With the recent closures of three rural Arizona obstetrician centers, heath educators are looking for ways to retain doctors in outlying areas.

Carol Galper, coordinator for the Rural Health Professions program, said Each year, 15 medical students are chosen to spend a minimum of 11 weeks in a rural hospital to get a dose of reality.

She said the program began in 1997 after the Legislature passed a bill stating, "We want the UA College of Medicine to be the foremost school in nurturing medical students in rural areas."

"They get to see the good, the bad and the ugly," Galper said.

Alison Hughes, director for UA rural health services, said programs like these may be the key to retaining physicians in rural areas, as the state faces a gross shortage of rural physicians - particularly obstetricians.

Just recently, Copper Queen Community Hospital in Bisbee closed its obstetrics ward when four of the six OB physicians closed their practices because of the increased cost of malpractice insurance.

Now, the only operative OB ward in Cochise County is at Sierra Vista Regional Health Center - 30 miles from Bisbee.

White Mountain Regional Hospital in Springerville is also in the process of closing its OB ward because of bankruptcy.

"The OB just isn't making enough money," said Linda Martin, media relations director for the hospital. "It's frustrating, because rural area hospitals provide the same services, but get paid less. Then they are forced to shut down. It seems like rural areas are getting hit hard."

Hughes said research shows that doctors who are from rural areas tend to practice longer at rural hospitals, despite financial difficulty. That is why, she said, the university pays attention to medical school applicants from small communities.

Carlyle Begay, a microbiology junior, said it's not that simple.

Begay, an American Indian student who has been researching cancer at the UA for two years, would like to give back to his roots as an oncologist on an Indian reservation after he graduates from medical school.

But he said the drawbacks of working in a smaller community are hindering him from doing so.

"Doctors are only allowed certain specialties on reservations, which drastically reduces my choices," he said. "The only way I can practice oncology on the reservation is to be contracted."

For this reason and relatively low pay, Begay said he will likely not practice medicine in a rural area.

"It's on the minds of all medical students," he said. "There are a lot of talented medical students who would love to practice in smaller areas, but there isn't enough incentive."

However, Galper remains optimistic that the Rural Health Professions program will support rural health.

May 2000 graduates were the first group to graduate from the program, so there is not yet any data available to show how many students go on to practice in rural communities.

But Galper said the program is helping students see the benefits of working in a small community rather than the plethora of drawbacks that usually scare off medical students.

"They get to see the professionalism that rural physicians have because they are so integral to the community," she explained. "These doctors play a role that's different. They become leaders in the community and even start up free clinics because they see a need."

Sen. Marsha Arzberger is sponsoring Senate Bill 1240 to establish a rural physician study committee.

The committee would review issues affecting the practice of medicine in rural areas in hopes of finding solutions to retain family physicians in small communities.

"All of this is going to help," Galper said. "We are in a fast-growing state, and we need to address these issues. The more we work together on this issue, the better. The rural areas are wonderful places to live and are deserving of good doctors."