Holly Moody-PorterNearly all of Maryland’s Eastern Shore is designated by the federal government as both a medically underserved area and a health professional shortage area. That means thousands of residents face serious barriers to accessing the care they need — from routine checkups to urgent medical treatment. In fact, the five Maryland counties with the fewest primary care physicians per capita are located on the Eastern Shore. Caroline County, for example, only has one provider for every 2,500 residents, compared to one per 1,000 in Baltimore County.
In response, the University of Maryland School of Medicine (UMSOM) established a program last year to train and place students in rural health care settings. This academic year, three students who received full-tuition scholarships and were accepted into the newly named Rural-MD Scholars program started gaining insight into their future practice on the Eastern Shore through interactions with local health care professionals, community engagement, and hands-on clinical experiences.
The state initially provided funding of $1.4 million to support the program, with additional funding provided by the University of Maryland, Baltimore (UMB); the University of Maryland Eastern Shore (UMES); the Rural Maryland Council; and $1 million from private donors. Recently, the state committed an additional $1.4 million to continue the program for the upcoming academic year, and an anonymous donor committed an additional $1 million. The program’s long-term goal is to provide full scholarships for up to 10 new students a year to mitigate the physician shortage on the Eastern Shore.
Rising second-year medical students Zobia Rani, Tahreem Riaz, and Sarah MacDonald were in the first class of rural scholars to be awarded full scholarships and are embarking on their specialized training. After medical school and residency training in the field of their choice, they will begin their medical careers within an Eastern Shore health care setting, committing to a minimum of four years of service in the community. The federal Teaching Health Center Graduate Education Medical Education Program reports that out of nearly 2,000 doctors who have graduated from rural residency programs, roughly 70 percent have continued their practice in underserved areas.
“We are extremely proud of our Rural-MD Scholars who have made a tremendous commitment to address health disparities in our state,” said Leah S. Millstein, MD, course director for the program and associate professor of medicine at UMSOM. “We are very excited to play an important part in Maryland’s mission to expand access to health care in rural counties.”
Physicians Offer Mentorship
Eight rural Eastern Shore counties have 76 percent of residents living in federally designated medically underserved areas (MUAs), with Caroline, Kent, Somerset and Worcester each having 100 percent of their population residing in designated MUAs. These residents tend to have lower life expectancies, as much as seven years shorter in some Eastern Shore counties compared to top-ranked suburban Montgomery County. In 2022, the Centers for Disease Control and Prevention reported that many deaths in rural America were potentially preventable including 20,000 from heart disease and stroke, 6,000 from cancer, 10,000 from unintentional injuries, and 6,000 from chronic lower-respiratory disease.
Since the program’s launch in fall 2024, five Eastern Shore physicians have committed to joining the program’s Core Physician Panel, offering students one-on-one mentorship opportunities and informing the curriculum with clinical insights from their practice in rural health care. This includes procedural techniques that students may need to know how to perform in low-resource health care facilities. The panel features a diverse group of health care professionals, ranging from private practice physicians to leaders of public health organizations, highlighting the various ways students can practice throughout their careers in medicine.
More Doctors, Longer Lives
Rates of preventable heart disease deaths were found to be significantly higher in rural areas compared to large central suburban areas throughout Maryland. A major reason cited by federal health researchers for this disparity was lack of access to health care. Increasing physician density in rural areas could reduce the rate of preventable deaths.
“Practicing medicine in a rural area presents a unique set of challenges to physicians who may find themselves with limited access to local specialists to refer patients to or the most advanced medical equipment,” said Casey Scott, MD ’10, MPH, health officer of the Dorchester County Health Department, who serves as a Core Physician mentor for this program. “It is vital for those in training to practice in rural areas to be fully prepared for these challenges, and that is what we are trying to ensure for students participating in the Rural-MD Scholars program.”
To further enhance community engagement, the program team aims to collaborate with the Core Physician Panel to identify Eastern Shore families that students can assist in navigating their various experiences in health care.
“We are incredibly grateful for the partnership of these dedicated physicians who have generously invested their time and resources in the development of our students,” said Donna L. Parker, MD, FACP, senior associate dean for medical education at UMSOM. “Their experiences in navigating barriers to care on the Eastern Shore and attending to a range of patient concerns are invaluable to our program’s success. We look forward to expanding clinical opportunities with their support in the years to come.”
Rural-MD Scholars is part of a larger effort to provide UMSOM students with a background in rural health care. Last year, the school began offering a two-year elective course to all students that provides comprehensive training on the medical needs of rural patients. The curriculum, called the Rural Health Equity and Access Longitudinal Elective, enables students to gain early exposure to the clinical skills needed to effectively manage patient care in low resource settings.
“One in four residents on the Eastern Shore lives at least 10 miles from a hospital, which increases the risk of delayed treatment,” said UMSOM Dean Mark T. Gladwin, MD, who also is the John Z. and Akiko K. Bowers Distinguished Professor at UMSOM and vice president for medical affairs at UMB. “Our rural residents urgently need access to skilled physicians like those we are training in our Rural-MD Scholars program who will understand the unique health needs of this population and strive to improve health outcomes.”
