UM to train more doctors for rural areas

The University of Maryland School of Medicine will receive $750,000 in federal funds to train more doctors for posts in rural areas, where the growing nationwide shortage of doctors is most acute.

The money, announced Thursday at the Baltimore school, comes from the U.S. Health Resources and Services Administration. It’s part of a $20 million award that will be made over a three-year period to develop rural residency programs across the country.

“The health challenges in rural America are clear. Rural communities face a greater risk of poor health outcomes than their urban counterparts,” said George Sigounas, the agency administrator, in a statement. “Programs like the Rural Residency Planning and Development grants take aim at one of the most persistent disparities: access to high quality healthcare providers.”

Residencies are the required clinical training doctors receive after medical school, and they focus doctors on primary care or a specialty.

Maryland’s medical school was among 27 programs in 21 states to receive a portion of the funding.

There are other federal and state programs aimed at boosting the number of providers in rural and underserved areas. Some doctors can receive tuition assistance or reimbursement to practice for a time in rural or underserved areas such as inner cities. In Maryland, they can earn tax credits.

The new federal money will go to schools of medicine, as well as rural hospitals, community health centers and health centers operated by the Indian Health Service.

Officials said that those who train in rural areas are more likely to practice there.

The University of Maryland already has a program that immerses first-year medical students in health care in rural and underserved areas. It aims to spur interest early before the students have chosen another field to pursue, including the higher-paying specialties. The school also has been recruiting students from rural areas in hopes they will return home to practice.

The rural doctor shortage comes as the nation faces a shortfall of doctors generally. The Association of American Medical Colleges recently projected a shortage of up to almost 122,000 physicians by 2032 as demand grows faster than supply. Primary care doctors represent nearly half of the shortage.

The group cited an aging population and longer life spans. It also has said that primary care attracts fewer potential doctors because pay is generally lower than in specialties and many new doctors are saddled with hefty medical school debt.

Fewer also are attracted to rural communities. Various studies have found that about 20% of the population lives in a rural area but fewer than 10% of doctors practice in those places.

The Maryland residency program will send doctors-in-training to the University of Maryland Shore Regional Health and the Choptank Community Health System.

The goal of the Maryland “program is to develop a sustainable, accredited rural training track in Caroline, Dorchester, Kent, Queen Anne’s and Talbot counties on Maryland’s Eastern Shore, and to ultimately expand the area’s rural primary care workforce,” said Dr. David Stewart, associate professor and chair of the school’s Department and Family and Community Medicine.

“This program will help create a pipeline for expanding the physician workforce in rural, medically underserved areas on Maryland’s Eastern Shore,” he said.

The program will include 12 residents and ramp up over the next three years, said Dr. Jason Ramirez, an assistant professor in the Department of Family and Community Medicine, who applied for the federal grant.

Dr. E. Albert Reece, dean of the University of Maryland School of Medicine, said the program could expand to other rural areas of the state. The majority of Maryland counties are considered rural.

The Eastern Shore area targeted by the program is expansive and has a population that is aging and has higher-than-average levels of chronic disease, said Kenneth Kozel, president and CEO of Shore Regional Health. The residents also often have a long ride to medical care and no public transportation option, complicating treatment.

He said the residents will learn to care for that population and its unique needs. They will spend their first year in Baltimore and then complete their final two years of training in medical practices and other clinical settings at the two health care organizations.

“We know doctors tend to stay near where they train,” Kozel said. “So if they’re born and raised here, come to train here, there’s a good chance they’ll practice here.”

Maryland lawmakers praised the funding in statements.

“As a physician myself, I know it’s important to train physicians in rural areas because many physicians consider staying in practice in the communities where they trained,” said Rep. Andy Harris, a Maryland Republican who represents rural Eastern Shore areas. “This HRSA grant will help our shortage of physicians on the Eastern Shore of Maryland.”