Minnesota Outcomes: Graduating Rural Primary Care Physicians

Context: In the early 1970s Minnesota created two disparate medical education programs at the University of Minnesota (UMN) to increase the number of rural primary care physicians: Years 1 and 2 of medical school in Duluth, and The Rural Physician Associate Program (RPAP) elective. The Duluth mission focuses on recruiting students who will chose rural primary care practice. Training experiences are provided to support this effort. RPAP is a 9-month immersion experience in a rural community with a primary care preceptor, open to Twin Cities or Duluth third-year students who apply and are accepted. All other UMN students spend their first two years in the Twin Cities and their third and fourth years on rotations in the Twin Cities. Objective: To compare four groups of students: 1) Duluth medical students who participate in RPAP, 2) Twin Cities students who participate in RPAP, 3) Duluth students who do not participate in RPAP, and 4) Twin Cities who do not participate in RPAP. The 4th group is a natural control because nothing in their recruitment or training predisposes them to rural primary care. Outcome Measures: Proportion of graduates who are currently rural primary care physicians. Population: 850 graduates of the UMN medical school from 1990 to present. Design and analysis: Compare the four groups on demographics (e.g. age, gender) community raised (rural vs. metro), current practice location (rural vs. metro) and specialty. Appropriate comparative statistics including analyses of variance will be completed. Conclusion: Report the extent to which the very different approaches during the first two years of medical school in either Duluth or the Twin Cities and then the immersion experience in RPAP either complement and reinforce each other, or to the extent they are redundant, or simply unproductive in training family physicians that chose rural practice