Dr. William Browne believes in his heart that physicians serve people, not geographic areas or populations. 

A third-year medical resident, Browne is the first general surgery trainee from the OU College of Medicine to undertake a rotation at Comanche County Memorial Hospital in Lawton, Okla. The 18-month rural surgery track is part of the residency program’s efforts to immerse trainees in the health care delivery of smaller communities, where physicians are too few to meet the needs of many.

Like other medical disciplines, surgery has become increasingly specialized and urbanized, magnifying the need in rural Oklahoma for well-rounded surgeons with a broader skill base. In Lawton, Browne is sharpening those skills while also relating to patients in a way that isn’t always possible in bigger cities.

“Practicing in a small community means you know your patients,” he says. “They are friends and neighbors—people who are part of your life outside of the hospital. The trust is deeper when both the physician and patient stay human. It makes us more accountable to one another.”

An estimated 41% of Oklahomans live in rural communities. Insufficient access to health care plays a significant role in the state’s poor health outcomes. Of Oklahoma’s 77 counties, 75 are considered health professional shortage areas, to such a degree that many thousands of people don’t have a primary care physician. Women often can’t give birth in the county where they live. Mental health providers are frequently not within driving distance, and dentists trained in the needs of children are sometimes too far away.

OU Health Sciences is rising to meet these challenges through programs building the workforce of tomorrow, and with innovations that increase healthcare access today.

Exposing health professional students to rural health care—both its challenges and delights—is a primary focus. Third- and fourth-year medical students can opt for month-long clinical rotations at sites like Jackson County Memorial Hospital in Altus, Okla., and the Chickasaw Nation Health System in Ada, Okla., where they work alongside physicians and nurses to care for people whose needs are sometimes different from urban patients. Students also get to know the community by going to farmers’ markets, visiting elementary schools and providing injury care at high school football games.

“To increase the geographic distribution of the physician workforce in Oklahoma, we have to expose students to what it’s like to live and practice in communities across the state,” says Mary Gowin, an OU College of Medicine associate professor and director of the Primary Care Health Policy Division. 

“There is something very special about practicing medicine in a small community, and many of our students are experiencing that during their rotations. Physicians don’t just see patients for 15 minutes in a clinic; they get to know them and their families. They build up a level of trust that you don’t always find in health care,” says Gowin, whose upbringing in a small western Oklahoma town shaped her career.

Many of OU’s efforts are funded by the U.S. Health Resources and Services Administration (HRSA), with a particular focus on building relationships in rural, tribal and medically underserved areas. One new HRSA-funded program sends physician associate (PA) students on three-month clinical rotations in rural primary care settings that integrate mental health services. 

Mental health providers are in short supply across Oklahoma. By training PAs in practices where patients can have both their physical and mental needs addressed, students will be better equipped to provide combined care in the future, says Darlla Duniphin, interim director of the PA program at OU Health Sciences.

OU medical, nursing and social work students also gain firsthand experience in the specialized care of older adults. Through the Oklahoma Dementia Care Network, funded by a newly awarded HRSA grant, students train at rural nursing homes, a federally qualified health center and several tribal health facilities. Students learn about the unique needs of patients with memory problems, as well as engaging with caregivers, who play a critical role.

Oklahoma faces an urgent shortage of geriatric care, with more than half of older adults living many miles away from specialized geriatric care. In 2023, Oklahoma ranked 48th in the nation for early death among older adults; by 2025, Oklahoma’s "older adult" population is estimated to exceed 750,000.

“We have a great opportunity to support and grow the geriatric workforce in Oklahoma,” says Lee Jennings, an associate professor of geriatrics in the OU College of Medicine who leads the grant team. “Caring for older adults is very fulfilling, and our students see what a difference they can make.”

OU Health Sciences is also addressing workforce shortages through increased enrollment. Three years ago, the Fran and Earl Ziegler College of Nursing began accepting all qualified applicants to its baccalaureate program. This fall, more than 600 new nurses will join the workforce, double the amount from 2021. Similarly, the OU College of Medicine plans to increase its first-year class size from 163 to 232 students within five years.

Like Browne in his Lawton surgery residency, residents in other health disciplines provide care in rural, tribal and underserved areas. On the OU-Tulsa campus, family medicine residents who plan to offer obstetrics care can undergo an extra layer of training in communities with fewer medical resources.

“Oftentimes, patients in rural areas receive almost no prenatal care,” says Dr. Karen Gold, chair of the Department of Obstetrics and Gynecology at the OU School of Community Medicine in Tulsa. “A lack of transportation or being unable to leave work often prevents them from driving to Tulsa for the approximately 10 visits they need from their first trimester through delivery. If we can offer these services in rural areas, we can detect problems before they become issues that could send them to the emergency room.”

Quick access to cancer care is also improving. Earlier this year, OU Health Stephenson Cancer Center announced its expansion to Tulsa, where people throughout northeastern Oklahoma can receive research-driven health care closer to home. This includes clinical trials, which can require several appointments a week—a fact that deters many people from driving to Oklahoma City. Stephenson Cancer Center also expanded to Norman to serve more people in southern Oklahoma.

Telehealth is another key to improving access. The university’s clinical partner, OU Health, is supplying stroke telemedicine equipment to several rural hospitals through a U.S. Department of Agriculture grant, providing 24/7 access to the OU Health stroke center team. Similarly, OU Health neonatologists support rural hospitals during high-risk resuscitations of premature babies.

OU Health Sciences also connects with young people across the state—many first-generation college students—who are interested in a health career but lack preparation and testing resources. Through an initiative called REV UP!, students are mentored as they prepare to take the Medical College Admission Test. REV UP! has already resulted in several students gaining admission to medical school, Gowin says. 

Studies show students from rural, tribal and medically underserved areas are more likely to return to their communities to practice, she says.

“Many students aspire to become doctors, but don’t have the resources to prepare themselves as competitive applicants,” says family medicine physician Robert Salinas, assistant dean for access and community engagement in the OU College of Medicine. “It’s vitally important that we continue these successful outreach and recruitment efforts if we’re going to meet the current demand for doctors in Oklahoma.

“Our ultimate goal is to reduce health disparities and raise the health of the state. A person’s ZIP code should not determine their health status,” he says. “Everyone deserves access to high-quality health care.” 

April Wilkerson is OU’s Senior Marketing and Communications Coordinator for Health Sciences Research.

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