The University of Florida College of Medicine determined years ago that to better meet the demands of rapidly advancing technologies and the changing health care landscape, it must transform how and where UF medical students learn. While the college embarked on a curriculum revision process two years ago that calls for increased small-group and active learning, optimal use of simulation and standardized patients and state-of-the-art technology, it also bolstered its plan to build a new medical education facility to accommodate the new curriculum.“An elite medical education program deserves elite facilities,” said Michael L. Good, MD, dean of the College of Medicine, who over the last year has heightened efforts to raise private support for the new building.
Joining Good in the initiative is Steven M. Scott, MD, who serves on the UF Board of Trustees. Scott is forming a coalition of long-standing College of Medicine supporters to make up a Leadership Council to assist in raising the funds necessary to complete the project.
“We can be a very good medical school with state funds, but private funds are what will allow us to be a great medical school and to achieve excellence,” the dean said.
How We Learn Defines How We Care is a series of stories that will highlight revisions to the medical school curriculum and outline the transformation of the learning environment for medical and physician assistant students.
The first installment describes a new study track aimed at addressing the need for more primary care physicians in Florida’s underserved rural and urban communities—an example of the college’s renewed commitment to addressing health disparities. It also tells the story of a College of Medicine graduate who has been serving one of these communities for the past 40 years.
New Rural and Urban Underserved Medicine
A new UF College of Medicine education track aims to target the Sunshine State’s medically underserved areas and attract more primary care physicians to Florida’s rural and urban communities.
The Rural and Urban Underserved Medicine track, a new early acceptance program to the college, accepted its first four students this spring, chosen from 60 applicants. UF juniors — Vishal Goswami, Jack Stacey, Rohann Whittingham and Chelsea Wiltjer — will make up RUUM’s charter class.
RUUM recruits UF undergraduates who excel academically and have an interest in serving rural or urban underserved populations. The program secures accepted undergraduates a place in the College of Medicine once they complete their undergraduate studies.
“We’re really looking for students with a demonstrated commitment to underserved communities, not students seeking yet one more pathway to the College of Medicine,” said Laura Guyer, PhD, administrator for the RUUM program.
The numbers clearly show the need. Nearly half of Florida’s 67 counties are considered rural and about 1.2 million people live in these areas, according to 2010 USDA Economic Research Service data.
Even more Floridians — an estimated 4.2 million or more than 22 percent of the state’s population — live in Health Professional Shortage Areas, according to the Health Resources and Services Administration.
The program addresses the “misallocation of physicians in the state,” said Nancy Hardt, MD, the college’s director of health equity and service learning programs. RUUM is particularly interested in recruiting students who are from the shortage areas where they may have personally experienced access issues.
“The most likely people to practice in underserved communities, whether rural or urban, are people who come from those communities,” Guyer said.
Joseph Fantone, MD, senior associate dean for educational affairs, agrees there is a shortage of primary care physicians in underserved rural and urban areas of the state and the new RUUM track seeks to help address this need.
While about 40 percent of UF medical graduates pursue primary care specialty training in the disciplines of internal medicine, family medicine, pediatrics and obstetrics and gynecology, Fantone said, many of these graduates choose to pursue subspecialty training and practice in large health care systems.
The challenges to practicing in a rural area can involve isolation from a larger health care system and other physicians, fewer opportunities for spouses and children and potentially lower pay. However, new technologies can also provide rural doctors more resources and options than before.
“Technology will allow more real-time connections for physicians working in rural places,” Fantone said. Access to affordable care is another major issue facing the state. Twenty-one percent of Floridians, including 16 percent of the state’s children, are uninsured, according to the Kaiser Family Foundation.
Goswami, an accepted RUUM student, grew up in the Orlando area and recalled friends who lacked health insurance and whose families struggled to get care.
“It’s a social injustice that needs to be rectified,” said Goswami, who volunteers on the Mobile Outreach Clinic.
Grant Harrell, MD, a 2010 UF College of Medicine graduate who is interested in serving rural communities, applauded the new track.
“I think trying to find people interested in rural and urban underserved medicine and cultivating that interest is wonderful,” Harrell said.
The grandson of founding College of Medicine dean Dr. George Harrell, he is currently completing his residency in internal medicine and primary care at the University of Kentucky.
“There is a real warmth and genuineness to a lot of the people who live in small towns and rural areas,” Harrell said. “They don’t take their health care for granted; they value their relationship with you.”