Applications may be submitted four times each year based on this schedule:
By January 1 for a March 1 or later start of rotation
By April 1 for a June 1 or later start of rotation
By July 1 for a September 1 or later start of rotation
By October 1 for a December 1 or later start of rotation
The application will be forwarded to the ASA Committee on Rural Access to Anesthesia Care for review and a final decision. The committee will notify the applicant of its decision by 30 days before the rotation starts.
A new analysis of the emergency physician resident workforce in Annals of Emergency Medicinefinds that while the number of residency programs is increasing, new residency programs are disproportionately located in urban areas in states with existing programs, rather than rural communities with limited access to emergency care.
“Predictions of an oversupply of emergency physicians in the next decade may not apply to every part of the country,” said Christopher L. Bennett, MD, MA, assistant professor of emergency medicine at Stanford University School of Medicine and lead study author. “Regional differences over time need to be considered in any discussions of workforce challenges—these findings underscore the likelihood that rural emergency physician shortages will persist.”
The number of emergency medicine residencies expanded from 160 to 265 between 2013 and 2020, according to Accreditation Council for Graduate Medical Education (ACGME) data analyzed. The study also notes that of 6,993 emergency medicine residents in the 2020 American Medical Association data set, 98% were in urban areas.
Recognizing the care inequities and the changing needs of rural America, the Council on Graduate Medical Education (COGME) provides this report and recommendations to strengthen rural health workforce training and improve access to health care through evidence-based, patient- and community-centered health workforce investments spanning education, training, and practice.
To address the crisis in access to care for rural populations and develop a health professional education system that increases rural health workforce capacity, COGME developed a series of three issue briefs on the rural health workforce, each with its own set of recommendations.
From these briefs, COGME calls on Congress and the Department of Health & Human Services to prioritize the following six (6) recommendations:
Federal funding for a comprehensive assessment of rural health needs to identify gaps in essential care.
Federal training investments should follow the National Academy of Medicine recommendation to link GME funding to population health needs.
Direct the HHS Secretary to develop a set of measures that ensure value and return on public investment in GME financing with a focus on rural areas
HHS should invest in sustainable solutions that focus on building a stable healthcare workforce in rural communities
Centers for Medicare and Medicaid Services work with the Health Resources and Services Administration and other agencies within the Department of Health and Human Services to identify and eliminate regulatory and financial barriers and create incentives to health professional education, training expansion and innovation that promote rural population health
CMS should support and test sustainable alternative payment models (APMs) that enhance the delivery of team-based interprofessional education and practice
For decades, rural and highly urban communities have had challenges accessing healthcare due to a lack of available providers. Passion to work with underserved communities in rural or underserved urban settings often wanes once a student begins preclinical coursework.
Area Health Education Centers, or AHECs, consist of around 300 locations that address primary care and family health needs in underserved communities. These sites provide pre-health and health professional students with opportunities to experience serving in healthcare shortage areas and working with health professional students from other disciplines.
“The true beauty of Norton, and the larger area of Southwest Virginia, lies within the people who constitute it.”
You do not have to look far to appreciate the beauty of Norton, Virginia. At every turn, you are greeted by mesmerizing mountains that span as far as the horizon, rugged trails that are sure to be an adventure and breathtaking sunsets that could easily find themselves colorfully painted on canvas. However, these grand scenes are merely the tip of the iceberg of what makes the Appalachian Highlands so unique.
When I first interacted with leaders of the internal medicine residency program, I was impressed with their warm, courteous and genuine demeanor. This initial impression was further reinforced when I observed how closely the program administrators and residents interacted, a stark contrast from the interactions I have witnessed at other institutions. I also had the opportunity to experience this close interaction when I met my program director for the first time at a local supermarket. The humor of the situation was surpassed only by the speed at which news of this encounter spread to others. It truly made me appreciate the dynamics of a rural area.
The true beauty of Norton, and the larger area of Southwest Virginia, lies within the people who constitute it. The program administration and hospital staff are among the sincerest and most approachable groups of individuals I have come across in my medical career. These values reflect the culture and way of life in this area. Many of my friends marvel at how closely I work with program administration, attendings and hospital staff because I am treated as an individual and not as a statistic. The degree of personal attention we receive and give to the patients here is unparalleled. I feel truly blessed to be part of this community.
Dr. Rehan Alam, MD Internal Medicine Resident Norton Community Hospital
Norton Community Hospital is a not-for-profit, 129-bed acute care facility that has served rural Southwest Virginia and Southeastern Kentucky since 1949. The hospital offers a unique internal medicine residency experience that blends training at a rural acute care center, Norton Community Hospital, and urban tertiary care centers like Holston Valley Medical Center and Bristol Regional Medical Center.
Norton Community Hospital takes great pride in training young physicians for our rural, medically underserved area. This dedication has resulted in an increase in quality primary care for Southwest Virginia, surrounding areas, and the growth of our institution.
The Lonesome Pine Hospital Family Medicine Residency Program is located in Big Stone Gap – a rural community in Beautiful Southwest Virginia, within a very short distance of Tennessee. This area is part of what is known here as The Tri-Cities, a region comprising the cities of Kingsport, Johnson City, Bristol and the surrounding smaller towns and communities in Northeast Tennessee and Southwest Virginia.
As a resident, you will work in a rural setting for primary care training, while also gaining invaluable experience from larger hospitals. Our residents have opportunities to do rotations a short distance away at Bristol Regional Medical Center and Holston Valley Medical Center. Both centers provide high quality medical care and both have continued to be recognized among the nations’ best hospitals.
What happens when an eager young doctor in a rural community with a passion to make a difference becomes the medical director for the nursing home, the overseer of the town’s emergency medical service, the football team’s sideline doctor, the clinic’s medical director, and the hospital’s trauma director and chief of staff?
And has two children?
This wasn’t a scenario we made up. This is a real story highlighted in a recent article by the Rural Health Information Hub:
Randall Longenecker, MD, FAAFP, serves as assistant dean for rural and underserved programs at the Ohio University Heritage College of Osteopathic Medicine and is the Executive Director of the national RTT Collaborative. He is an advocate of teaching medical students and residents skills to build their resilience and help them deal with the stresses of rural practice.
In Longenecker’s experience, rural settings can actually encourage providers to admit they have a problem. “One of the advantages of living in a ‘glass house’ where everyone knows each other’s business is that (burnout) quickly becomes apparent to others,” said Longenecker.
Providers who build strong relationships within their community also have an advantage when dealing with burnout. “Resilience, or the ability to persist and thrive through hardship, is a competency for a rural practice,” commented Longenecker. “Hardship itself is not the most important contributing factor (to physician burnout), the lack of healthy relationships is.”
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.
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 email@example.com
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.
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.