A multistate program to educate physicians: successful, economical, but endangered.

The Southern Regional Education Board (SREB) was formed in 1948 to facilitate multistate contracts for education exchange; at present, 15 states participate in this program. West Virginia is one of four states in the SREB that offer training in osteopathic medicine, and the West Virginia School of Osteopathic Medicine (WVSOM) is the only professional school in West Virginia that is a member of the SREB program. The authors describe (1) WVSOM's mission to provide primary care physicians to meet the medical needs of Appalachia, and (2) the success that an WVSOM-SREB partnership has had in training primary care physicians for participating states at a fraction of the effort and cost that would otherwise have been necessary. Concern is expressed for the program's future, and suggestions offered for the establishment of similar multistate programs to foster the production of physicians in a variety of specialties throughout the nation, since the WVSOM has clearly been successful in producing primary care physicians and in motivating graduates to return to their home states. For example, through the WVSOM-SREB osteopathic medicine program, students from states that share parts of Appalachia (Georgia, Mississippi, Alabama, and Maryland) and Florida have received their education at WVSOM. From 1978 until 1994, WVSOM graduated 148 SREB physicians; 122 of these are practicing physicians, 23 are in internships or residencies, and three have died. Of the 122, 53% have returned to practice in their home states; 85% of these graduates and 84% of all the SREB graduates who have returned to their home states or to other Appalachian states are practicing in primary care fields.