Healthy People… Healthy Rural Communities

1. Healthy People… Healthy Rural Communities

2. NCRHP MISSION STATEMENT To promote the health of rural communities through partnerships in education, service, research and policy. Healthy People…Healthy Rural Communities

3. NCRHP Partner Professions • Dentistry • Medicine • Nursing • Pharmacy • Public Health • Social Work Healthy People…Healthy Rural Communities

4. Building Rural Healthcare Infrastructure • Expand successful student recruiting methods to all disciplines • Expand rural health professions education using RHP teaching model • Enhance rural health workforce retention efforts • Establish and maintain a consistent database measuring the nation’s rural health workforce Healthy People…Healthy Rural Communities

5. The Rural Medical Education (RMED) Program at the University of Illinois at Rockford seeks to admit and prepare medical students from the state of Illinois who will, upon completion of residency training, locate and practice in rural Illinois as primary carephysicians. Healthy People…Healthy Rural Communities

6. What Makes Us Different “RURALITY” Coming from and understanding the rural lifestyle and culture (17 points) Healthy People…Healthy Rural Communities

7. The Need… • 20% of our population live in rural areas, but only • 9% of doctors are practicing in rural America. • 500 rural physician positions open in Illinois- • normally about 80 open positions. • Today, nearly 500 rural doctors in Illinois are at • retirement age. • Today, nearly 400 rural pharmacists in Illinois are • at retirement age. • “Rural America is a place where those most in need of healthcare services often have the fewest options.” • -Alan Morgan, NRHA Healthy People…Healthy Rural Communities

8. Shortage Areas Healthy People…Healthy Rural Communities

9. RMED Student Home Counties Healthy People…Healthy Rural Communities

10. RMED Graduate Practice Locations Healthy People…Healthy Rural Communities

11. RMED Results • Achievements After 20 Cycles • Applicants from 95% of Illinois’ rural counties • 327 students (Classes of 1993-2018) • Matriculants from over 80% of Illinois’ rural counties • 258 graduates (192 in practice, 66 in residency) • 68 students in medical school • 80% of graduates attend primary care residencies • 70% of graduates in Illinois practicing in towns • less than 20,000 people • RMED graduates practicing in 80 Illinois towns • 85% of graduates in Illinois practicing primary • care medicine Healthy People…Healthy Rural Communities

13. The Rural Pharmacy Education (RPHARM) Program at the University of Illinois at Rockford seeks to admit and prepare pharmacy students from the state of Illinois who will, upon completion of pharmacy school, locate and practice in rural Illinois as rural pharmacists. Healthy People…Healthy Rural Communities

14. UIC Pharmacy Grad Locations Healthy People…Healthy Rural Communities

15. Area Health Education Centers Healthy People…Healthy Rural Communities

16. Camps • 4-H Health Jam • Rural Healthcare Career Camps • Rural Healthcare Experience Camp Healthy People…Healthy Rural Communities

17. IntedisciplinaryPreceptorships 3 Rural Sites (Dixon, Centralia, Harrisburg) • Clinical • Community • Classroom Healthy People…Healthy Rural Communities

18. Rural Medicina Academy Recruit Hispanic/Latino students from targeted rural Illinois counties for RMED/RPHARM programs by means of culturally and linguistically-appropriateprograms and interventions Healthy People…Healthy Rural Communities

19. Native American Pathway Healthy People…Healthy Rural Communities

20. International Collaborations • WHO/PAHO Collaborating Center • Network: Towards Unity for Health • Princess of Naradhiwas University – Thailand • Maastricht University, Netherlands • University of Aberdeen, Scotland • Amazon, Columbia Healthy People…Healthy Rural Communities

21. RMED – Curriculum • Regular MD curriculum plus RMED curriculum • 15-20 of the 50 U of I COM Rockford students • M1 Year – Foundations in Rural Family and Community Medicine 1 • Focus • Comm. Health concepts, core concepts of family medicine, rural health issues • Methods • orientation, seminars, case-based small group discussion, fields trips, rural health conferences, shadowing rural family physician, select readings and assignments • Hours • 3 day orientation, 8-9 monthly sessions Healthy People…Healthy Rural Communities

22. RMED - Curriculum • M2 year – Foundations in Rural Family and Community Medicine 2 • Focus – Same as M1 year • Methods • Seminars, case-based small group discussions, field trips (opportunity to directly observe and interact with rural health professionals and rural communities), development of annotated bibliography on rural health topic with group presentation on four topics, select readings and assignments, ½ day per week in clinic • Hours • Nine monthly sessions Healthy People…Healthy Rural Communities

23. RMED - Curriculum • M3 – Interface between family medicine and community • Focus • Concepts of community-based medicine and COPC (Community Oriented Primary Care), core concepts of family medicine related to M3 curriculum and rural practice • Methods • Seminars, small group discussions, community health survey, “windshield analysis,” design COPC project, selected readings • Hours • Nine monthly evening sessions Healthy People…Healthy Rural Communities

24. RMED - Curriculum • M4 – Rural Family Medicine Preceptorship • Focus • Clinical skills development in rural settings, community structure study, implementation of COPC project in rural community • Methods • Immersion experience: 70% clinical, 30% community projects (collaboration with community individuals/organizations), log clinical encounters into computer database, present COPC project in poster session, compile community notebook • Hours • 16 week preceptorship in rural Illinois community working with a rural family physician Healthy People…Healthy Rural Communities

25. RMED – Med Students • Common interests and experiences • Close group of friends/colleagues • Supportive to one another • Lectures/assignments • Rotations • Specialty choices = ENCOURAGEMENT • Staying rural • Life long friendships • Residency together • Practice partnerships • Educational sessions as a group • Monthly dinner meetings • Efforts made to expose students to positive rural physician role models Healthy People…Healthy Rural Communities

26. RMED – Residency • Clinical skills – M4 16 week preceptorship accelerates skills • Similar to junior partnership in the practice • Students very prepared for rigorous residency training • Up to 750+ clinical encounters • Top candidate for rural training tracks and preparation for practice after residency • 4 years of lectures and experiences to better understand rural community health gives strong foundation to build upon • Late entry to care • Mental health challenges • Lack of specialty care • Uninsured and underinsured • Education levels – communicating with patients • RMED grads are frequently chief residents Healthy People…Healthy Rural Communities

27. RMED – Practice • Started learning about new roles as rural primary care physician in M1 • Small town politics • Adaptation as community member • Buying groceries, attending church, etc… • Town perception of likelihood to stay • Community members encouraged by rural background and RMED training • Role as a community leader • Integration with medical community Healthy People…Healthy Rural Communities

28. RMED - Summary • RMED program is a comprehensive, multifaceted program that combines recruitment, admissions, curriculum support and evaluation components and is longitudinal across all 4 years of medical school • RMED provides students with a rural-focused supplemental education • Favorable attitudes towards rural practice • Preparation for future practice • Confidence regarding career choice • Successful “Grow your own” approach Healthy People…Healthy Rural Communities