Hawai'i Rural Health Program: Shaping the Next Generation of Rural Doctors.

Like many areas of the United States, Hawai'i and its rural communities are suffering from a significant physician shortage. The University of Hawai'i (UH) John A. Burns School of Medicine (JABSOM) developed the Hawai'i Rural Health Program (HRHP) in 2011 to help provide early and substantial rural training experiences for its medical students in hopes of generating more rural health care providers. Thus far, 20.6% of the students who participated in this program and have since graduated from residency are now practicing in rural communities. Final exam grades of students who participated in the program were not statistically different from those who did not participate, suggesting a similar quality of training between both the rural and traditional cohorts of students. Reflections from students who completed the program demonstrate the large and lasting impact that this immersive experience has on their medical education and desire to help rural communities.

Neurologist Attitudes on Practicing in Hawai'i.

There is a shortage of neurologists nationwide, and the demand for neurologists is expected to increase in the upcoming years while the pool of practicing neurologists dwindles. Per Hawai'i Neurological Society, there were 44 practicing neurologists in the state of Hawai'i in 2019, representing a shortage of approximately 28 neurologists. Considering that Hawai'i is geographically, demographically, and culturally distinct compared to other states, a concern is that practicing neurology in Hawai'i poses unique challenges that may contribute to the low numbers of neurologists. An anonymous online survey was sent via email to all members of the Hawai'i Neurological Society from February 2019 to June 2019, inquiring about aspects of their practice they considered unique to Hawai'i. Twenty-three neurologists completed the survey, representing 52% of Hawai'i's neurology workforce. One neurologist completed a portion of the survey. Twenty-five percent of participants were born and raised or completed their medical education in Hawai'i. Self-reported reasons for practicing in Hawai'i included family, lifestyle, and patient population despite financial challenges and limited resources and opportunities. Participants suggested introducing a mandatory neurology rotation for Hawai'i medical students and creating an instate neurology residency program to combat the growing neurologist shortfall in Hawai'i. This survey identified local strengths and challenges in the field of neurology, potential ways to improve the practice environment in Hawai'i, and neurologists' perspectives on ways to address the neurology shortage.