Rural Health Education: Preparing Tomorrow's Country Doctors

Serving as a physician in a rural community creates some unique and powerful experiences—and today’s medical education programs can do more to promote this rewarding option. Just ask the 2019 recipient of the National Rural Health Association (NRHA) Outstanding Educator award, Michael Kennedy, MD, FAAFP. 

“I found working in rural healthcare to be energizing,” remarked Kennedy, who serves as the McCann professor and associate dean for rural health education and a professor of family medicine at the University of Kansas Medical Center (KUMC) in Kansas City.

“I loved the variety and being an integrated part of the community,” he continued. “I got to give talks on cancer and diabetes care; I worked with school systems and the library. As a rural physician I got to see how I was making the difference in the lives of individuals, as well as in the community as a whole.” 

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From rural practitioner to educator

Along with treating rural patients, educating rural physicians and other health professionals has become a passion for Kennedy. He became involved in rural health education when KUMC started sending students to study under him in his medical practice in Burlington, Kansas, about 100 miles southwest of Kansas City.

His academic career started with overseeing two to three students a year, then grew to five or six students a year. Next, he started volunteering at KUMC on a monthly basis teaching residents; that eventually turned into a weekly commitment, until in 2005, when he was offered a full-time teaching position. Nearly 15 years later, in April 2019, Kennedy was recognized by the NRHA as their Outstanding Educator of the Year.

Kansas currently has a need for about 40 new rural physicians each year and KUMC is only graduating about 20 each year. Kennedy, however, is part of creating programs and curriculums in rural health education to increase that number. 

Evolving rural health programs and curriculums

“We are actively looking at what are the issues in rural medicine and how can we address them,” Kennedy said. “I participate in a number of different task forces working on policy and creating opportunities for educating rural physicians.”

One program, called Scholars in Rural Health, begins working with college juniors who are interested in becoming physicians. Students who complete the program gain guaranteed acceptance to the KUMC medical school.  When the program started, it involved six students annually, but has since expanded to 15-20 students each year.

“Because the educational track for becoming a physician is a minimum of seven years, we are just now starting to see an increase in the number of graduates going into rural healthcare as a result of this program,” Kennedy explained.

Another program creates a summer training option for rural medicine. In this program, 32 medical students will work in rural family practice for up to six weeks and do targeted research.

“This program is empowering and enriching for students. They are able to see rural healthcare as a real option and become excited about the possibilities,” he noted.

The unique challenges of rural physician training 

While rural physicians are called on to care for a wide range of medical needs, their preparation has to go beyond medicine.

“As a rural physician, you are a big fish in a small pond. You are very visible; community members seek you out and want to know you. If you make a mistake, it is magnified; if you have a health outcome that wasn’t good, even if you did everything right, people hold it against you. You live with all of your mistakes. I talk to my students about all these things,” Kennedy reflected.

Additionally, rural physicians need to know how to partner with other healthcare providers in their community and how to navigate the politics that can sometimes be involved in those relationships. They need the people skills to solve disagreements and create a supportive team within the healthcare community.

“Some of what you have to deal with is not having every resource at your fingertips.  And it isn’t just medical resources. Some rural areas are food deserts and you have to get used to long drives for groceries and always making sure your car is gassed up. It can also create challenges for spouses finding fulfilling jobs,” Kennedy stated.

“A rural educators group I am a part of is looking at the phenomenon of burnout in rural health care providers. But we are also looking at the ideas of resiliency and grittiness and how that applies to the work of rural medicine,” he noted.

Despite the challenges in rural health education, Kennedy sees a promising future for tomorrow’s country doctors.

“This generation of students is extraordinary,” Kennedy said. “They are service-oriented and really want to make a difference. They seem to be drawn to the idea of being an immersed member of the community and feel like this is a setting where they can balance their professional and personal lives.”

Related: 
Where Have All the Rural Hospitals Gone? 
Dr. Daniel Dahle Named Staff Care’s 2019 Country Doctor of the Year 
National Rural Health Association 

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