- Associated Press - Saturday, May 17, 2014

MILWAUKEE (AP) - The University of Wisconsin ranks among the top 10 U.S. medical schools in producing graduates who go into family practice, an encouraging trend that could help stem an expected shortfall of doctors, especially in rural areas.

Over the past three years, one in six UW medical school graduates - or 16.5 percent - entered family practice, good for a ninth-place ranking overall, the American Academy of Family Physicians said this week. The University of North Dakota was first with 23.3 percent.

UW’s ranking suggests that efforts to expand the state’s pipeline for family-practice doctors are working, especially for those willing to practice in traditionally underserved rural areas. But it’s not always easy to convince students to do either. Last year, medical school students graduated with an average of $170,000 in debt, according to the Association of American Medical Colleges, leading many to specialize or move to higher-paying urban areas to get out of debt faster.

Federal and state programs, in conjunction with medical schools, are aiming to reverse the trend through solutions that include encouraging medical students to study family practice and giving graduates the opportunity to do their residencies - three to seven extra years after graduating - in rural areas. Statistics show that more than half of graduates who work outside of an urban setting stay rooted in the rural.

UW began receiving state funds in 2008 to create a program specifically for students who want to work in smaller, rural communities. Students spend two of their four academic years in rural areas, where they get hands-on clinical experience in a region they’re likely to end up serving.

“We have 26 students matriculating this fall,” said Byron Crouse, the director of the Wisconsin Academy for Rural Medicine. “I think it’d be good to see that number rise to 30 or 32, if we can find additional funding.”

Wisconsin’s longest-running rural family practice residency program is through St. Clare Hospital in Baraboo. The program began in 1996, well before the warnings of an impending doctor shortage started in 2004.

Doctors who had done their residencies in larger cities felt unprepared for the rigors of working in a rural area, hospital president and CEO Sandy Anderson said of the impetus behind the program.

Physicians in outlying areas need a broad range of skills so they’re prepared for various procedures, Anderson said -maybe a colonoscopy one day and a cesarean section delivery the next. That stands in contrast to doctors at larger hospitals, who have the luxury of referring patients to a colleague down the hall.

Twenty-three medical residents have gone through St. Clare’s, program director Stuart Hannah, a 2003 graduate, said. Of those, 11 remained in Wisconsin and six stayed in the immediate area.

While Hannah called the number of doctors staying in the state encouraging, he said there’s room for more progress. An increasing number of hospitals and clinics are willing to train residents, he said, as long as the federal government increases its funding assistance.

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Dinesh Ramde can be reached at dramde@ap.org.

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