By Allison Perry
University of Kentucky
The University of Kentucky College of Medicine has received a four-year, nearly $16 million grant from the Health Resources and Service Administration (HRSA). UK will receive $3.97 million a year over the next four years to support efforts to increase the number and diversity of primary care physicians in Kentucky, with the ultimate goal of improving health care access in underserved areas of the state.
The physician shortage is not unique to Kentucky, nor is it limited to primary care — a 2021 report from the Association of American Medical Colleges (AAMC) estimated that nationwide demand for all physicians will exceed the existing supply by 37,800 up to 124,000 by the year 2034. In Kentucky, 61% of the greatest physician needs are in rural areas. In rural and underserved areas, primary care physicians are often the residents’ only exposure to any health care professional, highlighting the urgent need to increase and improve access to these physicians.
Students working on the UK College of Medicine-Northern Kentucky Campus, a partnership between UK, Northern Kentucky University and St. Elizabeth Healthcare. (Photo by Gary Landers, UK)
Charles “Chipper” Griffith III, M.D., is the dean for the UK College of Medicine and is board-certified in internal medicine and pediatrics.
“As a physician who has provided primary care services for patients of all ages, I can tell you firsthand how important it is for people to have access to these providers,” Griffith said. “An established relationship with a primary care physician is a first line of defense against acute and chronic illness and injuries. We not only provide treatment for illness, but we actively work to help our patients prevent it by identifying risk factors and screening for disease. In a state that suffers from high rates for many chronic, preventable diseases, increasing access to primary care is a critical step in improving the health of our citizens.”
In recent years, the UK College of Medicine has worked diligently with academic and clinical partners throughout the state to meet this growing need for physicians by increasing class capacity through regional campuses. Now encompassing four sites — Lexington, Morehead, Bowling Green and Northern Kentucky — the UK College of Medicine graduated the largest-ever graduating class this past spring.
These partnerships were a key component in earning the HRSA multimillion-dollar funding for the new primary care initiatives. Led by a team from the UK College of Medicine and the Center for Interprofessional and Community Health Education (CICHE), the grant will both focus on expanding pathways to support students who are interested in medical school and providing scholarship opportunities for medical students who choose primary care as a career path. The goal is not just to increase the number of primary care physicians in the state, but to encourage new physicians to practice in underserved communities upon graduation.
The pathway to primary care — from middle school to medical school
UK has several programs already in place that are aligned to provide educational experiences that increase in complexity as students navigate the pre-med journey; upon completion, participants will have gained insight into the medical profession far beyond their initial understanding. With help from the new grant, these programs will place a greater focus on primary care, which includes family medicine, general internal medicine, general pediatrics, or the combination of internal medicine/pediatrics commonly known as Med/Peds.
Students with the UK College of Medicine in Lexington examining a patient in clinic. (Photo by Pete Comparoni, UK)
The pathway to a medical career begins years before students reach college. UK’s Area Health Education Center Program, part of the CICHE, is a collaborative effort between UK, the University of Louisville Health Science Centers, and eight regional centers across the state that supports, trains, recruits and retains health professionals in Kentucky.
To fully prepare students for a medical career, CICHE Director James Ballard, Ed.D., says educational opportunities need to begin early — ideally, by the eighth grade. The AHEC centers across the state provide programming and help identify young students, particularly from underserved areas, who are interested in medicine. From there, they receive wraparound support to help them meet their goals, including assistance in planning which classes to take in high schools, help with applying for college, STEM enrichment, and encouragement from health care role models.
At the high school level, AHEC offers two free residential summer camps at UK that will be revised and funded through the HRSA grant. The Summer Enrichment Program, for rising high school juniors, is a residential camp that allows students to gain some early college experience by spending three weeks learning, observing, and working hands-on with UK faculty, health professionals and health professions students. The program will add more mentoring specifically from primary care physicians to provide more specific education on what a primary care physician can do for patients, and understand how primary care physicians function within a collaborative system.
The Health Researchers Youth Academy takes a similar approach, but is more tailored to the research side of a medical career. The residential programs connect high school students with researchers, teach them research methods, and give them experience working in a lab; at the end of the camp, students will present their findings through poster presentations. In terms of primary care, the camp will educate students more on a primary care physician’s role in translational research — in other words, how basic science at the bench ultimately becomes a part of everyday patient care.
UK’s Rural Physician Leadership Program, developed by the UK College of Medicine, Morehead State University, and St. Claire HealthCare, trains students who are interested in practicing rural medicine. Photo by Jorge Castorena, UK)
Though CICHE has an overall goal of creating more health professionals across all spectrums, Ballard says their programming will provide education extolling the benefits of choosing primary care.
“We’ve always exposed students to a variety of professions in the past, but we want to get more specific when it comes to primary care. We want them to understand ‘This is what a primary care physician does, this is why it’s important, this is why it’s valuable to you,’” Ballard said. “It’s amazing what primary care physicians can do, especially in rural and underserved areas. We want to show them what a difference they can make in their community by choosing this as a career.”
For four decades, UK has offered undergraduate-level programs for students from underrepresented backgrounds or disadvantaged communities who are interested in a medical career. The Professional Education Preparation Program (PEPP) was first established in 1982 and restructured in 2019 into two programs:
• PEPP Scholars is for rising college freshman. This summer academic enrichment program is for students with a strong interest in a medical career and gives them the chance to observe, network and volunteer within a health care setting.
• PEPP-MD, for rising college sophomores takes this opportunity to a higher level. Students in this program are interested in becoming physicians, and in addition to more focused exposure to the profession, the program helps prepare them for future admission to medical school.
For rising college juniors, the successful UKMED program provides the opportunity to interact with medical students and physicians as well as enhance knowledge through customized workshops focusing on skill development. The goal is to draw interest to medicine, particularly from students who are underrepresented in medicine or from rural Appalachia. Through the HRSA funding, this program will expand to include more students and to provide an MCAT prep course.
In addition to supporting UK’s already-existing pipeline programs, new initiatives funded by this grant will include:
• Two postbaccalaureate programs for students who have graduated from college. These programs will provide opportunities for students to complete prerequisites for medical school and/or receive additional support and training to improve their chances of being accepted into medical school.
• A prematriculation program to prepare incoming medical students for the rigors of the curriculum and to highlight the benefits of choosing primary care as a career path.
• A Primary Care Scholarly Concentration, which will include targeted coursework and an enhanced community clinical rotation at a rural teaching health center.
“Our pathway programs deliver experiences that foster a career in medicine to individuals from diverse backgrounds while showcasing both the talent and possibilities at the UK College of Medicine,” said Wendy Jackson, M.D., associate dean for admissions. “The purpose of all the programs is to deliver robust experiences to premedical students in the hope of strengthening their candidacy as well as solidifying their commitment to both medicine and the Commonwealth of Kentucky.”
Reducing debt for future primary care physicians
Research shows that students with high college debt are less likely to choose primary care specialties due to lower compensation in comparison to specialty and sub-specialty practices, and these graduates are less likely to practice in underserved communities.
Medical students Katelin Maggard and Anna Cox on the UK College of Medicine-Bowling Green Campus, a partnership with UK, Western Kentucky University, and Med Center Health. (Photo by Clinton Lewis, UK)
The new HRSA funding will also allow the UK College of Medicine to provide up to $2.88 million a year in scholarships to students with demonstrated interest in primary care.
The new scholarships are positioned to decrease the debt burden by half for 80 students, and by a quarter for an additional 32 students. By reducing this burden, the team anticipates that more students will be likely to follow their passion for rural medicine and making a difference in underserved communities.
“Investing in the education of medical students through scholarships is not just an act of philanthropy, it’s an investment in the future of health care in Kentucky,” said UK College of Medicine Office of Medical Education Senior Associate Dean Stephanie White, M.D. “This award will be life-changing for our students who wish to pursue a career in primary care and have the desire to make a difference in underserved communities. These scholarships won’t just alleviate financial burden — they will empower dreams and nurture the talents of our next generation of primary care physicians.”
This program is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $3,970,759 with 0% financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.
