Rural and Urban Medical School Programs that Demonstrate a Commitment to Producing Rural Physicians

An association between medical school program mission and the production of rural and primary care physicians exists and has been well-established in the literature. In the early 1990s, health services researchers at the WWAMI Rural Health Research Center noted extreme variability in the production of rural physicians across the nation's medical schools. In examining the practice locations of physicians who graduated from medical school during the period from 1976 to 1985, they found that the rate of rural physician production ranged from a high of 41 percent to a low of 2 percent, and that just 12 medical schools produced over 25 percent of the rural physicians in that period. By 2023, the rate of rural physician production had declined significantly. The new top medical school's rural physician production rate was 25 percent and about 10 percent of schools reported that less than 1 percent of their graduates were rural physicians.

While the literature establishes an association between high rural output and certain program characteristics, including location in a rural state and rural mission, it is not which elements of organizational commitment lead to graduates practicing in rural primary care settings. The purpose of this study is to discover how medical schools with rural missions translate into committed action that ultimately result in a high level of production of rural physicians. We will use practice location data on the cohort of medical school graduates who were attending medical school at the time that these program characteristics were identified and in effect.