Further work is needed in identifying strategies to improve rural health services that are most appropriate and cost effective in regions with differing circumstances and needs. Substantial reform of payment systems favoring rural and primary care is essential to the effectiveness of educational reform. (Author/MSE)

Recent research on the physician workforce in the United States suggests that the projected supply of generalist physicians will be adequate. However, the Association of American Medical Colleges (AAMC) recommendation for training of more generalists is still valid, because more physicians will be needed to maintain an adequate generalist…

Medical education's current goal of producing 50% generalists, composed of practitioners in internal medicine, family practice, and pediatrics, is examined. Issues include the definition of generalist, the number of generalists needed, changes needed in graduate and undergraduate medical education, changes needed in the practice environment, and…

Issues related to the production of more generalists in medicine are discussed, including economic, practice-related, and scientific forces favoring practice of specialty medicine; the influence of the medical school experience on career choice; strategies for correcting the balance inside and outside academic medicine; and resulting alternative…

The design, curricula, and financing of four existing medical schools' rural training track programs (University of Washington, University of Nebraska, State University of New York/Buffalo, University of Kentucky) are described. The programs are seen as having potential to decrease the shortage of physicians choosing careers in rural areas.…

This study interviewed 263 persons to examine the organization, functions, activities, and effects of the national Area Health Education Center (AHEC) program. The findings describe a national network of school and community partnerships engaged in planning and implementing educational activities responsive to changing health care needs.…