Recruiting Medical Residents Presents Challenge In Rural Maine

In the first an "intermittent series" of articles on training rural physicians, the Bangor Daily News features the recruitment efforts of the Bangor-based Family Practice Center of Eastern Maine Medical Center (EMMC). Through its rural residency program, EMMC looks to attract medical school graduates who will work at the Family Practice Center for three years and select to practice in rural Maine after they complete their residencies. However, recruiting graduates is difficult, as rural practice is "viewed as neither profitable or prestigious." This "cultural bias," and the medical school debt prospective doctors face, leads to a lack of interest in rural health care. Yet working in Maine's rural environment has its advantages, according to providers. Robin Pritham, EMMC's residency program director, said small hospitals send their sickest patients to EMMC, noting, "There's very little that goes past us. That makes for an interesting training environment because we're a tertiary hospital serving a rural population." The program "aims" to secure nine residents each year, and the residents must complete rotations at rural hospitals across the state. In addition to EMMC's recruitment efforts, the Maine Medical Association has created a task force to recruit doctors for "hard-to-fill positions" in country towns. With about 20 openings for family practioners in rural areas across the state, it takes about six months to more than a year to fill the openings (Moore, Bangor Daily News, 2/12).

Maine Advocates Go to Washington
With a shortage of dentists in the state, the Maine chapter of the National Rural Health Association last week lobbied the state's congressional delegation to amend a program that recruits dentists to work in rural areas. Under the National Health Service Corp Program, health professionals who work in "underserved" rural or urban areas are offered loan reimbursements and scholarships. None of the dental schools in the program, however, are in New England. With the program up for congressional reauthorization this year, association representatives met with Rep. Tom Allen (D-Maine) to bring attention to the shortage, saying the program needs to expand to encompass more dental schools. In addition, the association is lobbying for a change in the J-1 visa program, which allows non-immigrants to work as physicians in underserved areas. Wages, however, are set by a Department of Labor survey of average salaries for dentists, orthodontists and oral surgeons in the area. These salaries are often too high for small centers to afford. The association says the salary requirements should be changed for J-1 participants to keep the average salary down, perhaps by creating a separate category for dentists (Stechert, Bangor Daily News, 2/7).