Category Archives: research

Preparing for Rural

The Rural Health Research & Policy Centers recently published, Outcomes of Rural-Centric Residency Training to Prepare Family Medicine Physicians for Rural Practice.  This policy brief identified family medicine residencies providing rural training and the practice locations of their graduates.


  • Family medicine physicians who graduated from rural-centric residency programs—those that actively recruit medical students with an interest in rural practice and require at least eight weeks of rural training—practiced in rural areas during the first five years after graduation at much higher rates than the entire population of family physicians.
  • No single program characteristic or model offered sustained advantages over any other type in producing high yields to rural practice.
  • Graduates of rural-centric family medicine residencies also chose to practice in Primary Care Health Professional Shortage Areas (both rural and urban) at high rates, up to 54% three years post-graduation, declining by five years post-graduation to 42%.
  • The combination of a program mission to produce rural physicians with required rural training experiences may help to account for similar outcomes among a diverse group of residency programs that produce family physicians who choose rural practice.
  • More research is needed to determine whether rural practice choices are sustained beyond five years post-graduation, the time period of this study.

The last point is of particular interest as the paper notes:

It is not known the extent to which these high rates of practice in shortage areas are the result of incentive programs, such as the National Health Service Corps, or Conrad 30 Waiver Program, or other factors. If incentives are driving this trend, we do not know whether these physicians will remain in shortage areas once incentive obligations are fulfilled, since incentive programs typically involve two to six years of service in underserved locations.

Rural Residents Research Symposium

The agenda has been posted for the April 22nd
Rural Residents Research Symposium:

8:30 am – Continental breakfast and registration

9:00 am – 10:00 am – How to Conduct Community Health and Primary Care Research
Dr. Alexis Stoner, Faculty Instructor and Course Director of Epidemiology, Clinical Prevention, and Population Health, Edward Via College of Osteopathic Medicine, Carolinas Campus

10am – 11am – How do I report data on rural populations to answer hypothesis driven research questions?
Susan L. Meacham, Ph.D., R.D., Professor, Nutrition
Discipline of Family Medicine, Preventive Medicine and Public Health, Via College of Osteopathic Medicine-Virginia Campus

11am – 11:30am –Rural Health Clinics: the Overlooked Option

11:30am – 1:00pm – Lunch

1:00pm – 2:00pm – Habit and Habitus: A Faith-based Health Initiative
Dr. Troy Reece, PGY-1, Johnston Memorial Hospital Family Medicine Residency will present with attending physician Dr. Giovani Ferrante, vascular surgeon at Johnston Memorial Hospital

2:00pm – 3:00pm – Residency Culture: Survival Tips

The Symposium will be held at the Slemp Center of UVA Wise.

Click here to register.  For questions, contact GMEC Director Wendy Welch at

Affordable Medications

One of the hard realities of serving in rural communities is that many of our patients have a hard time affording the medications they desperately need.

We’ve located a resource to help with that process.  The National Center for Farmworker Health has produced a series of easy-to-read fact sheets about the safest and most affordable medications to treat specific conditions or illnesses. Topics include diabetes, heart disease, menopause, depression, and many others.

Available in both English and Spanish, each fact sheet is based on extensive reports published by Consumer Reports Best Buy Drugs that share the results of research conducted to determine the most effective, safe and affordable medicines available in the market for each condition. Generic medicines, if available, were included in the analysis as well.

What other resources for affordable medications do you have?

Registration Now Open!

Registration for the Rural Residents Research Symposium is now open!

Scheduled for April 22nd at the Slemp Center of UVA Wise; this is a day for residents to present original research (not case studies) regarding topics of interest to rural primary care docs and their peers.

Slots at the Rural Residents Research Symposium are 30-45 minutes long; anyone interested in presenting must meet the criteria of rural focus and should apply through their residency coordinator.

A limit of two applications per residency program will be accepted with a total of 10 presentations.  The top two presentations will be invited to speak at the 2016 Head for the Hills event in October.

Click here to register.  For questions, contact GMEC Director Wendy Welch at


Urban Choosing Rural

A recent study noted that having a rural origin is a primary factor in medical students choosing to practice in rural areas.  The study decided to turn that information around and ask what influences urban students to also choose rural.

“Determinants of an urban origin student choosing rural practice” used a scoping review of the literature, in contrast to a traditional systematic review.  Out of these 17 studies, the following four factors that suggest why urban-origin medical students may choose rural practice were generated:

  • geographic diffusion of physicians in response to economic forces such as debt repayment and financial incentives
  • scope of practice and personal satisfaction
  • undergraduate and postgraduate rural training
  • premedical school mindset to practice rurally

The study concluded:

Urban-origin students may choose rural practice because of market forces as well as financial incentives. The participation in undergraduate and postgraduate rural training is reported to positively alter the attitude of urban-origin students. A small subset of these students has a predetermined mindset to practice rurally at the time of matriculation.

Obstacles for choosing a rural carrier include, but are not limited to lack of job and education opportunities for spouses/partners, lack of recreational and educational opportunities for children, and obscure opportunities for continuing medical education.




Media headlines are full of ADHD information.  Recent examples include:

  • —“Study finds 17% of college students misuse ADHD drugs”
  • —“ADHD Medications Don’t Lead To Drug Or Alcohol Abuse”
  • —“Children with ADHD more likely to have eating disorder”
  • —“Is the Internet giving us all ADHD?”


One of the great presentations at Head for the Hills was Dr. Hofford’s Attention-Deficit Hyperactivity Disorder: What’s New and What is Our Data.

This session:

  • —Reviewed the diagnosis of ADHD
  • Reviewed the latest treatment options/algorithms for ADHD
  • —Reviewed recent Virginia Medicaid ADHD data and how do we compare with North Carolina and the United States

We hope you are able to use Dr. Hofford’s information as your starting point for finding solid ADHD references!


Finding Research Data Sources

The Rural Resident Research Symposium held at UVA-Wise in April included a presentation on Finding Research Data Sources for Populations in Rural Virginia.” by Susan Meacham.

The presentation strove to answer the question; Where do I find data on rural populations to answer hypothesis driven research questions?     It then addressed the following objectives:

  • Identify primary and secondary sources of data
  • Recognize the procedures needed to obtain approvals to use personal record information in research
  • Locate common sources of county, district and state level data for rural populations

The examples provided in the presentation were based on a study the Edward Via College of Osteopathic Medicine is conducting on the chronic health conditions in Central Appalachia.  It strives to determine not only what is “going wrong” in coal country, but what is going right.

View the presentation.