Both first-time and re-applicants were included in the sample. A total of 350 applications (112 in 20, and 126 in 2019) were excluded because they were either incomplete or withdrawn. Due to the rising gap in rural versus urban physicians, UNC SOM established multiple pipeline programs to recruit rural students, specifically, the Middle School Science and Technology Enrichment Program (middle school), Health Professions Recruitment and Exposure Program (high school), and Medical Education Development Program (college). This study presents a model for analyzing these recruitment efforts. A preprint of this article was previously posted to Research Square on February 5, 2021.Īll in-state applicants for the 2017, 2018, and 2019 admission cycles were included in the analyses (n = 2,791). The University of North Carolina at Chapel Hill’s School of Medicine (UNC SOM) plays a key role in producing a physician workforce that meets the state’s healthcare needs. Bourdieu’s theory underscores challenges facing rural students accessing higher education due to a lack of role models. In one study, children of farmers were less likely to pursue higher education than children of professionals. Individual’s educational paths and potential access are constrained by habitus, where habitus is defined as a set of dispositions, including family background, rural versus urban upbringing, and financial status. Ĭhallenges recruiting rural applicants to medical school may be explained by Bourdieu’s theory of habitus. Some studies indicate rural applicants are equally likely to be admitted to medical school relative to urban applicants. The causes of the underrepresentation of rural students have been attributed to a shortage of applicants. Because growing up in a rural area is a strong predictor of future rural practice, recruiting rural medical school applicants is an important strategy to boost the rural physician workforce. Unfortunately, rural students are underrepresented in medical schools nationwide and their numbers are declining. By 2018, this gap had increased to 13.1 more physicians per capita. In 1979, urban counties had about 6.1 more physicians per 10,000 population compared to rural counties.
Over the past four decades, even though the physician supply of North Carolina (NC) has grown, the maldistribution of physicians in urban versus rural areas has increased. Rural populations have poorer health outcomes and higher mortality rates, stemming from lack of health insurance coverage, health behavior and risk factors, lower socioeconomic status, and physician shortages in rural areas.
Addressing rural physician workforce needs will require multiple strategies that affect different parts of the medical education and healthcare systems, including boosting college completion rates in rural areas. This model of analysis can also be applied to other pipeline programs to document the success of the recruitment efforts. Our model of analysis successfully calculated the impact of recruitment efforts to achieve proportional parity in the medical school class with the rural population of the state. An increase of just 14 additional rural applicants annually would bring the proportion of rural UNC SOM applicants in alignment with the potential applicant pool in rural NC counties. Between 20, 9.3% (n = 225) of UNC SOM applicants were from a rural county. Roughly 10.9% of NC’s population of college-educated 18-34-year-olds live in rural counties. The likely pool of rural applicants was based on the number of college-educated 18-34-year-olds by county. As a result, the medical school implemented pipeline programs to recruit more rural students. This study investigates the results of these recruitment efforts.ĭescriptive analyses were conducted to compare the number and percentage of rural and urban students from NC who applied, interviewed, and were accepted to the University of North Carolina’s School of Medicine (UNC SOM). In rural counties, access to care and health disparities remain concerning. However, the distribution of physicians between urban and rural areas increased, with many more physicians in urban areas. Over the past 40 years, the physician supply of North Carolina (NC) grew faster than the total population.
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