Thirty Years Training Rural Physicians: Outcomes From the Michigan State University College of Human Medicine Rural Physician Program

Purpose There is a shortage of primary care and rural physicians in the United States. In 1974, Michigan State University College of Human Medicine (MSU-CHM) created the Rural Physician Program (RPP) to address these issues and increase primary care physicians in Michigan's Upper Peninsula (UP). The authors describe the program and analyze 30 years of outcomes. Method Using American Medical Association Masterfile data, authors performed cross-sectional analysis of all MSU-CHM graduates from 1978 to 2006. Logistic regression was used to compare specialty choice and practice location for RPP graduates and all other MSU-CHM graduates. RPP graduate outcomes were compared over time. Results In 2011, RPP graduates were more likely to practice primary care (RPP 88/168 [48%]; MSU-CHM 1,143/2,610 [44%]; P = .04), practice a rural high-need specialty (RPP 122/168 [73%]; MSU-CHM 1,612/2,610 [62%]; P = .006), practice in Michigan (RPP 89/168 [53%]; MSU-CHM 1,119/2,610 [43%]; P = .01), practice in the UP region (RPP 44/168 [26%]; MSU-CHM 28/2,610 [1%]; P < .001), practice in a Health Professional Shortage Area (RPP 106/168 [63%]; MSU-CHM 1,279/2,610 [49%]; P < .001), and practice in a rural area (RPP 76/168 [45%]; MSU-CHM 361/2,610 [14%]; P < .001). Percentages of graduates meeting program goals and from the UP region have increased as the program has matured. Conclusions Program characteristics, including targeting rurally interested students, primary care focus, and substantial clinical training within a rural region, can successfully foster rural physician careers. The greatest benefit is to the rural region where the program is based.