Amid an ongoing shortage of physicians in rural America, one health system and its academic medical partner are putting a new spin on two residency programs.
CHI Health and Creighton University School of Medicine unveiled hybrid tracks for their internal medicine and psychiatry training programs in November. The new doctors who match to the Nebraska-based programs will spend the first portion of their training in an urban setting and will finish the remainder at a rural facility.
Dr. Joann Porter, associate dean for graduate medical education at Creighton University in Omaha, said she hopes the opportunities help address the state’s rural health challenges. Data show 90 of Nebraska’s 93 counties experienced a clinician shortage in 2022, according to the Rural Health Information Hub.
“There’s a desperate need to get more providers out at these sites,” said Dr. Cary Ward, chief medical officer at CHI Health, the Midwest division of nonprofit CommonSpirit Health.
The two specialties were selected to aid patients who have to travel hours for baseline primary care or mental health services and who face health disparities associated with the lack of access, Porter said. Rural patients are more likely to die from heart disease, cancer and stroke than those living in metro areas, according to the Rural Health Information Hub.
While rural residency programs are common, the leaders say the hybrid approach is new. A final rule, which implemented terms of the Consolidated Appropriations Act of 2021, expanded funding for residency training and allowed for the creation of such hybrid options.
“This now allows us the best of both worlds,” Porter said.
The urban training will take place in Omaha, population 487,000, while the rural training will happen at a hospital in Kearney, with a population under 34,000.
Both programs have garnered interest, and physicians will be selected in March.
“We’ve got a lot more applicants than we have spots, so we’re very excited about that,” Porter said.
Four physicians will be chosen per year for the internal medicine hybrid program, spending 30% of their three-year training in an urban setting and 70% working rurally. Two residents per year will participate in the psychiatry hybrid program and spend 40% of their four-year training in an urban setting and 60% working rurally.
The leaders said they hope the resident physicians will keep working in rural communities after wrapping up training in Kearney.
CHI Health and Creighton aim to expand the hybrid programs offered by adding obstetrics, family medicine and general surgery in the next two to three years. They also hope to increase the number of residents selected for the programs and, in turn, bring more care to the state’s rural communities.
“Patients want to stay in these communities when they possibly can, and it is much better if they can have ready access to providers,” Ward said.