Keeping Rural Medical Students Connected to their Roots: A “Home for the Holidays” Immersion Experience
Preclinical medical students with an initial affinity for rural practice often experience urban disruption during training. Longer summer rural immersion experiences have been shown to be somewhat effective in keeping rural students connected to their rural roots. Some students cannot adapt their schedules to these longer experiences. In response, a brief practice experience near home during the winter break of the academic year was established.
Nineteen detailed rural practice assessments were completed by preclinical medical students during school years 2009-2014 and essays and anonymous evaluations of the experience were analyzed.
All students reported the four components of the experience increased understanding of rural medicine and all but 2 reported it was relevant to their career objectives. These two, at this early stage in training, decided rural practice was not for them and subsequently chose sub-specialty training. Six of the 12 (50%) who have completed medical school chose a family medicine residency. The themes in the essay portion included insights into rural lifestyle, returning home, health system organization issues, and patient expectations and traditions.
Initial experience with a “home for the holidays” approach for rural immersion of rural medical students was successful in reconnecting these students to their roots, and 17/19 (90%) reported their intention to choose rural practice.
Conflict(s) of Interest
References with DOI
1. Rabinowitz HK, Diamond JJ, Markham FW, Wortman JR. Medical school programs to increase rural supply: a systematic review and projected impact of widespread replication. Acad Med. 2008 83(3):235- 243. https://doi.org/10.1097/acm.0b013e318163789b
2. Crandall LA, Dwyer JW, Duncan RP. Recruitment and retention of rural physicians: Issues for the 1990s. J Rural Health. 1990 6(1):19-38. https://doi.org/10.1111/j.1748-0361.1990.tb00188.x
3. Vaughn DL, Vaughn PR. Preparing rural youth for an urban environment: a handbook for educators 1986 [Cited September 18, 2015]. Available from: https://ia801409.us.archive.org/3/items/ERIC_ED270243/ERIC_ED270243.pdf.
4. Crump WJ, Barnett D, Fricker S. A sense of place: rural training at a regional medical school campus. J Rural Health 2004 20(1):80-84. https://doi.org/10.1111/j.1748-0361.2004.tb00011.x
5. Farmer J, Kenny A, McKinstry C, Huysmans RD. 2015. A scoping review of the association between rural medical education and rural practice location. Hum Resour Health. 2015 13:27-42. https://doi.org/10.1186/s12960-015-0017-3
6. Geyman JP, Hart G, Norris TE, Coombs JB, Lishner DM. Educating generalist physicians for rural practice: how are we doing? J Rural Health. 2000 16(1):56-80. https://doi.org/10.1111/j.1748-0361.2000.tb00436.x
7. Elam CL, Rosenbaum ME, Johnson MMS. Geographic origin and its impact on practice location in Kentucky. J Ky Med Assoc. 1996 94(10):446-450.
8. Looney SW, Blondell RD, Gagel JR, Pentecost MW. Which medical school applicants will become generalists or rural-based physicians? J Ky Med Assoc. 1998 96(5):189-193.
9. Crump, WJ. The Trover Campus in Madisonville: The western Kentucky commitment to training physicians for rural areas. J Ky Acad Fam Physicians. 2001 47(4):9-12.
10. Polk HC. Can AHES really influence the distribution of physicians? J Med Educ. 1977 52(8):633-638. https://doi.org/10.1097/00001888-197708000-00002
11. Todini CR, Crump WJ. Building a regional clinical campus: experience with preclinical students. Fam Med. 1999 31(1):6-7.
12. Crump WJ, Fricker RS, Ziegler CH. Outcomes of a preclinical rural medicine elective at an urban medical school. Fam Med. 2010 42(10):717-722.
13. Cutchin MP. Physician retention in rural communities: the perspective of experiential place integration. Health Place. 1997 3(1):25-41. https://doi.org/10.1016/s1353-8292(96)00033-0
14. Boulger JG. Family medicine education and rural health: A response to present and future needs. J Rural Health. 1994 7(2):105-115. https://doi.org/10.1111/j.1748-0361.1991.tb00713.x
15. Crump WJ, Fricker RS. A medical school prematriculation program for rural students: staying connected with place, cultivating a special connection with people. Teach Learn Med. 2015 27:(4):422-430. https://doi.org/10.1080/10401334.2015.1077709
16. Hunt D, Norris T, Ballweg R. The University of Washington WWAMI program: 25 years of experience with manpower shortages in rural areas. Aust J Rural Health. 1995 3(4):152-158. https://doi.org/10.1111/j.1440-1584.1995.tb00171.x
17. Stearns JA, Stearns MA, Glasser M, Londo RA. Illinois RMED: A comprehensive program to improve the supply of rural family physicians. Fam Med. 2000 32(1):17-21.
18. Lynch DC, Willis SE. Can a 3-day preceptorship change first-year medical students’ opinions about living and working in small towns? Fam Med. 2000 32(7):495-499.
19. Crump WJ, Fricker RS, Ziegler CH, Wiegman DL. Seeking the best dose of rural experience: comparison of three rural pathways programs at one medical school. J Ky Med Assoc. 2015 113:5-15.
20. Crump WJ, Fricker RS, Ziegler CH, Wiegman DL. Rural track training based at a small regional campus: equivalency of training, residency choice, and practice location of graduates. Acad Med. 2013 88(8):1122- 1128. https://doi.org/10.1097/acm.0b013e31829a3df0
21. Crump WJ, Fricker RS, Ziegler CH, Wiegman DL. Increasing the rural physician workforce: a potential role for small rural medical school campuses. J Rural Health. 2015. doi: 10.1111/jrh.12156. https://doi.org/10.1111/jrh.12156
22. Shannon CK, Jackson J. Validity of medical student questionnaire data in prediction of rural practice choice and its association with service orientation. J Rural Health. 2015 31(4):373-381. https://doi.org/10.1111/jrh.12123
Crump, William J. MD and Fricker, R. Steve MPA
"Keeping Rural Medical Students Connected to their Roots: A “Home for the Holidays” Immersion Experience,"
Marshall Journal of Medicine:
1, Article 8.
Available at: https://mds.marshall.edu/mjm/vol2/iss1/8