- Need: An increased interest among young people to pursue a medical career in rural North Carolina
- Intervention: Two medical students started a program that gives high school seniors medical academic training, mentor relationships, and hands-on experience in rural North Carolina facilities.
- Results: Project PROMISE has graduated 26 high school students, 7 of whom are pursuing an undergraduate degree with an interest in studying medicine.
Rural counties in North Carolina are suffering from a persistent shortage of healthcare providers. Studies have shown that medical students with rural backgrounds are more likely than their peers to return to rural areas, and yet schools of health professions continue to have low enrollments of students from these regions.
As a result, two UNC School of Medicine students started Project PROMISE (Providing Rural Opportunities in Medicine through Inspiring Service and Education). Based in Spruce Pine, North Carolina, the educational and experiential pipeline program was intended to pique the interest of high school students not only in pursuing a career in medicine, but also in returning to practice in rural North Carolina.
Through an application and interview process, Project PROMISE selects up to 6 high school seniors who have an authentic interest in healthcare. Participating students are from Mitchell High School, McDowell High School, and Mountain Heritage High School. Each student completes a semester-long course that includes weekly sessions taught by medical students, rotations in healthcare facilities throughout Mitchell, Yancey, and McDowell Counties, and several health-related service projects. Through these elements, Project PROMISE provides their students with more than 135 credit hours and exposure to the following healthcare professions: dentistry, anesthesiology, obstetrics and gynecology, pediatrics, palliative care, family medicine, public health, geriatrics, pharmacotherapy, internal medicine, and radiology.
This program is modeled after the Minority Medical Mentoring Program in Asheville and the University of Alabama Rural Health Leaders Pipeline. Project PROMISE is sustained through the help of these organizations:
- Western Carolina Medical Society (WCMS)
- Mountain Area Health Education Center (MAHEC)
- University of Chapel Hill School of Medicine
Project PROMISE was initially pitched to the Albert Schweitzer Foundation who accepted the program founders into their year-long healthcare leadership and community-engagement fellowship. The Foundation helped with strategic planning and initial costs for the launch of Project PROMISE. Additional funding from a private foundation and personnel support from MAHEC now allows for a program administrator, an undergraduate intern, and service project expenditures.
Project PROMISE launched in the Fall of 2014 with their first group of students. Since then, several aspects have changed to further embed the program into the local communities and give the students hands-on training. The program now includes the following main components:
- Rural Workshops – Project PROMISE hosts medical workshops at high schools in 5 Western North Carolina counties (Yancey, Mitchell, McDowell, Swain, and Madison). Students gain professional development and hands-on experiences at the 6 workshops held per semester. The workshops are open to all high school students, but marketed to those who have a medical interest.
- Rotations – Rural medical facilities host students 4 days a week for several hours each day. The regular rotations give students an opportunity to learn first-hand from medical preceptors within a rural healthcare setting.
- Health-Related Service Projects – Students coordinate efforts such as pet therapy, peer-to-peer presentations, and Meals on Wheels in order to “give back” to their towns. Such initiatives are meant to foster professional connections and a sense of pride in their rural communities.
- Mentorship – UNC School of Medicine students serve as mentors, regularly checking in with Project PROMISE’s students to discuss their rotations and answer questions.
The Fall semester of 2018 marks the 7th semester of Project PROMISE. Since the program's beginning, they have seen the following results:
- 1,223 students have participated in the rural health workshops.
- 21 clinicians have participated as preceptors and mentors.
- 26 high school students have graduated from Project PROMISE.
- 2 additional workshops held at MAHEC have been added, accepting home schooled students and those from the Medical Minority Mentorship Program. So far, 33 students have attended.
For more information on Project PROMISE, visit A Promise for Rural Medicine, published by UNC Health Care.
- At the end of the first year, a survey was distributed and exit interviews conducted with the program’s graduates. The outcomes were not as prominent as the founders had initially hoped. More defined measurables are being created to better track students’ progress and understanding of rural healthcare.
- The 3-hour drive time for the weekly teaching sessions, on top of the program’s administrative duties, became a drain on the founders who were also juggling medical school and preparation for residency.
- Although a benefit of the participating high schools was their rural location, poor internet connection posed a large problem. The founders’ vision of mentorship and trainings through technological interaction has not yet become a reality.
- The amount of work required and the necessity to change several aspects of Project PROMISE led the founders to put a hold on the program for the 2015 Fall semester. They reopened the program for the 2016 Spring semester.
- Activities like sports, additional classes, and jobs competed with the program for students' commitments. As such, a focus group was conducted with rural providers and educators, and a health careers summer camp was proposed as a solution. It is planned for June 2019.
The following are words from the founders to those interested in launching a similar program:
- Capitalize on popular healthcare topics. Because healthcare education and physician retention are currently common discussion points, Project PROMISE has caught the attention and assistance of funders, partners, and medical professionals.
- When you come from outside of a rural community, no matter how good your intentions, there will always be some skepticism. The degree of their welcoming your program stands upon your understanding of their culture and town politics, as well as the ability to execute your proposed plan.
- Start small. During your first year, it may be all you can do to “shield your flame” so that the fire doesn’t burn out. Continue on until you can find the right funding and partnerships that can make your program take flight.
- Be open to change and willing to alter your initial plans to allow your program to become more sustainable.
- Continue to invest in your program and retain those who were once involved, including your medical school mentors, rural preceptors, and creating opportunities for your program’s students to return as interns.
Children and youth
Health workforce education and training
Health workforce pipeline
February 2, 2016
Date updated or reviewed
April 17, 2019
Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.