Kairys S, Newell P
J Med Educ. 1985 Oct;60(10):786-92. doi: 10.1097/00001888-198510000-00006.
Rural primary care is often reported in the medical literature as frustrating, lonely, and nonrewarding. Many graduating residents who choose small town practice become quickly disenchanted with the life-style and leave for a more populous territory or subspecialty training. Opportunities to learn how to take advantage of rural settings and establish rewarding community practices are few. The Primary Care Pediatric Residency Program at the Dartmouth-Hitchcock Medical Center has developed a training program in rural primary care. Residents experience over a three-year period the many facets of rural practice and are introduced to community-oriented approaches to child health care. Selected rural pediatric practices within a 45-mile radius of the medical center serve as teaching laboratories in which residents develop the skills necessary to manage children's problems related to school, behavioral disorders, and chronic diseases.
医学文献中经常提到，乡村初级医疗工作令人沮丧、孤单且没有成就感。许多选择在小镇行医的即将毕业的住院医师很快就对这种生活方式感到失望，然后前往人口更密集的地区或接受专科培训。学习如何利用乡村环境并建立有意义的社区医疗实践的机会很少。达特茅斯-希区柯克医疗中心的初级保健儿科住院医师项目已经开发了一个乡村初级保健培训项目。住院医师在三年时间里体验乡村医疗实践的诸多方面，并接触到以社区为导向的儿童保健方法。医疗中心半径45英里范围内选定的乡村儿科诊所充当教学实验室，住院医师在其中培养处理与学校、行为障碍和慢性病相关的儿童问题所需的技能。
