Residency Training in Primary Care

ABSTRACT Project Title: Addressing physician shortages in rural Kentucky through an enhanced and community- focused residency curriculum Organization: University of Kentucky Project Director Name: Robert R. Atkins, MD Contact Phone Numbers: Office (606) 439-3557 Email Address: [email protected] Grant Program Funds Requested: $2,194,671.36 Our application is in response to the Primary Care Training and Enhancement: Residency Training in Primary Care Program (HRSA-20-008) to improve access to primary care physicians in rural and underserved Appalachian Kentucky. This rural region has been and remains extremely impoverished and is plagued by a shortage of primary care providers. In the southeastern region of Kentucky, every county falls into the lowest quartile of Kentucky county rankings based on health outcomes1. Our project will center on the service area of the North Fork Valley Clinic, which includes Perry, Knott and portions of Leslie County ranked at 119, 106, 115, respectively, for health outcomes. Our new curriculum will be implemented at the Family Medicine Residency Program in Hazard, Kentucky, and is a collaborative project with faculty and staff in the Department of Family and Community Medicine in Lexington, Kentucky. Twelve trainees per year will develop knowledge, skills and competencies to help mitigate the critical health problems that are characteristic of the area: Opioid Use Disorders, mental health services, and lack of primary care. Telehealth technology will be a constant feature of the clinical service training that residents receive across clinical venues so that they may better serve patients (and address SDOH that are so prevalent) in this rural region. Chronic disease management using interprofessional and team-based care will be the backbone of a new curriculum that will train medical providers on the benefits of a multi-disciplinary approach to patient care. We currently have an interprofessional and team-based care approach to the treatment of diabetes and have proven the effectiveness of this approach, having shown a statistically significant improvement in patient outcomes. We will train future physicians to practice in rural and underserved settings using two parallel programs: an intensive and focused recruitment program for medical students to encourage them to select the Family Medicine Residency in Hazard; and a residency curriculum that will train these students to become exemplary Family Medicine physicians who are committed to practicing in rural areas of Eastern Kentucky/central Appalachia, Perry County or surrounding counties. These physicians will provide Medication Assisted Treatment as a part of their practice and will increase access to primary care services. Project Objectives The overarching aim of this proposal is to develop a growing primary care workforce in Appalachia that is responsive to the most critical health challenges in the region. This will be accomplished by the following objectives: 1) Recruit current medical students to join a Family Medicine residency program located in a rural, underserved region of Kentucky and train them to become skilled practitioners who can meet the medical and health needs of rural and underserved patients/communities; 2)Train FM residents to inform their knowledge and clinical skills that will enable them to provide direct care for patients with Opioid Use Disorder, thereby increasing access to Medication Assisted Treatment in a rural and underserved region, and 3) Develop and implement focused, clinical training for residents that incorporates telehealth technologies and interprofessional, team-based models of care.