村培训途径的10年成果。
利用内部登记处和公共来源的数据，我们的回顾性研究调查了农村培训途径毕业生的人口统计学和毕业后实践特征。我们确定了毕业后在农村（符合农村卫生政策联邦办公室拨款条件）和联邦指定的医疗服务不足地区/人群（MUA/P）的安置率。我们评估了完成培训项目三年以上毕业生的当前安置情况。
在10年期间，有25名学员从两个住院医师培训扩展点毕业。毕业后立即，84%（21人）在初级保健卫生专业人员短缺地区（HPSA），80%（20人）在MUA/P，60%（15人）在农村地区。16名毕业生已完成培训项目三年以上，其中69%（11人）在初级保健HPSA，69%（11人）在MUA/P，50%（5人）在农村地区。
这种CHAMP合作支持了农村培训途径的发展，该途径将家庭医学住院医师安置在社区卫生中心，并有效地增加了在农村和MUA/P的安置。本报告补充了关于农村劳动力发展的全国性研究，突出了学术-社区伙伴关系在传统资金模式之外扩展农村住院医师培训方面的作用。
