An evaluation of osteopathic school programs designed to promote rural location by graduates

Background: Many osteopathic medical schools across the United States seek to produce physicians who will ultimately locate in rural areas. Most of these schools offer courses and programs designed to promote rural location. Objective: To explore how mandatory and optional programs offered by Oklahoma State University (OSU) College of Osteopathic Medicine (and student perception of them) impacted the location decisions of students graduating from the osteopathic program between 1997 and 2002. Methods: Data on student hometowns, medical school schedules and course evaluations, and current practice location were obtained for 190 OSU osteopathic graduates. Logistic regression was used to find factors that were significant in predicting the location decision. Results: Of the 190 students in the dataset who are now practicing physicians, approximately 30% chose to practice in a rural location. The regression results suggest that an optional summer program during a student's first year in which they spend 4 weeks in a rural primary care setting increases their probability of locating in a rural area by roughly 24%. There is also some evidence that a more positive overall experience in the first one-month rotation in a rural community hospital improves the likelihood of rural location. Conclusions: The findings show that programs implemented by an osteopathic school can influence where graduates choose to practice. In particular, programs taking place in both the 1st and 4th year of training have an impact on rural practice location, implying that students can be influenced both early and late in their medical school careers.