Outcomes of a preclinical rural medicine elective at an urban medical school.

BACKGROUND AND OBJECTIVES The University of Louisville School of Medicine Trover Campus (ULTC) was established in rural west Kentucky in 1998 with the purpose of increasing the number of rural physicians. Utilizing the affinity model, a primary goal of the ULTC is to encourage rural students to pursue a medical education and return to rural Kentucky for practice. One aspect of this geographically separate clinical campus includes a Rural Medicine Elective (RME) offered during the basic science years. We report here the effect of the RME on student opinions and knowledge concerning rural practice, as well as initial effects on specialty and rural practice choice. METHODS Opinion responses and knowledge on a written exam using a pre-RME and post-RME survey for the 2004-2009 classes were analyzed. Pre-RME opinion items were examined descriptively (n=36). Pre-and post-opinion responses (n=23) and summation scores of 11 domains on exam questions (n=50) were compared using the Wilcoxon Signed Rank test. The proportion of students choosing family medicine and subsequent practice site choice were also measured. RESULTS RME student opinions about rural practice indicated improved agreement with information as presented in the course material. Similarly, on 11 knowledge examination summation scores, pre- and post-exam results showed significant increases in 10 domains. The pre-test answers provided an interesting baseline of beliefs. RME students were far more likely to choose family medicine than their classmates, and initial results show an increased likelihood of subsequent rural practice. CONCLUSIONS The initial outcomes of the RME are encouraging and indicate such an elective can maintain positive opinions about rural practice among rural students attending an urban medical school. The RME is also successful in increasing students' knowledge about rural practice and may maximize the likelihood that they will choose rural practice.