@medschool0001, I understand your point of view regarding their mission, and receiving public state funding. This isn’t just a problem at NEOMED, but at ALL public institutions whose mission might be in primary care (not all of them have this mission, just because they are public). Private institutions as you know can do whatever they want, and can have missions that aren’t primary care oriented, i.e. in the same state, Case Western. Again, I don’t believe NEOMED is PURPOSEFULLY only recruiting students from Cincinnati and Columbus at the expense of rural areas. We’ve always had less total applicants in certain segments apply to med school – underserved urban areas and in rural areas. I think cost has a lot to do with it these days, esp. with alternative healthcare fields available. Many people don’t want to go 6 figures in debt, and in such a ridiculously long training path, and I don’t blame them.
That being said, rural areas (just like cities) need BOTH type of physicians – primary care and specialists/subspecialists. Right now, rural areas are deficient in both, so even receiving a subspecialist is a win in terms of providers, because a subspecialists can also do primary care, if they want to. There are even programs in which people can do rural healthcare to pay off their loans, and as you can imagine, those doctors do their x # of years to pay off their loans, or at least get them under manageable condition and then move right back to the city, so it ends up being more of a rotational basis in terms of providers, which I don’t know if that’s really any better for rural areas. While there is a higher likelihood of those from rural areas going back to their communities to practice like you might think, I’ve also just as often seen the opposite, where those who were from rural areas their entire lives, never go back there again once they finish residency, and wish to live in major cities in which there are a lot more things to do compared to where they came from. A lot of things change in people’s lives when they get married, have children, etc. especially in medicine in which there is such a delayed gratification factor in terms of life milestones. Medical students also tend to train in academic medical centers for residency which tends to have a lot of specialists within reach, which tend to almost always be in major cities. It’s also where research to come up with new therapies and treatments come from. There was a study done that showed that residency graduates tended to always stay within x number of miles of the city they did their residency at (I don’t know the exact number), since unlike PAs and NPs, MDs have no choice but to complete a residency, so they may not only live in a non-rural area, but also a completely different state, depending on where on their list they match for residency, which is out of their control, as it is run under a computer algorithm. But I think a lot of things contribute to the discrepancy, that are way outside the bounds and reach of the med school to be able to control – student preferences based on exposure, the residency application system, student’s life milestones, etc. Surely you don’t think a med school is responsible if someone 20 years after graduating from their med school (so now 46 years old), decides to live in the city with their family, do you? Right now, we live in a country, in which the federal government doesn’t distribute doctors to specific areas, like they do in Canada, which has a single payer, federal govt. run system. Unless we go to that type of system, it’s very difficult to control where doctors decide to live since doctors, because like all other working professionals, they still have free will.
And yes, I am well aware of rural pipeline track programs, as a few med schools have had these type of programs for decades, but like mentioned above, it still doesn’t take into account free will, and that we just don’t have that many total rural applicants willing to apply to and go thru the physican track of going to med school, residency, etc… Even for programs that pay your tuition for working in a rural/underserved area, that will still be only for a very limited time, and once that time is up, that person will pick themselves up, and move to where they really want to move.