title: Increasing the medical school applicant pool: a key to training more rural physicians.
abstract: BACKGROUND
  Workforce studies show shortages of physicians in many areas of the United States. These shortages are especially severe in states such as Kentucky with many rural counties and are predicted to worsen in the future unless there are changes throughout our educational system to build aspirations and prepare students for medical school education.
  
  
  OBJECTIVE
  To examine rural-urban differences and community characteristics of applicants and matriculants to Kentucky's two allopathic medical schools and influences on the educational aspirations of young students who wish to become physicians.
  
  
  METHODS
  The number of Kentucky applicants and matriculants to allopathic medical schools was obtained from the Association of American Medical College's data warehouse for the period from 2002-2006. A continuous, multidimensional measure was used to classify counties by degree of rurality. Socio-demographic variables were selected for the counties of residence for applicants and matriculants. Model variables were tested in a least squares multiple regression model for their ability to explain patterns among Kentucky's 120 counties in the number of both resident applicants and matriculants to medical school. Data from a survey of middle school participants in summer health camps were analyzed to help identify important influences on young students aspiring to a career as a health professional, especially becoming a physician, and how these might be supported to increase the supply of rural medical school applicants.
  
  
  RESULTS
  The low number of rural applicants to medical school was highly correlated with the relative rurality of their county of residence, a low physician-to-population ratio and a low number of total primary care physicians. The percentage of county residents having a bachelor's degree level of education or higher had a positive impact on the application rate. Respondents became interested in health careers at age 15 or younger, and parents and grandparents, teachers, and close associates stimulated their aspirations, with teachers being the most influential.
  
  
  CONCLUSIONS
  Prospective students respond to their perception of need for physicians. Rural students are influenced by those who are more highly educated. To overcome the shortage of physicians in rural communities efforts must be made to increase the aspirations for medical education of prospective students from rural counties.
authors.affiliation: Office of Health Research and Development, University of Kentucky 40506-9983, USA.
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Anderson
authors.forename: Elmer T
authors.initials: ET
authors.lastname: Whitler
authors.forename: Andrew O
authors.initials: AO
authors.lastname: Johnson
authors.forename: Carol L
authors.initials: CL
authors.lastname: Elam
authors.forename: Emery A
authors.initials: EA
authors.lastname: Wilson
authors.forename: Linda M
authors.initials: LM
authors.lastname: Asher
mesh_terms: D000293:Adolescent; D002321:Career Choice; D004504:Education, Medical, Undergraduate; D005260:Female; D006801:Humans; D007629:Kentucky; D016015:Logistic Models; D008297:Male; D010820:Physicians / Q000600:supply & distribution*; D019035:Rural Health Services; D012424:Rural Population; D012577:Schools, Medical; D013340:Students, Premedical / Q000523:psychology*; D014505:Urban Population; D000078329:Workforce