Since Heartland began sponsoring the Area Health Education Center in St. Joseph, several doctors have returned to stay. "I don't know if we can grow enough; we'll still have to recruit from other places. But this is very encouraging for us," Kruse says. "The earlier you can create a passion in people to work in rural areas the better off you are. The thing about an AHEC program is the students are sure not going to be surprised if they take a rural job. They've been there for months and know what they're getting into."

Having the students at Heartland also helps the hospital understand what it takes to attract doctors to the St. Joseph area, Kruse says."Younger people are more interested in their families and communities," he says. "Too often in the past we thought our job was done when we helped them set up their practice. Now we know the job isn't done until we've helped them assimilate into the community."

Webb agreed: "You can't just drop a doctor in a rural community without support. They just won't make it."

With that knowledge also came the recognition that MU and AHEC sponsors like Heartland are not just in competition with big cities for physicians, but with rural communities in other states as well. To help ensure that MU graduates and residents stay in Missouri, the rural track has created a bridging program to match residents to jobs. "Up until this, we were putting these people in the pipeline and they could go off to Nebraska or Iowa or Florida," Williamson says.

Kathy Brown, director of the Missouri Physician Placement Program, scouts opportunities for residents, gathers information about communities and arranges job interviews. She also helps newly hired doctors find homes and jobs for their spouses. "The typical head hunter advocates for the client; Kathy is the advocate of the resident," Webb says.

Because the pipeline from undergraduate pre-med to medical student to resident is so long, it's still too early to tell how successful MU's rural track program will be. The first Bryant Scholars who began as undergraduates are only now in the final years of their residencies.

Programs in other states have been lucky to place about half their students in rural areas. The first indications for MU, however, look more promising. Of the 22 Bryant Scholars who graduated between 2002 and 2005, close to three quarters have chosen a primary care residency, and 73 percent have entered a residency program in Missouri.

That's a good sign they'll be heading to small towns, in sharp contrast to statistics for their classmates. Only 32 percent of other MU medical school graduates stayed in Missouri for their residencies, and just 53 percent chose a primary care specialty. "So far, we think it looks very good," Webb says.

Published by the Office of Research.

©2006 Curators of the University of Missouri. Click here to contact the editor.