title: Retention of rural family physicians after 20-25 years: outcomes of a comprehensive medical school rural program.
abstract: BACKGROUND
  The Physician Shortage Area Program (PSAP) of Jefferson Medical College (JMC) is one of a small number of comprehensive medical school rural programs that has been successful in increasing the supply of family physicians practicing in rural areas. Although retention is a critical component of the rural physician supply, published long-term outcomes are limited.
  
  
  METHODS
  Of the 1937 JMC graduates from the classes of 1978 to 1986, we identified those who were practicing family medicine in a rural county when they were first located in practice (in 1986 for 1978-1981 graduates and in 1991 for 1982-1986 graduates). Using the Jefferson Longitudinal Study, we then compared the numbers of PSAP and non-PSAP graduates who were still practicing family medicine in the same area in 2011.
  
  
  RESULTS
  Of the 92 JMC graduates initially practicing rural family medicine, 90 were alive in 2011, and specialty and location data were available for 89 (98.9%). Of the 37 PSAP graduates who originally practiced rural family medicine, 26 (70.3%) were still practicing family medicine in the same rural area in 2011 compared with 24 of 52 non-PSAP graduates (46.2%; P = .02).
  
  
  CONCLUSIONS
  This study provides additional support for the substantial impact of medical school rural programs, suggesting that graduates of rural programs are not only likely to enter rural family medicine but to remain in rural practice for decades.
authors.affiliation: Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA. Howard.Rabinowitz@jefferson.edu
authors.forename: Howard K
authors.initials: HK
authors.lastname: Rabinowitz
authors.forename: James J
authors.initials: JJ
authors.lastname: Diamond
authors.forename: Fred W
authors.initials: FW
authors.lastname: Markham
authors.forename: Abbie J
authors.initials: AJ
authors.lastname: Santana
mesh_terms: D004504:Education, Medical, Undergraduate / Q000379:methods*; D005194:Family Practice / Q000193:education / Q000706:statistics & numerical data; D006801:Humans; D008507:Medically Underserved Area; D010414:Pennsylvania; D010821:Physicians, Family / Q000193:education / Q000706:statistics & numerical data / Q000600:supply & distribution*; D015397:Program Evaluation; D019035:Rural Health Services / Q000706:statistics & numerical data; D000078329:Workforce