Wisconsin Academy for Rural Medicine (WARM)

There is a geographic shortage and maldistribution of physicians affecting rural Wisconsin. While 28% of Wisconsin citizens live in rural areas, only 11% of physicians have rural practices. This compares unfavorably to national data where 20% of the population are rural residents, and 9% of physicians have rural practices. Eighty-three percent (60/72) of Wisconsin counties are designated as totally or partially underserved. Seventy-seven percent of the underserved counties are rural. This shortage of rural physicians is projected to increase. A proposal for a rural medical education program, the Wisconsin Academy for Rural Medicine (WARM), was developed and funded by the Wisconsin Partnership Fund for a Healthy Future.

WARM is dedicated to improving the supply of physicians in rural Wisconsin and improving the health of rural Wisconsin communities. This comprehensive rural medical education program will increase the size of the medical school class, beginning with five students in the fall of 2007 and increasing until reaching the goal of 25 new students per year over the next several years. The program utilizes a targeted admissions process designed to select those students most likely to develop rural medical practices.

While many WARM students are expected to choose a specialty in Family Medicine, they are able to explore opportunities in a variety of specialty areas. These students will participate in a longitudinal educational curriculum designed to prepare them for rural practice by providing extensive clinical training in rural Wisconsin settings and fulfilling the requirements of the University of Wisconsin School of Medicine and Public Health. The WARM curriculum will also integrate components of public health and students will be expected to be able to perform as a member of an interdisciplinary health care team -- an important skill for a career in rural medicine.

WARM is an evidence-based approach to solving Wisconsin's physician shortage. However, the length of the rural clinical experience, the breadth of the proposed WARM program -- from Undergraduate Medical Education (UME) to Graduate Medical Education (GME) to Continuing Medical Education (CME) -- and the fact that no other rural program nationally has embraced laying the foundation for work in multiple specialty areas, makes WARM unique and innovative. WARM will serve as the keystone for a Wisconsin Rural Pipeline for physician manpower development.

WARM has partnered with three health systems in the state:

• Marshfield Clinic
• Gundersen Lutheran-La Crosse
• Aurora Bay Care-Green Bay and their respective rural clinics

to serve as the regional and rural learning environments for WARM students in their third and fourth years of medical school. Physicians, public health professionals, and community leaders will work with these regional partners to provide additional, applicable training.

Wisconsin Rural Pipeline (adapted from recent IOM report)

The statewide network of the Department of Family Medicine campuses are excellently positioned to participate in the clinical training of WARM students during their third and fourth years of medical school. As students locate in the regional areas for their rural and tertiary experiences, there will be opportunities for the residents and faculty at our statewide campuses to interact with the WARM students.

Residency programs in Augusta, Baraboo, Eau Claire, Fox Valley and Wausau may be of particular interest to WARM students. The educational literature is replete with examples of the importance of positive role models in influencing specialty choice and practice behavior. As the rural curriculum is developed for the WARM students to complement the core third and fourth year experiences, there will be opportunities to promote combined resident and student experiences in activities such as rural EMS training or rural community health initiatives.

As WARM students graduate, it is hoped that there will be an increase demand for rural tracks and interest in statewide residencies. Certainly, the Department of Family Medicine has an important role to play in WARM's mission to increase the number of physicians in rural Wisconsin.