A new initiative by the University of Oklahoma Health Sciences aims to recruit and graduate medical students from underserved Oklahoma communities to reduce health disparities across the state.
OU will receive $16 million over four years from the Health Resources and Services Administration of the U.S. Department of Health and Human Services to recruit medical students from tribal, rural and medically underserved communities with the goal that those students will return to practice medicine in their home communities.
The Tribal, Rural and Medically Underserved Communities in Oklahoma Pathways Program, or TRU-OK, is jointly administered between the University of Oklahoma College of Medicine on the OU Health Sciences campus in Oklahoma City and the OU-TU School of Community Medicine in Tulsa.
The grant will help fill the critical workforce shortage in primary care medical services in the state, where doctors are retiring faster than medical schools can replace them, said Mary Gowin, an associate professor in family and preventive medicine at OU College of Medicine and co-investigator for the project.
“We have got to get more people interested (in primary care practice) to address the leaky pipeline,” Gowin said. “What we’re looking to do is follow what the evidence shows us.”
When medical school graduates return to their hometown, they come back with an immediate level of respect and trust, she said. “And they understand the community and how people live their lives. They will be likely to be much more successful in their practice and to stay there.”
They also see better outcomes for patients, said Frances K. Wen, co-investigator, professor and director of research for family and community medicine at OU-TU School of Community Medicine in Tulsa.
“There is this extra depth of understanding and an approach to health care that enhances that doctor-patient relationship,” Wen said.
About 95% of the state was designated a Primary Care Health Professional Shortage Area in 2022, according to the Oklahoma State Department of Health.
In addition to rural and tribal communities, some urban areas are medically underserved because all the health care is concentrated around a few hospitals or health systems, Wen said.
Lack of access to quality primary care is reflected in Oklahoma health rankings. The United Health Foundation’s 2022 Oklahoma annual report shows the state ranks 45th in overall health including access to clinical care (49th), use of preventive services (49th), quality of care (48th), having a dedicated health care provider (42nd) and preventable hospitalizations (42nd).
A broad partner network is key to the TRU-OK project.
The team is working with several academic, tribal and hospital partners to expand opportunities for students to gain experience in primary care, social determinants of health, vulnerable populations and trauma-informed care, as well as opportunities to do rotations and clerkships and electives in underserved areas across Oklahoma.
Clinical rotations in smaller communities also are beneficial for medical students from urban areas who get to experience a different lifestyle and may discover they want to practice primary care in a rural setting, Gowin said.
Evidence shows that students interested in primary care who get their training in the state tend to stay here, Wen said.
“That’s another reason our partnerships are so important,” Gowin said. “We have already been closely partnering with the Muscogee (Creek) Nation, Chickasaw Nation Medical Center, Hillcrest HealthCare Systems and Jackson County Memorial Hospital, and we plan to continue and expand those relationships.”
New partners coming on are Integris Health, SSM Health, Variety Care, Southwestern Oklahoma State University and Langston University.
Another key is addressing barriers students face to entering medical school. The initiative will create an online pre-medical program to give students a broad range of tools and resources to support their application to medical school, such as study materials and interview preparation resources.
“Some of the students who come from tribal, rural and underserved communities are first-generation college students. It’s that much harder looking at going into a medical profession,” Wen said. Providing medical students as mentor is one way the program will support those students.
The project also offers support through scholarships and stipends for participation in primary care research experiences and travel to primary care conferences.
“We don’t want to just create access to primary care,” Gowin said. “We want to create access to high-quality primary care.”
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