Healthy People…Healthy Rural Communities

Healthy People…Healthy Rural Communities

To promote the health of rural communities through partnerships in education, service, research and

policy.

NCRHP MISSION STATEMENT

Healthy People…Healthy Rural Communities

•Dentistry•Medicine•Nursing•Pharmacy•Public Health• Social Work

NCRHP Partner Professions

Building Rural Healthcare Infrastructure

• Expand successful student recruiting methods to all disciplines

• Expand rural health professions education using RHP teaching model

• Enhance rural health workforce retention efforts

• Establish and maintain a consistent database measuring the nation’s rural health workforce

Healthy People…Healthy Rural Communities

The Rural Medical Education (RMED) Program at the University of Illinois

at Rockford seeks to admit and prepare medical students from the

state of Illinois who will, upon completion of residency training, locate and practice in rural Illinois

as primary care physicians.

Healthy People…Healthy Rural Communities

What Makes Us Different

“RURALITY”

Coming from and understanding the rural

lifestyle and culture(17 points)

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• 20% of our population live in rural areas, but only 9% of doctors are practicing in rural America.

• 500 rural physician positions open in Illinois- normally about 80 open positions.

• Today, nearly 500 rural doctors in Illinois are at

retirement age.

• Today, nearly 400 rural pharmacists in Illinois are

at retirement age.

“Rural America is a place where those most in need of healthcare services often have the fewest

options.” -Alan Morgan, NRHA

The Need…

Healthy People…Healthy Rural Communities

Healthy People…Healthy Rural Communities

Shortage Areas

RMED Student Home Counties

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RMED Graduate Practice Locations

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Achievements After 20 Cycles• Applicants from 95% of Illinois’ rural counties

• 327 students (Classes of 1993-2018)

• Matriculants from over 80% of Illinois’ rural counties

• 258 graduates (192 in practice, 66 in residency)

• 68 students in medical school

• 80% of graduates attend primary care residencies

• 70% of graduates in Illinois practicing in towns less than 20,000 people

• RMED graduates practicing in 80 Illinois towns

• 85% of graduates in Illinois practicing primary care medicine

RMED Results

Healthy People…Healthy Rural Communities

The Rural Pharmacy Education (RPHARM) Program at the

University of Illinois at Rockford seeks to admit and prepare pharmacy students from the

state of Illinois who will, upon completion of pharmacy school,

locate and practice in rural Illinois as rural pharmacists.

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Rural Communities

UIC Pharmacy Grad Locations

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Area Health Education Centers

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Camps• 4-H Health Jam

• Rural Healthcare Career Camps• Rural Healthcare Experience Camp

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Intedisciplinary Preceptorships

3 Rural Sites (Dixon, Centralia, Harrisburg)ClinicalCommunityClassroom

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Rural Medicina Academy

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Recruit Hispanic/Latino students from targeted rural Illinois

counties for RMED/RPHARM programs by means of

culturally and linguistically-appropriate

programs and interventions

Native American Pathway

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International Collaborations• WHO/PAHO Collaborating Center• Network: Towards Unity for Health• Princess of Naradhiwas University –

Thailand• Maastricht University, Netherlands• University of Aberdeen, Scotland• Amazon, Columbia

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RMED – Curriculum• Regular MD curriculum plus RMED curriculum

– 15-20 of the 50 U of I COM Rockford students• M1 Year – Foundations in Rural Family and

Community Medicine 1• Focus

– Comm. Health concepts, core concepts of family medicine, rural health issues

• Methods– orientation, seminars, case-based small group discussion,

fields trips, rural health conferences, shadowing rural family physician, select readings and assignments

• Hours– 3 day orientation, 8-9 monthly sessions

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RMED - Curriculum• M2 year – Foundations in Rural Family

and Community Medicine 2• Focus – Same as M1 year• Methods

• Seminars, case-based small group discussions, field trips (opportunity to directly observe and interact with rural health professionals and rural communities), development of annotated bibliography on rural health topic with group presentation on four topics, select readings and assignments, ½ day per week in clinic

• Hours– Nine monthly sessions

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RMED - Curriculum• M3 – Interface between family medicine and

community• Focus

– Concepts of community-based medicine and COPC (Community Oriented Primary Care), core concepts of family medicine related to M3 curriculum and rural practice

• Methods– Seminars, small group discussions, community health

survey, “windshield analysis,” design COPC project, selected readings

• Hours– Nine monthly evening sessions

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RMED - Curriculum• M4 – Rural Family Medicine Preceptorship• Focus

– Clinical skills development in rural settings, community structure study, implementation of COPC project in rural community

• Methods– Immersion experience: 70% clinical, 30% community

projects (collaboration with community individuals/organizations), log clinical encounters into computer database, present COPC project in poster session, compile community notebook

• Hours– 16 week preceptorship in rural Illinois community working

with a rural family physician

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RMED – Med Students• Common interests and experiences

– Close group of friends/colleagues• Supportive to one another

– Lectures/assignments– Rotations– Specialty choices = ENCOURAGEMENT– Staying rural

• Life long friendships– Residency together– Practice partnerships

• Educational sessions as a group– Monthly dinner meetings

• Efforts made to expose students to positive rural physician role models

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RMED – Residency• Clinical skills – M4 16 week preceptorship accelerates skills

• Similar to junior partnership in the practice– Students very prepared for rigorous residency training

» Up to 750+ clinical encounters

• Top candidate for rural training tracks and preparation for practice after residency– 4 years of lectures and experiences to better understand rural

community health gives strong foundation to build upon• Late entry to care• Mental health challenges• Lack of specialty care• Uninsured and underinsured• Education levels – communicating with patients

• RMED grads are frequently chief residents

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RMED – Practice• Started learning about new roles as

rural primary care physician in M1– Small town politics– Adaptation as community member

• Buying groceries, attending church, etc…

– Town perception of likelihood to stay• Community members encouraged by rural

background and RMED training

– Role as a community leader– Integration with medical community

Healthy People…Healthy Rural Communities

RMED - Summary

• RMED program is a comprehensive, multifaceted program that combines recruitment, admissions, curriculum support and evaluation components and is longitudinal across all 4 years of medical school– RMED provides students with a rural-focused

supplemental education• Favorable attitudes towards rural practice• Preparation for future practice• Confidence regarding career choice

• Successful “Grow your own” approach

Healthy People…Healthy Rural Communities