A sense of community

RPAP students broaden their focus to tackle community health problems in Greater Minnesota

Over the years, the University of Minnesota's Rural Physician Associate Program (RPAP) has received accolades from numerous sources, including the Carnegie Foundation and the New England Journal of Medicine. And this year, the popular program has more participants than ever before. But like every good leader, RPAP director Gwen Halaas, M.D., raised the bar, demanding a bit more of the program and its students, knowing that both would benefit in the long run.

The state legislature launched RPAP in 1971 as a way to address the dire shortage of primary-care physicians in rural Minnesota. The idea was innovative yet simple: Third-year medical students would spend 36 weeks living, learning, and caring for patients in a rural Minnesota community. They'd work closely with rural physicians in a range of health-care settings, and if the program worked as planned (which it has), their experience would encourage them to return to a rural setting when they began their careers.

Among the oldest and largest programs of its kind, RPAP has now graduated 1,127 physicians—some 60 percent practice in rural communities, and about 80 percent provide primary care. RPAP has served as a model for programs in other states, including New York, Florida, and Alaska—and medical schools as far away as Australia have studied it. This year, 47 students are participating in RPAP communities—the largest group in the program's history.

Looking for a way to involve students more broadly in their host communities, Halaas revamped the program's community health component after becoming RPAP director in 2004. The new community health assessment projects she initiated in 2005 require students to examine a health-care issue confronting their host community and to collaborate with local experts to seek solutions. Students may choose to investigate smoking cessation, teen pregnancy, depression in the elderly, obesity — any health-care issue of concern to the community.

"These projects are an opportunity for us to return something of value to the community for hosting and teaching our students," says Halaas, who this spring became director of the Academic Health Center's new Center for Interprofessional Education. "I really wanted students to go further than just the clinic or hospital they were working with—to learn from others in the community."

The following three community health assessment projects completed by RPAP students last year demonstrate what Halaas envisioned: students gaining a deeper understanding of community health; physicians and other health-care providers obtaining valuable information from the students' research; and, ultimately, patients receiving better care.

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