Sanford School of Medicine M.D. Program

Rural Track Program FAQ

What is the Rural Track?

The University Of South Dakota Sanford School Of Medicine's rural track is called Frontier And Rural Medicine (FARM). Frontier And Rural Medicine was established by Senate Bill 197, which increased the class size of the Sanford School of Medicine for the purpose of developing a rural track program for up to six students. It is a unique opportunity for a select group of Pillar 2 students to obtain nine months of their clinical training in carefully selected rural communities. At their rural clinical sites, students will participate in the full spectrum of rural medicine as they provide supervised care and follow patients and their families over time in clinic, hospital, and extended care settings.

Why was the Rural Track (FARM) created?

There is a rural health crisis. There are not enough physicians within easy access of citizens residing in many of our rural and frontier communities. This has gained further attention due to the Affordable Care Act and the increased need for primary care physicians this major healthcare initiative will require. Meanwhile, South Dakota is aging as are South Dakota's primary care physicians. It is estimated that by 2025, 21.6% of our population will be 65 years of age and older. A 2006 study by the America Academy of Family Physicians showed that nearly 36 percent of South Dakota's family physicians were 50-64 years of age with more than 68 percent 40-64 years of age. Data from the American College of Physicians in 2007 revealed that nearly 31 percent of general internists were 50-64 years of age and 61 percent between the ages of 40 and 64. There was also interest among many of our applicants and students who had matriculated into our school, particularly those considering a career in rural practice, for an opportunity to train in a rural environment. Through the FARM program students will gain an understanding of the benefits of a rural lifestyle, learn the rewards and challenges of practicing in a rural community, and develop a level of comfort in practicing in a rural healthcare setting.

Do any other institutions have a Rural Track (FARM) program?

There are several programs. The longest running of which is the University of Minnesota's Rural Physician Associate Program (RPAP) established by the Minnesota State Legislature in 1970. Over the history of the program, more than 70% of RPAP graduates are in primary care (>60% family medicine). Two-thirds of graduates practice in Minnesota and two-thirds practicing in Minnesota are in rural communities. Two nearby universities with newer rural track programs include: the University of North Dakota, which established the Rural Opportunities in Medicine (ROME) program, and the University of Wisconsin School of Medicine and Public Health, which established the Wisconsin Academy of Rural Medicine (WARM) program. Our FARM program is being modeled primarily on the Minnesota program.

What will students in the Rural Track (FARM) do?

Students will train in a rural community for nine months of Pillar 2. They will participate in the full spectrum of rural medicine as they provide supervised care and follow patients and their families over time in clinic, hospital, and extended care settings. Students will have opportunities for increased hands-on educational experiences, gain an appreciation of the benefits of continuity in patient care, and develop strong bonds with instructors who mentor students on the professional and personal aspects of being a physician. Learning will be enhanced by specialty clinics on-site, academic faculty visits, on-line cases, telemedicine and videoconferences. Students will learn the rewards and challenges of rural practice while living, learning and becoming engaged in their communities. Students will complete a community project assisted by the South Dakota Area Health Education Center.

Which rural communities are involved?

The initial sites for the FARM Program were selected through a competitive process. The SSOM has many excellent rural training sites due to the long standing rural family medicine preceptorships and clerkships for many years. This allowed us to select the sites best suited for the FARM program. A Request For Proposals was developed and broadly distributed to active teaching sites. Among eligibility requirements, communities need to have populations of fewer than 10,000 people. Following a review of applications and detailed supporting materials of the medical practices and communities, on site visits by the FARM program leadership group, and further deliberations, five communities were selected as our inaugural FARM teaching sites. They are: Milbank, Mobridge, Parkston, Platte, and Winner.

How are students selected for the FARM Program?

In the fall of the first academic year, FARM program leaders and community representatives give a presentation to first-year students explaining the Program. An application process follows for interested students. Applicants are interviewed by members of the FARM Program Selection Committee and notified of the committee's decisions. Students are subsequently matched with communities on the basis of student preferences, with the goal to honor their first or second choices.

Do you expect that students in the Rural Track (FARM) will be able to get a comprehensive clinical experience?

From ongoing review of data we are required to track, we know that students on our rural 2nd Year Preceptorship and 4th Year Family Medicine Clerkship see a broad spectrum of patients. We also know from national studies, that students trained in rural track programs like FARM, perform at the same level as traditionally trained students on standardized and clinical skills testing. The leadership group for the FARM Program has and will continue to devote a great deal of effort in support of the students and our faculty at FARM training sites. Regular visits by, not only the leadership group, but faculty from the various clinical departments and representatives of the Office of Medical Education will help assure our students are getting the experience they need. It should also be understood that students will have another 19 months of medical education following the FARM program, and as with all students, any areas of identified or perceived weakness can be addressed during their final year of medical school on one of our main campuses. The FARM Program has the full support of the Dean's Office and the SSOM faculty. It has gained a lot of attention and enjoys the support of the Board of Regents, the SD State Legislature, and the Governor's Office.

When do you plan to put the first students in the rural communities?

The first students were selected in January of 2013. They will be on-site in their FARM training sites beginning July 2014.

Are there scholarships for FARM program students?

Students participating in the FARM Program are not provided scholarships based on the program, but are eligible for the SSOM Scholarship available to any students.

What about housing for the FARM students?

Student housing will be provided in the community as part of the rural experience.