The Utah rural residency study: a blueprint for evaluating potential sites for development of a 4-4-4 family practice residency program in a rural community.
BACKGROUND
Most graduates of rural residencies enter rural practice. Rural residencies therefore have emerged over the past 2 decades to increase the supply of rural physicians. However, researchers have published few descriptions of strategies to evaluate and select communities in which to locate rural residencies.


OBJECTIVE
This report describes the development and application of such a strategy to assess 7 rural communities in Utah as potential sites for family practice residency training.


METHODS
Criteria were developed on the basis of an examination of the literature, residency accreditation requirements, and characteristics of existing rural residency programs. Ten rural or frontier communities with hospitals were selected as study candidates, and 7 agreed to participate. Data were collected through hospital surveys, state hospital discharge records, and community site visits.


RESULTS
Specific evaluation criteria that were developed included the presence of a medical practice of the appropriate specialty and size, a sufficient number of medical subspecialty physicians, an adequate number and mix of hospitalized patients, an adequate number of ambulatory patients, adequate outpatient facility space to accommodate learners, and a commitment by the practicing physician and hospital to lead the program and teach residents. Two communities were found to be potentially capable of supporting a residency if physicians and hospital leaders in the communities were to become motivated to lead program development.


CONCLUSIONS
These criteria may be useful in other states, but they have not been tested for validity or reliability and are subject to limitations such as exclusion of alternate rural residency models. Future research should address data needs and the relationship of the evaluation criteria to the quality of resident learning.
Catinella
A Peter
AP
Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City 84132, USA. peter.catinella@hsc.utah.edu
Magill
Michael K
MK
Thiese
Steven M
SM
Turner
Deborah
D
Elison
Gar T
GT
Baden
Daniel J
DJ
D000068:Accreditation; D005194:Family Practice / Q000193:education*; D017408:Guidelines as Topic; D006780:Hospitals, Rural / Q000145:classification / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration* / Q000592:standards; D007857:Leadership; D011365:Professional Practice Location; D016730:Program Development; D015203:Reproducibility of Results; D019035:Rural Health Services; D014589:Utah; D000078329:Workforce