Recommendation 4. Schools of medicine, dentistry, nursing, allied health, and public health and programs in mental and behavioral health should:

  • Work collaboratively to establish outreach programs to rural areas to attract qualified applicants.

  • Locate a meaningful portion of the educational experience in rural communities. Universities and 4-year colleges should expand distance learning programs and/or pursue formal arrangements with community and other colleges, including tribal and traditionally African American colleges, located in rural areas to extend the array of rural-based education options while encouraging students to pursue higher levels of education.

  • Make greater effort to recruit faculty with experience in rural practice, and develop rural-relevant curricula addressing areas that are key to improving health and health care, including the five core competencies (i.e., providing patient-centered care, working in interdisciplinary teams, employing evidence-based practice, applying quality improvement, and utilizing informatics), the fundamentals of population health, and leadership skills.

  • Develop rural training tracks and fellowships that (1) provide students with rotations in rural provider sites; (2) emphasize primary care practice; and (3) provide cross-training in key areas of shortage in rural communities, such as emergency and trauma care, mental health, and obstetrics.

Furthermore, the federal government should provide financial incentives for residency training programs to provide rural tracks by linking some portion of the graduate medical education payments under Medicare to achievement of this goal.

The residents of rural communities also have a key role to play in improving population health. Residents can contribute to improving their own health and that of others by pursuing healthy behaviors and complying with treatment regimens, assuming appropriate caregiving roles for family members and neighbors, and volunteering for community health improvement efforts. As is the case with many urban populations, many rural populations have low levels of health literacy (the degree to which individuals have the capacity to obtain, process, and understand basic health information) that currently hamper efforts to engage residents in health-related activities. The Department of Education and state education agencies should work in partnership with local nonprofit literacy associations and libraries to measure



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