The Rural Family Medicine Residency Program was suspended December 31, 2011, for lack of sustainable funding. Until this is remedied, the program remains accredited through 2015, but inactive as a residency program.
Up until its suspension, however, the OSU Rural Family Medicine Program was meeting the challenges of rural medicine with an innovative residency program combining the best of two worlds—the education, experience, and support of a Family Medicine program at a major academic medical center and the hands-on, real-world training at a rural office practice and hospital. The Ohio State University Rural Family Medicine Program was a division of Mary Rutan Hospital, located in Bellefontaine, Ohio and affiliated with the Wexner Medical Center at the Ohio State University and College of Medicine. As a “2-2-2” integrated rural training track (two residents in each of the three postgraduate residency years), residents had been spending all three years in clinical practice at Mad River Family Medicine and Mary Rutan Hospital. This small town continuity practice was interspersed with periodic tertiary hospital experiences at the Wexner Medical Center at The Ohio State University and Nationwide Children’s Hospital in Columbus.
During their residency, these young physicians were expected to refine a personal vision for practice, make a significant contribution to the health of the community, and conduct a scholarly activity, adding to their own learning and that of their colleagues and to all of family medicine. Unique aspects of the program included the residency’s family practice center embedded in a rural private group practice; a particularly strong emphasis on continuity of patient care across settings and stages of life, including a high-volume continuity OB practice; a practice-based small group learning program; and a sabbatical elective in the third-year promoting a cross-cultural experience in another underserved area in this country or overseas. The Rural Family Medicine Program was founded on the belief that when it comes to creating a safe and nurturing learning community, “small is better.” As a rurally located program, its strengths lay in its wide, general scope of practice, an abundance of procedures, experienced and passionate faculty, and adaptability to individual learning needs and practice goals. One rather unique feature of the Rural Family Medicine Program was a case-based inter-professional resident and faculty group exercise entitled “Clinical Jazz.” This weekly seminar promoted learning collectively from experiences with peers, patients, and their families in an integrated and holistic manner. Facilitated by a family physician and a clinical psychologist, this exercise explored the doctor-patient relationship as the foundation of clinical practice and addressed those aspects of doctoring that are particularly challenging, difficult, or intriguing. While underserved areas across the U.S. and around the world face many difficulties meeting their healthcare needs, Ohio State’s Rural Family Medicine Program was training a new generation of family physicians who were eager to meet these challenges and improve the lives of people in their communities.
Since its inception in 1998, the program has graduated 17 physicians, 13 of them to rural practice. Another 3 physicians had the privilege to train at least for one year. Hopefully, with additional funding the program can be reactivated and continue this important work in the future.
The biggest challenge to rural medical education around the world is sustainable funding. With normally tight budgets and the added burden of a staggering economy, Rural Medicine must compete with high-profile programs such as Cancer, Heart Disease, and Neurobiology. Therefore, endowment support is absolutely essential to ensuring the continued success and growth of the Rural Family Medicine Program. Since its establishment in 2003, the Rural Family Medicine Endowment Fund has greatly assisted those seeking a career in Rural Family Medicine. The endowment produces an annual income, and is being applied to faculty salary support for the otherwise unfunded position of Assistant Dean for Rural Medical Education at the College of Medicine.