title: Efforts to graduate more primary care physicians and physicians who will practice in rural areas: examining outcomes from the university of Minnesota-duluth and the rural physician associate program.
abstract: OBJECTIVE
  To compare practice choices (primary care or specialty) and practice locations (rural or metropolitan) of medical students at the Duluth and Twin Cities (Minneapolis and St. Paul; TC) campuses of the University of Minnesota (UMN). In the early 1970s, Minnesota created two medical education programs at UMN to increase the number of rural and primary care physicians: the first two years of medical school at UMN-Duluth, where the program focuses on recruiting students who will be rural family physicians, and the Rural Physician Associate Program (RPAP) elective, a nine-month, longitudinal immersion experience with a preceptor in a rural community.
  
  
  METHODS
  In 2008, the authors analyzed outcomes for four student groups: (1) UMN-Duluth and (2) UMN-TC medical students who participated in RPAP and (3) UMN-Duluth and (4) UMN-TC students who did not participate in RPAP. UMN medical students complete their first two years on either campus; they can apply to RPAP for their third year. Non-RPAP students spend most of their third- and fourth-year rotations in the Twin Cities metropolitan area.
  
  
  RESULTS
  The UMN-Duluth and RPAP students were most likely to select a rural location and primary care practice. UMN-TC, non-RPAP students followed national trends, choosing predominantly metropolitan and specialty practices.
  
  
  CONCLUSIONS
  RPAP and UMN-Duluth provide significant, complementary educational programs that lead more graduates to choose rural and primary care practices. Efforts across the nation to address the crisis in rural primary care should build on these successful efforts.
authors.affiliation: Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota 55455, USA. zink0003@umn.edu
authors.forename: Therese
authors.initials: T
authors.lastname: Zink
authors.forename: Bruce
authors.initials: B
authors.lastname: Center
authors.forename: Deborah
authors.initials: D
authors.lastname: Finstad
authors.forename: James G
authors.initials: JG
authors.lastname: Boulger
authors.forename: Lillian A
authors.initials: LA
authors.lastname: Repesh
authors.forename: Ruth
authors.initials: R
authors.lastname: Westra
authors.forename: Raymond
authors.initials: R
authors.lastname: Christensen
authors.forename: Kathleen Dwyer
authors.initials: KD
authors.lastname: Brooks
mesh_terms: D000328:Adult; D004501:Education, Medical / Q000458:organization & administration*; D005194:Family Practice / Q000193:education; D005260:Female; D006801:Humans; D008297:Male; D008910:Minnesota; D010821:Physicians, Family / Q000193:education* / Q000600:supply & distribution; D015397:Program Evaluation / Q000379:methods*; D012189:Retrospective Studies; D019035:Rural Health Services; D013337:Students, Medical / Q000706:statistics & numerical data*; D014495:Universities; D000078329:Workforce