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First Rural Medical Residency Opens on U.S./Mexico Border

Dr. Adrian Billings, chief medical officer of Presidio County Health Services, speaks to attendees of a community health clinic in Marathon, Texas. Photo courtesy of the Denton Record-Chronicle. (2012)

There’s a crisis in the nation’s healthcare. The lack of family doctors, an issue throughout the U.S., is a problem felt most acutely in rural regions, which lacks doctors of all specialities. But a possible solution to make up this deficit has made its way to the U.S/Mexico border, opening here in Texas.

Rural Medical Residencies, where medical students are placed in rural settings for at least two years of their medical training, is a model currently used in a handful of places around the country. The idea is to train doctors in the places they are needed most.

Dr. Adrian Billings, chief medial officer of Presidio County Health Services, worked with Texas Tech Health Sciences Center Permian Basin to open the rural training track residency, which started July 1. It is the first rural training program on the U.S.-Mexico border.

"Most of the time the residents love our patients, they love the area. If you can just get them out here you have a great chance of recruiting them back," he says.

Billings is correct. Studies indeed do show that doctors will set up practice within 100 miles of where they do their residency. And research shows a student who is exposed to a rural setting when in training is more likely to go back.

Fourth-year medical student Casey Sharpe of UT Medical Branch Galveston is a perfect example. He planned a career for the urban ER but changed his mind after rural rotations with Dr. Billings in Alpine and Marfa.

"In comparison to city...the interactions were more authentic, expectations of me were different and more realistic," Sharpe says. "It's important to me to feel appreciated. And I just sensed that appreciation so much more deeply out there," Sharpe said.

Doctors in these rural programs qualify for state and federal loan forgiveness programs.

The town of Presidio, for example, is one of the most underserved areas in the country, with a population of 7000 and no full-time physician. But the more rural, the more difficult these programs are to fund continuously over time.

This is a part of the concern for Mike Ellis, CEO of Big Bend Regional Medical Center in Alpine. He is currently in talks with Texas Tech Permian Basin to open a second rural training track for the region in July 2015, if he can make it work with his hospital's bottom line.

"There are vast differences in what you consider rural. We are considered frontier. Seriously!" Sharpe says, "We are considered a frontier hospital and no legislation looks at frontier because there are so few of us."

Dr. Randall Longenecker, an assistant dean at Ohio University Heritage College of Osteopathic Medicine, knows this first hand. He opened a rural training track in 1998 and saw it close in 2011.

"The funding for these programs traditionally goes through large teaching hospitals....and when you have 2 residents going to a rural site and there are 600 at the mothership, you can imagine what takes priority," he said.

Meanwhile, studies show students who chose rural residencies stay rural, for life. Residents like Casey, the young physician.

"I am committing myself to a certain kind of life with this decision but I think I have made up my mind," he says, "I am ready to leave the city behind and just get into that zone."

Which means residents of underserved areas have just a little more hope for their healthcare future.

Reported by Paige Phelps