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Editorial  |   May 2017
Developing a Sustainable Rural Physician Pipeline for Oklahoma
Author Notes
  • Financial Disclosures: None reported. 
  • Support: None reported. 
  •  *Address correspondence to Kayse M. Shrum, DO, Dean, Oklahoma State University Center for Health Sciences College of Osteopathic Medicine, 1111 W 17th St, Tulsa, OK 74107-1898. E-mail: chs.president@okstate.edu
     
Article Information
Medical Education / Graduate Medical Education
Editorial   |   May 2017
Developing a Sustainable Rural Physician Pipeline for Oklahoma
The Journal of the American Osteopathic Association, May 2017, Vol. 117, 287-288. doi:10.7556/jaoa.2017.049
The Journal of the American Osteopathic Association, May 2017, Vol. 117, 287-288. doi:10.7556/jaoa.2017.049
The Oklahoma State University Center for Health Sciences College of Osteopathic Medicine (OSU-COM) has had a long and rich history of training primary care physicians for rural practice. Founded in 1972, OSU-COM's mission has been to train osteopathic primary care physicians to care for the rural and underserved populations in Oklahoma. At a time when Oklahoma is facing a severe shortage of primary care physicians in rural regions, coupled with an aging rural physician workforce, carrying out our mission is more important than ever. 
According to the United Health Foundation's 2016 America's Health Rankings, Oklahoma ranked 46th in the nation in overall health.1 The poor health status of Oklahoma can be attributed to the prevalence of chronic diseases as well as to the shortage of primary care physicians.1 The number of primary care physicians per 100,000 population is 123.7 in Oklahoma, compared with the national average of 145.3.1 Rural areas of Oklahoma are disproportionately affected by the primary care physician shortage. To exacerbate the situation, 52% of rural primary care physicians are older than 55 years.2 It is critical that OSU-COM implement a strategy to help replenish rural Oklahoma's primary care physician workforce. 
To this end, OSU-COM has implemented a “rural physician pipeline” model for the recruitment of medical students from rural Oklahoma and the training of medical students in rural health. Two articles in this issue of The Journal of the American Osteopathic Association,3,4 authored by faculty and staff who are intimately involved in helping to build a rural physician pipeline, describe efforts to produce more primary care physicians for rural Oklahoma. 
In their article on rural training initiatives, Wheeler and Hackler3 assessed the impact that the OSU-COM Rural Medical Track (RMT) has had on increasing the number of resident physicians in rural-based residency programs. In 2011, the OSU Center for Rural Health at OSU-COM received a grant from the US Health Resources and Services Administration to develop the RMT, a rural-focused elective curriculum. This comprehensive and integrated rural-focused curriculum was designed to train a small cohort of medical students interested in serving as primary care physicians in rural Oklahoma. Students enrolled in the RMT typically come from rural backgrounds and have expressed interest in returning to a rural community to practice medicine. Medical students in the RMT receive exposure to a rural clinical experience early on and have unique learning opportunities to prepare them for a successful rural practice. For example, students shadow a rural primary care physician after the first year of medical school, complete a rural health–focused research project in their second year, and complete the bulk of their clinical rotations in rural settings during the third and fourth years of medical school. The leadership at OSU-COM believes that if we recruit medical students from rural Oklahoma and train them in rural settings early on and consistently throughout medical school, they will be more likely to return to rural Oklahoma to complete their residency training. 
The RMT has been successful in nurturing medical students’ interest in rural primary care medicine and influencing their decision to select a rural-based residency program. Since its inception in 2012, the RMT has doubled in student enrollment, and 71% of RMT graduates have been matched to a rural-based residency program. 
In the second article by OSU-COM faculty, Wilson4 examined the effectiveness of 2 high school research-focused internship programs in encouraging participants to pursue osteopathic medicine. Over the past 5 years, OSU-COM has launched a plethora of high school recruitment programs to identify promising osteopathic medical school prospects from rural and underserved communities. The Oklahoma Science Training and Research Students (OKStars) program and the Native Oklahoma Science Training and Research Students (Native OKStars) program represent 2 shining examples of OSU-COM's successful high school recruitment programs. OKStars is an innovative nonresidential program that enables 20 to 25 high-performing high school students to spend 6 weeks on the OSU-COM campus and conduct advanced research under the guidance of OSU-COM professors. 
This intensive summer research experience requires that each student participate during the weekdays for the entirety of the program. In addition to research, students have an opportunity to work with cadaveric specimens to achieve a greater understanding of the human body. Each student is paired with a medical student for one-on-one mentoring. The high school students also gather twice each week for a group lunch where they receive information about successful life transitions; strategies for success in college, career options in science, technology, engineering, and math; and pathways to medical school. Native OKStars has the same programmatic structure as OKStars, but participants in Native OKStars must be Native American, and they receive mentoring by Native American faculty and medical students. As OSU-COM continues to grow the size and quality of the medical school application pool from Oklahoma, innovative high school recruiting programs like OKStars and Native OKStars will enable us to target high-potential medical school candidates from rural and Native American communities. 
These 2 articles provide a small glimpse into the innovative programs taking place at OSU-COM to address the rural primary care physician shortage in Oklahoma. Programs such as the Rural Medical Track, OKStars, and Native OKStars will enable OSU-COM to be recognized as an unequivocal leader in rural health care and osteopathic medicine. 
References
America's Health Rankings Annual Report. Minnetonka, MN: United Health Foundation; 2016.
Oklahoma Senate Interim Study 15-12, Oklahoma's Aging Physician Workforce. Tulsa, OK; Center for Rural Health, 2015.
Wheeler DL, Hackler JB. Preparing physicians for rural-based primary care practice: a preliminary evaluation of rural training initiatives at OSU-COM. J Am Osteopath Assoc. 2017;117(5):315-324. doi: 10.7556/jaoa.2017.058
Wilson NF. OKStars and Native OKStars: introducing high school students to careers in osteopathic medicine. J Am Osteopath Assoc. 2017;117(5):325-330. doi: 10.7556/jaoa.2017.059