UMMC among nation's best at providing physicians to rural areas

The University of Mississippi School of Medicine is among the best in the country at producing rural physicians.

That's according to a study reported in the April 2010 issue of Academic Medicine, which lists the school at the University of Mississippi Medical Center as the second-highest MD-granting school in the country in the percentage of its graduates in primary care in rural areas. An osteopathic medical school, of which there are 26 in this country, ranked first with 41 percent of its graduates in rural medicine.

The University of Minnesota-Duluth, which was established to provide physicians for rural Minnesota and native-American populations, ranked second with 36 percent of its graduates practicing in rural areas.

The data used in the paper looked at medical school graduates from 1988 through 1997 who were practicing in rural areas in 2005. According to the report, 32 percent of UMMC graduates during that period were practicing in rural areas of the state.

Dr. Steven T. Case, UMMC associate medical school dean for admissions, says he has "absolutely" no idea how to predict which of the applicants for medical school will end up in a rural practice in Mississippi.

"What we do know from all national data is that the students most likely to practice in a rural area are the kids who grew up in rural areas, and in the last 10 years about 28 percent of our entering students are from rural counties."

No doubt, state demographics and the fact that the school doesn't accept out-of-state students play a role in the practice decisions of the school's graduates. Nonetheless, the school has traditionally placed great emphasis on primary care.

The Mississippi Rural Physicians Scholarship Program offers $30,000 scholarships to students who commit to practice primary care in a rural area. Preceptor programs in the Departments of Medicine and Family Medicine keep students focused on the need for their future services in underserved areas of the state.

In fact, Case thinks "we may be bucking a national trend" in the declining number of students going into family medicine and primary care. Among this school's 2010 graduates, 53 percent (33 percent without the students who chose general internal medicine) have chosen a primary care residency - family medicine, ob-gyn and pediatrics. And primary care is the postgraduate medical education path that takes most medical school graduates to rural areas.

The study used the rural-urban commuting area (RUCA) codes to determine rural status. Instead of basing the urban-rural designation solely on population, the new codes use census-tract demographics and data about work-commuting patterns to determine how an area is defined.

For instance, the most rural designation (isolated rural) would be a community with a population of less than 2,500 where there is virtually no work commuting to urban areas.

Information from the Academic Medicine report correlates - given the difference in the time periods - to that provided to medical schools from the Association of American Medical Colleges (AAMC). It allows medical schools to see how they stand in relation to other medical schools in complying with one of several AAMC benchmarks.

UMMC ranked in the 90th percentile of medical schools in the percentage of its graduates (25.7) in rural practice. The AAMC looked at medical school graduates from five classes, 1995 through 1999.