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Nebraska’s Rural Health Opportunities Program: 20 Years of Educating Health Professionals
for Rural Communities
Ann Kraft, Program CoordinatorUniversity of Nebraska Medical CenterRural Health Education NetworkNebraska AHEC Program Office
NAO ConferenceJune 24, 2010
UNMC Develops the Rural Health Education Network (RHEN)
• Form partnerships among rural communities
• Develop a network of volunteer faculty
• Change how and where health science students are educated
• Develop programs to encourage students from rural communities to consider health care careers
Established in the early 1990’s to address the shortage of health professionals in rural Nebraska
R H E N
Student/ResidentEducationAnd Rotation in Community Health
StudentAssociation forRuralHealth
Student Rotations
RuralHealthOpportunitiesProgram
ScienceEducationPartnershipAward
AreaHealthEducationCenter
Regional and State Science Meets for8th graders
Career Days
Science Teacher Connections
Science Teacher Retreat
Weeklong Workshops for College Students• Cultural Competency• Geriatric Careers• AgroMedicine• Behavioral Health Careers
Rural Health Opportunities Program (RHOP)
• “Grow Our Own” • To recruit rural Nebraska students
into the health professions
• Support programs to recruit them back to rural Nebraska communities
• RHOP spans 9 health professions
Rural Health Opportunities Program (RHOP)
• 1989 - Discussions between UNMC’s College of Medicine and Chadron State representatives. Wayne State joins a year later.
Chadron State College
University of Nebraska Medical Center
Wayne State College
Three Nebraska State Colleges
Chadron
Omaha
▼
▼
▼
Wayne
Peru
Rural Health Opportunities Program (RHOP)
Students who are accepted into RHOP are pre-admitted to UNMC’s academic programs when they begin their undergraduate education
Medicine
Pharmacy
Dentistry
Dental Hygiene
Clinical Laboratory Science
Physician Assistant
Physical Therapy
Radiography
* Nursing (at Chadron only)
Negotiations are underway to add nursing at Wayne State*
Rural Health Opportunities Program (RHOP)
Which programs? How long? How many positions?
Length of Education # of Positions
Program Degree College UNMC CSC WSC
Medicine MD 4 years 4 years 5 5
Pharmacy PharmD 3 years 4 years 3 3
Dentistry DDS 4 years 4 years 3 3
Dental Hygiene BSDH 2 years 2 years 1 2
Clinical Laboratory Science
BSCLS 3 years 1 year 4 3
Rural Health Opportunities Program (RHOP)
Length of Education # of Positions
Program Degree College UNMC CSC WSC
Physician Assistant MPA 4 years 28 months 4 4
Physical Therapy DPT 4 years 3 years 3 2
Radiography BSRST 3 years 1 year 2 1
Nursing BSN 1 ½ years 2 ½ years 6 n/a
Which programs? How long? How many positions?
How do students apply?
• Apply on-line to RHOP at the same time they apply for admission to WSC or CSC
• May apply ONLY to one program and ONLY to one college
• Applications due December 1
Criteria used for selection
• From a rural Nebraska community • Well rounded student
• ACT/SAT scores
• Grade point averages (especially science)
• Essay– Interest in rural; connecting to rural
• Experience/Knowledge of health care– Shadowing– Volunteer work
How many are interviewed?
• About 2-3 times the number of positions available
• Who interviews
• Students notified before March 1
• Alternate status – must enroll at selected undergrad institution
• Alternates have a high acceptance rate to UNMC because of the RHOP experiences
What’s the commitment?
A “commitment of the heart” to return to rural Nebraska
•Applicants are too young to sign a contract
•We want the graduates to set up practice in a small community and make it their home.
•Not leave once the “commitment” is completed
Early Financial Incentives
1993• RHOP Loan Program
• $400,000 from legislature
• All RHOP students eligible
Early Financial Incentives
1998 RHOP Loan Program Discontinued
• High penalties for default
• Faculty discouraged use
• Funds returned to State of Nebraska’s loan / loan forgiveness programs for those who practice in underserved areas
Financial Incentives • Tuition waiver for all programs at the
undergraduate level
• Eligible for waiver through the State College Board of Trustees
• Many RHOP students qualify for Rural Health Advisory Commission Loan or Loan Forgiveness
• Strict definitions of underserved to qualify for loan repayment regulations
RHOP Odds –n- Ends
• RHOP Bachelor of Science in Nursing program offered at UNMC’s College of Nursing, West Nebraska Division (500 miles from Omaha)
• “Rural Issues” is a distance education course from UNMC to the undergraduate students
• Annual visit to UNMC
RHOP Pipeline
Med Pharm DentalDent al Hygiene Nurse
Phys Asst
Phys Thpy
Clinic Lab Science Rad Total
CSC 15 7 9 3 6 7 12 2 4 68
WSC 19 7 10 4 --- --- --- 3 --- 43
UNMC 33 18 16 3 6 5 11 2 2 96
Grads 81 56 42 25 7 51 44 36 14 356
TOTAL 151 88 77 35 19 63 67 43 20 563
RHOP Graduates by Year GraduatedPracticing in Rural Nebraska
PRACTICINGRHOP
Graduates TotalRural Nebr
UrbanNebr
RuralOut of State
UrbanOut of State
% GradRural Nebr
% Grad Rural
(NE and OS)
% GradsStaying in Nebraska
Medicine 67 36 14 5 12 54% 61% 75%
Dentistry 41 23 4 5 9 56% 68% 66%Dental
Hygiene 25 10 6 3 6 40% 52% 64%
Pharmacy 53 22 17 -0- 14 42% 42% 74%
Nursing 7 5 2 -0- -0- 71% 71% 100%Physician Assistant 49 34 4 5 6 69% 80% 78%
Clinical Lab Science 29 16 2 4 7 55% 69% 62%
Physical Therapy 41 21 9 7 4 51% 68% 73%
Radiography 11 3 5 -0- 3 27% 27% 73%
323 170 63 29 61
Percentage Totals 53% 20% 9% 19% 53% 62% 73%
Fall 2009
2009 RHOP Hometowns563 RHOP students and graduates from 227 hometowns
2009 RHOP Hometowns563 RHOP students and graduates from 227 hometowns
• 384 are from 201 towns with populations of < 5,000
• 108 are from 16 towns with populations 5,000–10,000
• 71 are from 10 towns with populations > 10,000
RHOP Practice Sites
RHOP Practice Sites
323 practicing graduates who have completed residency170 working in rural Nebraska 63 working in urban Nebraska233 providers in 60 Nebraska communities (73%)
What we learned along the way
• Market, market, market
• Clarify requirements i.e. Ralston, NE
• Communicate expectations
• Define the advantages – early admission
What we learned along the way
RHOP Acceptance Decision
• seniors in high school vs. end of freshman year in college
Benefits to State Colleges
• Increased applications
• Increased tuition to fund science curriculum
• Stronger faculty
RHOP Success
• Number of graduates who have completed residency: 323
• 53% in rural Nebraska• 9% in rural across the U.S.
62% currently rural!
Since RHOP began, 71% of all graduates have practiced in a rural community at some point.
RHOP Success
Drs. Kate & Jason Hesser
2006 College of Medicine RHOP graduates
3 year family practice residencies through UNMC’s Rural Training Track Program in Grand Island
Joined the medical staff at Crete Medical Center (July 2009 )
RHOP RESULTS
Niki and Aaron Salomon, live in GothenburgShe’s a pharmacist in CozadHe’s a physician assistant in North Platte
RHOP Success
Kyle Klammer (left)2004 State Science Meet(8th grade)
2008 freshman Chadron State College(freshman)
2007 Alumni Science Meet(junior in high school)
