Residency

Fellowship in Rural Family Medicine and Obstetrics

With the second highest number of U.S. counties designated as Health Professions Shortage Areas (HPSAs) or Medically Underserved Areas (MUAs), Texas' need for primary care physicians in underserved areas is crucial. Texas has 226 regions designated as (MUAs) or as Medically Underserved Populations (MUPs). Nearly 90 percent of rural Texas counties are partially or completely designated as medically underserved. Twenty five counties in the state have no physician at all, and nearly twenty percent of Texans, or 3.2 million people, do not have access to a primary care provider. Rural OB care is an area of particular concern, as rural pregnant women receive late or no prenatal care in 33.8% of rural births. Among rural pregnant women, 7% of infants born weigh less than 5.5 lbs. Rural areas of the state also experience a higher rate of child abuse, elder abuse, births to women under age 18, infant mortality; and accidental death.

The shortage of primary care physicians in rural and underserved areas in Texas is a major problem. Sixty three percent of all practicing physicians in Texas are located in just ten counties, where just 54% of the state's population lives. Only 9% of Texas physicians practice in rural areas, although 20% of the population lives in these areas. Among primary care physicians, only 13 percent are rural. Of these, twenty seven percent are family physicians. More than 400 primary care physicians are needed to locate or practice in Health Professions Shortage Areas in order to eliminate the federal designation of need in Texas, and more than 900 primary care physicians are needed in these areas in order to provide adequate medical care.

To help alleviate the shortage of primary care physicians in the state's rural and underserved areas, the Texas State legislature has charged the state's health agencies, medical schools, and primary care residency programs to develop physician workforce strategies that address:

• the imbalance between primary care and specialty physicians;
• insufficient access to primary care physicians in rural and urban underserved areas;
• the need for a physician work force that more closely mirrors the cultural diversity of the population;
• a disproportionately poorer health status among minorities;
• an inadequate focus on comprehensive and coordinated delivery system for primary care and preventative health care services.

The Fellowship in Rural Family Medicine and Obstetrics is offered by the UTMB Department of Family Medicine to improve the number of family physicians choosing to practice in underserved rural areas of Texas, and to provide residency-trained family physicians with the additional knowledge and skills needed to provide high quality care in these settings.

For more information about the Fellowship in Rural Family Medicine and Obstetrics, please view the documents below.

• Qualifications, Detailed Description, Evaluation Process
• Goals, Objectives, and Requirements
• Application Procedure