|JAMA Study Shows Jefferson Medical
College Program Brings Family Physicians to Small Town America
Despite an increasing oversupply of physicians in the United States, statistics show that rural areas of the country continue to suffer from a shortage of physicians, especially family physicians. In response to this national geographic maldistribution of physicians, Jefferson Medical College initiated the Physician Shortage Area Program (PSAP) in 1974 to increase the number of family doctors in rural and underserved areas, especially in Pennsylvania.
Now 25 years old, the PSAP, which admits approximately 15 students per year, accounts for 12 percent of rural family doctors in Pennsylvania. A retrospective study demonstrating the impact of the PSAP on easing the shortage of rural physicians over the past two decades appeared in the January 20 issue of the Journal of the American Medical Association (JAMA).
According to Howard K. Rabinowitz, MD, Professor of Family Medicine at Jefferson Medical College and Director of the PSAP since 1976, the program recruits students who have grown up in a rural area and who are committed to practicing family medicine in the same or similar area.
PSAP students follow a curriculum similar to their non-PSAP classmates, but take some courses that focus on practicing family medicine in a rural community, receive training in rural or small town areas and pair with an academic advisor from Jeffersons family medicine department.
The study used current data to compare a total of 206 PSAP graduates from the classes of 1978 to 1991 currently practicing family medicine in rural and underserved areas of Pennsylvania with all allopathic (MD) medical school graduates in the state, and with all United States and international graduates. All PSAP graduates were also compared with their non-PSAP peers at Jefferson Medical College regarding their United States practice location, medical specialty, and retention for the past five to 10 years.
Study results show that PSAP graduates, who represent only 1 percent of the graduates from Pennsylvanias seven allopathic medical schools, accounted for 21 percent of family physicians practicing in rural Pennsylvania coming from those schools. Among all national and international medical school graduates, PSAP graduates represented 12 percent of all family physicians in rural Pennsylvania. Results were similar for PSAP graduates practicing in other underserved areas.
Overall, PSAP graduates were eight times more likely than their non-PSAP classmates at Jefferson to practice family medicine in a rural area of the United States Program retention was also found to be high, with the number of PSAP graduates currently practicing family medicine in rural and underserved areas of the United States equal to approximately 90 percent of the number practicing five to 10 years ago.
The biggest impact of the PSAP program has been our ability to provide doctors to rural areas that have a limited number of physicians, explains Dr. Rabinowitz. With more people living in rural Pennsylvania than in any other state in the nation, the medical needs of this population are great, and this program has let us meet JAMA continued from page one these needs to a large extent.
Dr. Rabinowitz views the PSAP as a public service program, providing family physicians to rural areas where the demand for good medical care is high and the availability is low.
Since 1978, the PSAP has also been supported by the PSAP Cooperative Program, a joint program with six undergraduate institutions in Pennsylvania Allegheny College, Bucknell University, Franklin and Marshall College, Indiana University of Pennsylvania, the Pennsylvania State University and the University of Scranton. All of these institutions assist in the recruitment and selection of PSAP applicants.