Where Are Future Doctors Who Southern Rural African Americans Will Trust? A Look Back into Rural Medical Scholars Data.

Abstract

Objectives: African Americans' distrust of institutions extends to southern US rural communities, limiting their use of healthcare resources. Local physicians are scarce, and treatable diseases accumulate. These communities want local doctors they can trust, consistent with research promoting culturally concordant doctor-patient relationships. African American student inclusion was a priority of the Rural Health Leaders Pipeline, which included precollege pipeline programs and a professional track (Rural Medical Scholars Program) of a master's degree program and medical education. The purpose of the present study was to review African American students' experience in the professional track to inform future efforts to produce rural African American physicians.

Methods: We retrospectively tracked African Americans in the Rural Medical Scholars Program from 1996 to 2017. Data from pipeline and professional programs supplied racial identity, recruitment mechanism (from pipeline or general admissions), completion of a master's degree program, medical school matriculation, medical school attended, and medical school progression. We counted students for visual analysis with a table for students' distribution and graph for student progression.

Results: In 21 years, 1045 students participated in the Rural Health Leaders Pipeline-380 (36%) were African American, including 195 high school, 169 posthigh school, and 16 professional track students. Ten (63%) of these African American Rural Medical Scholars had been earlier pipeline students compared with 15% of non-African American peers. All 16 African American Rural Medical Scholars completed the master's program, 12 entered medical school, and 10 progressed successfully, producing one rural African American physician every 2 years. These numbers were too small for statistical analysis.

Conclusions: Enthusiasm among preprofessional students and academic success through the master's degree program but so few accessing medical education was the major finding, matching Association of American Medical Colleges' data showing fewer than 0.01% of US medical students are rural African Americans. Interventions beyond recruitment are needed to involve African American students in rural medicine programs to produce culturally concordant physicians whom their communities can trust.