By Steve Spencer

It’s not news that there is a physician shortage across the country, particularly in primary care, and Alabama is no exception. The Alabama Office of Healthcare Workforce estimated that our state would need an additional 250 primary care physicians (PCP) in 2024 to fill its needs. The lack of providers is especially acute in the rural communities.

With that in mind, the UAB Heersink School of Medicine has created the Project to Recruit Rural Medical Students, a program that is based on the pipeline concept, which is directed toward students who could be good candidates to practice in a rural area.

“Medical school graduates who have grown up in a city don’t tend to consider practicing in a small town,” said David Bramm, MD, Director of Rural Medicine at the UAB Heersink School of Medicine. “So we focus on recruiting students who are from rural communities. If they already know and enjoy that kind of life, the odds that they will return there are better.”

Bramm’s department has several initiatives for these students, starting with the College of Community Health Sciences Rural Pre-Medical Internship program. This is a seven-week summer program for pre-medical undergraduate students interested in rural primary care. The program is conducted at both the Tuscaloosa Regional Campus and the Huntsville Regional Medical Campus with 12 slots available at each site, and campus housing is provided. In order to participate, students must have four semesters of college with a GPA of 3.2 or higher, and be an Alabama resident.

“We want to identify college students who might be interested and give them a sense of what a career in rural medicine is like. The summer internship program introduces them to basic skills,” Bramm said. “They’ll do clinical shadowing where they learn to take a history, use a stethoscope to listen to the heart and lungs, take a blood pressure and look for common anomalies on a basic x-ray, EKG and other medical equipment. They learn about the social determinates of disease, and work with medical students and residents.”

In the last two weeks of the program, the students get to shadow a primary care physician. “After they’ve learned some basic skills, we pair them up with a board certified physician,” Bramm said. “We look for partners who are good mentors and try to place students with a medical practice near their home. They get a real world sense of what it’s like working as a doctor in a small town.

“Here in Huntsville, we tend to see students from or interested in working in north or eastern Alabama. We also see some students who grew up in rural areas of Tennessee. At the Tuscaloosa campus, students tend to be more interested in west or south Alabama.”

The students receive a stipend of $2000 at the completion of the summer internship, which is meant to help defray the cost of food and transportation. If they do well in the summer internship, it’s a plus for getting accepted into medical school.

Students who have graduated, been accepted to the UAB Heersink School of Medicine, and want to practice in a smaller town, can choose to go through the Rural Medicine Program, which is a five-year study that starts with a year of pre-matriculation coursework at the post-baccalaureate level in the College of Sciences and Mathematics at Auburn University, followed by four years of medical school. Students do their pre-clinical courses at the UAB Heersink Medical School in Birmingham, followed clinical rotations at the Huntsville Regional Medical Campus with special courses and rotations in rural medicine.    

“Not every student makes it through medical school and back to their hometown,” Bramm said. “Some may fall in love with another specialty along the way, or marry someone who wants to live somewhere else. However, our graduation numbers are higher than 90 percent of the pipeline programs across the country that release their data. Between 52 and 56 percent of the students who start the program end up in rural Alabama. That’s one of the best rates in the country.

“Every doctor we send out to help underserved patients is a doctor we might not have had without the support of the pipeline program. It’s someone who will make a real difference in the lives and health of so many people working in a career where the need is so great.”