Predoctoral Training in Rural Kentucky

Physician workforce distribution is impacted by the location of student training and residency choice. Medical schools that use community hospitals for clinical training produce more generalists than tertiary and quaternary academic centers. Medical education is an enculturation process with both intended and unintended curriculums that influences students' perceptions and understanding of the health care field. The University of Kentucky College of Medicine (UKCOM) has identified rural medical training as an institutional priority. It is creating a rural regional medical school training site in Morehead, KY, where 10 students each year will receive the last two of four years of medical training. Students will be selected for this experience, called the UK Rural Physician Leadership Track (RPLT), based on their interest in rural medicine. _Th_e goal of the proposed proiect is to maintain and enhance student interest in rural practice and provide training in generalist competencies towards satisfying and effective practice in rural underserved areas. We will accomplish this goal by creating a four-year rural clinical curriculum that emphasizes involvement in the community, trains in a patient-centered approach and addresses effective approaches to significant health conditions in the region. The project will work with St. Claire Regional Medical Center, regional primary care physicians, UKCOM faculty, and students to design, implement and evaluate a four year curriculum for rural health care. The proposed objectives are driven by and consistent with Healthy People 2010. This project relates directly to Goal 1, which is to increase quality and years of life and Goal 2, which is to eliminate health disparities among different segments of our population. Further, as other medical schools create expansion plans to meet future demands for physician workforces, the results of this project may provide a useful resource for other programs seeking to design satellite training experiences.