Purpose There is a shortage of primary care and rural physicians in the United States. In 1974, Michigan State University College of Human Medicine (MSU-CHM) created the Rural Physician Program (RPP) to address these issues and increase primary care physicians in Michigan’s Upper Peninsula (UP). The authors describe the program and analyze 30 years of outcomes. Method Using American Medical Association Masterfile data, authors performed cross-sectional analysis of all MSU-CHM graduates from 1978 to 2006. Logistic regression was used to compare specialty choice and practice location for RPP graduates and all other MSU-CHM graduates. RPP graduate outcomes were compared over time. Results In 2011, RPP graduates were more likely to practice primary care (RPP 88/168 [48%]; MSU-CHM 1,143/2,610 [44%]; P = .04), practice a rural high-need specialty (RPP 122/168 [73%]; MSU-CHM 1,612/2,610 [62%]; P = .006), practice in Michigan (RPP 89/168 [53%]; MSU-CHM 1,119/2,610 [43%]; P = .01), practice in the UP region (RPP 44/168 [26%]; MSU-CHM 28/2,610 [1%]; P < .001), practice in a Health Professional Shortage Area (RPP 106/168 [63%]; MSU-CHM 1,279/2,610 [49%]; P < .001), and practice in a rural area (RPP 76/168 [45%]; MSU-CHM 361/2,610 [14%]; P < .001). Percentages of graduates meeting program goals and from the UP region have increased as the program has matured. Conclusions Program characteristics, including targeting rurally interested students, primary care focus, and substantial clinical training within a rural region, can successfully foster rural physician careers. The greatest benefit is to the rural region where the program is based.

(1) Background: There is increasing scholarly support for the notion that properly implemented and used, technology can be of substantial benefit for older adults. Use of technology has been associated with improved self-rating of health and fewer chronic conditions. Use of technology such as handheld devices by older adults has the potential to improve engagement and promote cognitive and physical health. However, although, literature suggests some willingness by older adults to use technology, simultaneously there are reports of a more cautious attitude to its adoption. Our objective was to determine the opinions towards information technologies, with special reference to brain health, in healthy older adults either fully retired or still working in some capacity including older adult workers and retired adults living in an independent elderly living community. We were especially interested in further our understanding of factors that may play a role in technology adoption and its relevance to addressing health related issues in this population; (2) Methods: Two focus groups were conducted in an inner-city community. Participants were older adults with an interest in their general health and prevention of cognitive decline. They were asked to discuss their perceptions of and preferences for the use of technology. Transcripts were coded for thematic analysis; (3) Results: Seven common themes emerged from the focus group interviews: physical health, cognitive health, social engagement, organizing information, desire to learn new technology, advancing technology, and privacy/security; and (4) Conclusions: This study suggests that in order to promote the use of technology in older adults, one needs to consider wider contextual issues, not only device design per se, but the older adult’s rationale for using technology and their socio-ecological context.

BACKGROUND AND OBJECTIVES: Adequate parental leave policies promote a supportive workplace environment. This study describes how US family medicine (FM) residency program parental leave policies compare to reported leave taken by residents and faculty. METHODS: This is a descriptive study of questions from a 2017 Council of Academic Medicine Educational Research Alliance (CERA) survey of accredited US FM program directors. RESULTS: The overall survey response rate was 54.6% (261/478). Paid maternity leave policies varied widely (0 to >12 weeks; mean=5.3 weeks for faculty and 4.5 weeks for residents); paid paternity leave ranged from 0 to 12 weeks (mean=2.7 weeks for faculty and 2.4 weeks for residents). Some FM programs reported offering residents (29.1%) and faculty (28.5%) no paid maternity leave; 37.2% offered residents and 40.4% offered faculty no paid paternity leave. Both female and male faculty took significantly less paid leave than was offered (maternity leave: faculty 0.6 weeks less, P<.01; residents 0.5 weeks less, P<.01; paternity leave: faculty 1.6 weeks less, P<.01; residents 0.6 weeks less, P<.01). The amount of paid and total maternity and paternity leave surrendered by residents was strongly correlated with the amount surrendered by faculty in the same program (correlation coefficients 0.46-0.87, P<.01). Residents in smaller programs, and programs with a rural focus, surrendered more parental leave. CONCLUSIONS: Programs vary widely in their parental leave offerings, and FM residents and faculty frequently take less parental leave than offered. As the amount of leave taken by residents and faculty at the same institution is correlated. institutional culture may contribute to parental leave use.

RRH: Rural and Remote Health. Published article number: 4355 - Women in rural family medicine: a qualitative exploration of practice attributes that promote physician satisfaction

Introduction: Despite rural origin being a strong predictor of rural practice for health care professionals, rural students face educational barriers and are underrepresented in medical schools. The aim of this study was to identify rural high school students’ perceived barriers to college and health-related careers and compare whether perceptions were similar based on gender, socioeconomic status (SES), and parental education. Methods: We performed a cross-sectional survey of all high school students from one rural Michigan community. The survey included 13 multiple-choice and 5 short-answer questions. We compared results using χ2 analysis and logistic regression. Free-text answers were grouped thematically and analyzed for patterns. Results: Survey response rate was 97.1% (506/521); 45.3% (229/506) of students were contemplating health care careers. Rural females were more likely to plan on college (females 83.9%, males 75.6%, P=0.03) and to contemplate a health care career (females 64.1%, males 25.2%, P<0.01). Students of lower SES and those who would be first-generation college students were less likely to plan on college (SES: low 76.8%, high 84.7%, P=.04; parental college: yes 84.4%, no 72.0%, P<0.01), although they were equally likely as other students to consider a health care career. Gender and parental education were significant independent predictors of plans for college; female gender was the only significant predictor for health care interest. The most frequently reported barrier to post-high school education was financial, and for health care training, it was academic success. Conclusions: Rural students are interested in health-related careers. Addressing perceived academic and financial barriers for students from high-need rural communities may inform targeted interventions to increase the rural health care workforce.