Program Preps Med Students to Practice in Rural Communities

The UA College of Medicine’s Rural Health Professions Program – now in its 17th year – encourages graduates to practice primary care in rural areas in four- to six-week mentorships.
July 15, 2013
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A list of communities hosting students and their mentors is available on the Arizona Health Sciences Center's Office of Public Affairs website.

UA medical student Brianna Grigs (left) recently was mentored by Dr. Cathy Taylor at her pediatric/internal medicine practice at North Country HealthCare's Round Valley Clinic in Springerville, Ariz.
UA medical student Brianna Grigs (left) recently was mentored by Dr. Cathy Taylor at her pediatric/internal medicine practice at North Country HealthCare's Round Valley Clinic in Springerville, Ariz.

A select group of physicians are practicing medicine in small Arizona communities this summer as part of a University of Arizona College of Medicine program to help alleviate shortages of physicians in rural areas. This is especially critical as older physicians retire and health-care coverage expands under the Affordable Care Act.

The physicians are faculty members in the UA College of Medicine's Rural Health Professions Program, volunteering for four to six weeks to mentor medical students from the UA College of Medicine – Tucson and UA College of Medicine – Phoenix. Physicians share with students what attracted them to rural practice, while encouraging them to choose rural practices in the future.

The Rural Health Professions Program, or RHPP, was established in 1997 by the Arizona Legislature to encourage medical school graduates to practice medicine in rural communities. Program graduates practice in rural communities throughout Arizona.

Physicians in the program volunteer as preceptors – or mentors – to students between their first and second years of medical school. Several of the physicians are UA College of Medicine graduates who participated in RHPP as medical students and now are serving as mentors to the next generation of rural physicians.

Students work with physicians at their practice sites and reside in their communities for four to six weeks between the end of May and early August. Students are matched with preceptors based on medical specialty interest and community preference. Physician specialties include family practice, pediatrics, internal medicine, obstetrics and gynecology, and surgery. The students continue to work with their preceptors over the course of their three remaining years of medical training, returning to the rural communities in their third and fourth years.

"This program helps nurture students' interest in a rural practice," says Carol Galper, assistant dean for medical student education in the UA College of Medicine. "Many of the students grew up in rural towns in Arizona and have a desire to practice in small communities, perhaps even returning to their hometowns. Their RHPP experiences help them understand the unique health-care needs of rural populations as well as strategies to address these needs, and help them decide about where they want to practice in the future."

By working side-by-side with a physician – consulting with patients, discussing lab results, helping to diagnose childhood ailments and attending surgeries – students learn about the unique health-care needs of rural populations and how to meet them. By returning to the same community during each year of medical school, they learn to appreciate the area's culture and character and begin to experience the lifestyle of rural residents.

This year, 20 students from the UA College of Medicine – Tucson and two students from the UA College of Medicine – Phoenix were selected for RHPP, using a combination of funds from the Arizona Area Health Education Centers (the Arizona AHEC Program); the Arizona Center of Excellence, funded by a grant from HRSA (Health Resources and Services Administration); and the state of Arizona. "With the expansion of the medical school to include the Phoenix campus, AHEC funding enables us to provide RHPP opportunities to Phoenix-based students as well," Galper said.

RHPP students receive intensive preparation, including a course, "Issues in Rural Health," covering health-care and access-to-care issues, challenges of rural practice, referral needs, the impact of poverty and lack of health care, environmental health concerns, the influence of culture and the role of physicians in rural communities, as well as topics not taught until their second-year curriculum. This helps bring them up to speed and allows them to be well prepared for their initial rural rotation.

Students also learn to use telemedicine technology in communities linked to the Arizona Telemedicine Program, a health-care telecommunications network that allows rural physicians and patients to have real-time online medical consultations with specialists at the UA College of Medicine in Tucson. The system also allows rural physician-preceptors and their students to attend grand rounds lectures "virtually" at the UA College of Medicine. The RHPP course is teleconferenced between Tucson and Phoenix, with instruction originating alternately in Tucson and Phoenix.

Rural physician-preceptors enhance their teaching skills by attending faculty development and continuing medical education programs conducted by the UA College of Medicine. To minimize disruption of the physicians' medical practices, the programs are offered regionally by video links provided by the Arizona Telemedicine Program to the UA College of Medicine.

RHPP students develop long-term relationships with their rural physician-preceptors, who act as medical and career counselors, helping the students make informed choices when they decide where they will practice medicine.

Initial follow-up of 97 graduates of the program who have completed residencies shows that 42 percent have practiced in rural Arizona, 30 percent are in current rural Arizona practice and 8 percent are in rural practice in other states.

"We have graduates throughout the state," Galper said. "The RHPP is creating rural physicians for Arizona, and these physicians now are mentoring the next generation of rural doctors."