Daniel M. Avery

Admission Factors Predicting Family Medicine Specialty Choice: A Literature Review and Exploratory Study among Students in the Rural Medical Scholars Program.

PURPOSE The Rural Medical Scholars Program (RMSP) was created to increase production of rural family physicians in Alabama. Literature review reveals reasons medical students choose careers in family medicine, and these reasons can be categorized into domains that medical schools can address through admission, curriculum, and structural interventions. We examine whether admission factors can predict family medicine specialty choice among students recruited from rural Alabama. METHODS We developed a questionnaire to study the ability of admission factors to predict family medicine specialty choice among Rural Medical Scholars (RMS). Eighty RMS graduates were surveyed by mail and 64 (80%) responded. FINDINGS Student characteristics of humanitarian outlook with commitment to rural or underserved populations, family medicine decision or intention made before or at medical school admission, and community influence were positive associations with RMS choosing family medicine residencies; shadowing in an urban hospital was a negative association. CONCLUSIONS Statements of interest, intentions, plans, and decisions regarding family medicine should be elicited at the time of RMSP admission interview. Strong attachment to home community and commitment to serving and living in a rural area are also important. Students whose introduction to medicine was informed through shadowing or observing in urban hospitals should be considered less likely to become family physicians. Larger sample size studies are needed to assess the role of gender, race, marital status, size of rural town, and MCAT score of candidates in affecting residency choices of students selected for this rural medical education track.

The Economic Impact of Rural Family Physicians Practicing Obstetrics

Background: The economic impact of a family physician practicing family medicine in rural Alabama is

Why Is There a Deficit of Rural Surgeons in the United States

1,000,000 a year in economic benefit to the community. The economic benefit of those rural family physicians practicing obstetrics has not been studied. This study was designed to determine whether there was any added economic benefit of rural family physicians practicing obstetrics in rural, underserved Alabama. The Alabama Family Practice Rural Health Board has funded the University of Alabama Family Medicine Obstetrics Fellowship since its beginning in 1986. Methods: Family medicine obstetrics fellowship graduates who practice obstetrics in rural, underserved areas were sent questionnaires and asked to participate in the study. The questions included the most common types and average annual numbers of obstetrics/gynecological procedures they performed. Results: Ten physicians, or 77% of the graduates asked to participate in the study, returned the questionnaire. Fourteen common obstetrics/gynecological procedures performed by the graduates were identified. A mean of 115 deliveries were performed. The full-time equivalent reduction in family medicine time to practice obstetrics was 20%. Conclusions: A family physician practicing obstetrics in a rural area adds an additional

Obstetric Care by Family Physicians and Infant Mortality in Rural Alabama

488,560 in economic benefit to the community in addition to the

Neonatal Outcomes of 26,331 Infants Delivered by Obstetrics Fellowship Trained Family Physicians and OB/Gyns

1,000,000 from practicing family medicine, producing a total annual benefit of

Rural Surgery Training Programs in the United States: A Review of the Literature

1,488,560. The investment of

Smoking in Rural and Underserved Pregnant Women

616,385 from the Alabama Family Practice Rural Health Board resulted in a

Cellulitis Following Newborn Circumcision

399 benefit to the community for every dollar invested. The cumulative effect of fellowship graduates practicing both family medicine and obstetrics in rural, underserved areas over the 26 years studied was

Cesarean Hysterectomy for Family Medicine Physicians Practicing Obstetrics

246,047,120.

Family physicians providing rural obstetric care makes good business sense

There is a national shortage of general surgeons in the United States. There is a critical need for surgeons in rural areas, which are hit the hardest by the deficit. Fewer medical students are choosing surgery as a residency. Our training programs are producing less general surgeons. More than 80% of general surgery residents pursue fellowship training. The prediction 3 decades ago of an abundance of general surgeons has not been the case and there is a great demand for general surgeons, especially in rural areas. The population is aging and there is an increased need for surgeons.