title: Influencing residency choice and practice location through a longitudinal rural pipeline program.
abstract: OBJECTIVE
  The University of Missouri School of Medicine developed the Rural Track Pipeline Program (MU-RTPP) to increase the supply and retention of rural physicians statewide. The MU-RTPP features a preadmissions program for rural students (Rural Scholars), a Summer Community Program for rising second-year students, a six-month Rural Track Clerkship (RTC) Program for third-year students, and a Rural Track Elective Program for fourth-year students. The purpose of this study is to report the specialty choices and first practice locations of Rural Scholars, RTC-only participants, and Rural Track Clerkship Plus (RTC+) participants (students who participated in the RTC Program plus an additional MU-RTPP component).
  
  
  METHODS
  The authors compared the residency specialty choices of 48 Rural Scholars (tracked since 2002) with those of 506 nonparticipants and the residency specialty choices of 83 RTC participants and 75 RTC+ participants (tracked since 1997) with those of 840 nonparticipants. The authors calculated the relative risk (RR) for the likelihood of participants matching into primary care compared with nonparticipants and analyzed first practice location.
  
  
  RESULTS
  Rural Scholars were more than twice as likely to match into family medicine (RR=2.6; 95% confidence interval 1.5-4.4). RTC and RTC+ participants entered primary care, especially family medicine, at rates significantly higher than nonparticipants. Over 57% of students who participated in the RTC program (and potentially other MU-RTPP offerings) chose a rural location for their first practice.
  
  
  CONCLUSIONS
  The longitudinal MU-RTPP successfully recruits students for rural and primary care practice to address the health care needs of Missouri.
authors.affiliation: Area Health Education Center, Rural Track Pipeline Program, Department of Rural Health Programs, University of Missouri, School of Medicine, Columbia, Missouri 65212, USA. quinnk@health.missouri.edu
authors.forename: Kathleen J
authors.initials: KJ
authors.lastname: Quinn
authors.forename: Kevin Y
authors.initials: KY
authors.lastname: Kane
authors.forename: James J
authors.initials: JJ
authors.lastname: Stevermer
authors.forename: Weldon D
authors.initials: WD
authors.lastname: Webb
authors.forename: Jana L
authors.initials: JL
authors.lastname: Porter
authors.forename: Harold A
authors.initials: HA
authors.lastname: Williamson
authors.forename: Michael C
authors.initials: MC
authors.lastname: Hosokawa
mesh_terms: D002321:Career Choice; D004503:Education, Medical, Graduate / Q000458:organization & administration; D004504:Education, Medical, Undergraduate / Q000458:organization & administration; D005194:Family Practice / Q000193:education; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D008137:Longitudinal Studies; D008297:Male; D008923:Missouri; D010816:Physician Incentive Plans / Q000458:organization & administration*; D011365:Professional Practice Location; D016730:Program Development; D015397:Program Evaluation; D019035:Rural Health Services / Q000458:organization & administration* / Q000600:supply & distribution; D055815:Young Adult