Fall 2002

SEARCH Program Offers Real-World

Learning Experiences

Connecting Communities and

Academia to Meet the Primary

Health Care Needs of the 

Nation’s Underserved . . . . . . . . . . . .1

From the Director

The Continuum of Contact 

Fosters Educational Pathways 

to Success . . . . . . . . . . . . . . . . . . . . . .2

HRSA Reorganization

NHSC Moves to the Bureau of

Health Professions . . . . . . . . . . . . . .6

Educating the Next Generation 

to Care for the Underserved

Former NHSC Clinician Appointed

Dean of New College of Medicine 

in Florida . . . . . . . . . . . . . . . . . . . . . . . .7

The Continuum of Contact: 

Recruiting and Retaining Primary

Care Clinicians Throughout the

Professional Life Cycle . . . . . . . . . . . . .8

Students ‘Try Out’ Working with 

the Underserved

SEARCH Program in Virginia Links

the Community with Academia . . .8

Oregon Campus Offers 

Support Network for Students

Committed to Working With

Underserved Populations . . . . . . . . .10

Study Findings Indicate NHSC

Scholarship Predictive of

Commitment to the Underserved . .12

NHSC Resource Corner . . . . . . . . . . .13

New Hampshire AHEC Combines

Forces with Education Institutions 

to Ensure Top-Notch Health Care 

for Underserved Communities . . . . .14

In This Issue

SEARCH Program Offers Real-World

Learning Experiences

Connecting Communities and Academia to Meet the 

Primary Health Care Needs of the Nation’s Underserved 

“All patients have a story to tell, and

this [experience] has shown me that

success depends on how well it can 

be listened to and incorporated into 

the care.”

—Doug Kolorick, Ohio State University

School of Medicine and Public Health

That’s just one of the many positive

reactions from students who have gone

through the Maine Student/Resident

Experiences and Rotations in Community

Health (SEARCH) program, and it’s a sentiment expressed by students in SEARCH

programs taking place throughout 

the country. 

What Doug Kolorick is referring to is the

essence of why the National Health Service

Corps (NHSC) established the SEARCH 

program—providing culturally competent,

community-responsive health care to the

underserved begins with the patient, but 

is sustained by the education of new 

generations of students and clinicians. 

In Maine, the education and real-world

experiences provided by the SEARCH program begin with the Maine Ambulatory

Care Coalition (MACC) and its training and

recruitment coordinator, Jim Dowling.

MACC has been in operation for roughly 

18 years, so a solid foundation was in place

when the SEARCH program, which is funded by NHSC, was added about 9 years ago. 

continued on page 3

NATIONAL HEALTH SERVICE CORPS

InTouch

Dowling’s role is really that of a bridge

between academia and the communities

served by more than 40 community and

Indian health centers and rural primary

care practices. Through direct interaction

with experienced clinicians, Dowling gets

a clear picture of their teaching interests

and of their communities’ health needs.

He is then able to place medical, physician

assistant, and family nurse practitioner

students and family practice residents

where they are needed most and where

their learning opportunities are greatest. 

By fostering the connection between

the underserved and students and residents in primary care, the Maine SEARCH

program provides an enriching educational

experience and improves the health of

communities. But it also has the lasting

effect of nurturing deep roots in those

communities. For example, roughly 10 percent of the clinicians currently in Maine’s

community health care system came

through the SEARCH program. In addition,

10 percent of those who participate in the

Maine SEARCH program go on to find

jobs in Maine, and 25 percent of the students remain in the State to do their 

residencies.

Although these statistics are impressive,

MACC is focused on steadily increasing

these numbers. Because most students

learn about SEARCH through word of
The Continuum of Contact Fosters Educational 

Pathways to Success

Dear NHSC Clinicians:

The spirit of patriotism and commitment to service exemplified by all Americans in the

wake of the tragic events of September 11 is, by default, tinged with sadness. But at the

same time, it is truly inspiring. At the National Health Service Corps (NHSC), we’ve been

nurturing such a spirit in our primary health care clinicians for many years, and we continue

to strengthen our resolve to improve access to health care for all.

We believe we have the mechanisms in place to achieve our goal. Through a progression of programs to recruit and retain clinicians, which we call the "continuum of contact,"

we strive to span the professional life cycle of primary care clinicians dedicated to working with underserved populations. The continuum is not a secret recipe created in a

boardroom, however. Instead, it is a real-world solution predicated on a very simple

idea—an idea expressed simply by the word dedicated. The health care professionals

who are part of the NHSC are dedicated to helping the underserved. By having a continuum

of contact, we dedicate our efforts to ensuring that they have what they need at every

stage of their professional careers. 

Critical to the continuum is outreach to States, communities, and academic training

institutions to attract promising students early in their educational process and to support

them through their careers and lifetime learning experiences. There are many players

involved in these outreach efforts, including NHSC’s Student/Resident Experiences and

Rotations in Community Health (SEARCH), Area Health Education Centers (AHECs), university and State-run organizations, and private foundations. The NHSC is the bridge linking all these vibrant pockets of activity.

The dedication to serve would be there with or without the NHSC, but with the continuum of contact we create pathways that enable the dedication to flow back and forth

more easily. Individual generations of students will come and go. Many students will go

on to work with underserved communities, and many others will go on to a variety of

career opportunities. However, they will all be richer for having traveled the pathways that

the NHSC helps develop between academia and communities and between communities

and academia.

In this issue of NHSC In Touch, we are pleased to present a story of continuous

renewal and rededication of our health care professional resource for the improvement

and expansion of quality health care for everyone. It is the same tale told from different

points of view by a cast of innovative players. It is about how we inspire, mentor, and reenergize new generations of American heroes dedicated to the

health and prosperity of the Nation. 

2

From the Director

Donald L. Weaver, M.D.

Director

Division of the National Health

Service Corps

We want to hear

from you!

We need your help to make your

newsletter work for you. We want

your ideas for stories and other 

features. Share news; pass along

practice tips; submit letters to the

editor. Tell us about a member of

the NHSC family with a unique

approach to providing care. 

E-mail us at 

NHSCInTouch@matthewsgroup.com

Or send information to:

Editor, NHSC In Touch

National Health Service Corps

4350 East West Highway

8th Floor

Bethesda, MD 20814

Produced by Matthews Media Group,

Inc., for the National Health Service

Corps under Contract # 232-00-0046,

issued by the Health Resources and

Services Administration (HRSA). 

The views and opinions expressed 

do not necessarily represent the 

official position or policy of the 

U.S. Department of Health and 

Human Services.

The National Health Service Corps 

is a program of the Federal Health

Resources and Services

Administration’s Bureau of Health

Professions (BHPr). BHPr programs

help to assure access to quality

health care professionals in all geographic areas and to all segments of

society. BHPr puts new research findings into practice, encourages health

professionals to serve individuals 

and communities where the need is

greatest, and promotes cultural and

ethnic diversity within the health 

professions workforce. 

Published quarterly by the National

Health Service Corps. 

Donald L. Weaver, M.D., 

Director

Division of the National Health

Service Corps
background are placed in

primary care settings

throughout the State. These

programs last 6 weeks, during which the student

spends time with a preceptor and other clinicians to

gain firsthand insight into

what rural family practice

entails. Typically, students

spend 50 percent of their

time working on a community project identified by the

health center, such as a

program affords participants

opportunities to experience

the delivery of health care

in a truly rural environment.

Two distinct programs are

available from Maine’s

SEARCH program to provide these opportunities:

year-round clinical rotations

for academic credit and preclinical community experience programs that take

place in the summer. 

In the preclinical summer programs, students

with little or no clinical

3

mouth, a greater emphasis

is now being placed on outreach. Dowling leads that

charge by also serving as

the editor of the Bruit

Rurale, a newsletter for

medical and other health

professions students that is

published six times per academic year. The Bruit Rurale

is distributed to 15 schools,

only two of which are in

Maine. By featuring student-written pieces about

their experiences in the

SEARCH program, the

SEARCH Program... continued from page 1

newsletter presents a

detailed picture of the challenges and rewards of practicing medicine in a rural

community. 

Maine has many such

challenges and rewards to

offer that are particularly

appealing to students and

residents interested in rural

primary health care. 

Because of the geographical and cultural isolation, as well as poverty

issues, in many parts of

rural Maine, the SEARCH

LESLIE BENNETT, M.S.W., a clinician at the Behavioral Health

Clinic, Inc., in King Cove, Alaska, in the Aleutian Islands, discovered her

calling and her life’s work through her experience on a SEARCH rotation

in the summer of 2000. As it turned

out, SEARCH was a means to an end

for Bennett. She was looking for a

cultural environment that would fire

her professional imagination and

where she could ultimately become

part of the community. Her SEARCH

project, which focused on developing

a program to link elders of the Aleut

people with the younger generations in their tribes, took her eventually

to King Cove and the Behavioral Health Clinic. The facility is run by

Eastern Aleutian Tribes, Inc., a native corporation funded by the Indian

Health Service that is the sole provider of health care services in the six

remote villages of the Aleutians East Borough.

Here she has become an integral piece of a reviving culture and an

important member of a special society. "I wanted to learn and grow as

well as give to a community. I am doing all of these things and more in

my current job," Bennett says. " I am really glad I had the foundation of

being in Anchorage at my SEARCH rotation because it has given me

the insight into the services I need to access for my patients."

Since taking her position as a therapist, community outreach worker, and school social worker, Bennett has given back to the SEARCH

program that initially brought her to Alaska.

She served as a preceptor to another

SEARCH social work student whose imagination was also fired by the prospect of helping

the Aleut people rekindle their spirits through

cultural revival.

DEBRA RAY, a physician assistant student at Idaho State University, was hoping to

reaffirm her desire to work in a rural Idaho

setting when she went to Health West in Pocatello, Idaho, for a 5-

week SEARCH rotation. She emerged from her placement with a

renewed and more focused commitment to work with the medically

underserved and disadvantaged of rural Idaho. As a project, she chose

to spread the word about how the Idaho Registry Immunization

Systems (IRIS) could help mothers and children stay current with childhood immunizations. 

"Many of the people I spoke to had never heard of Idaho’s IRIS. It

felt good getting them registered in a program that will keep their children safe from childhood diseases."

During her SEARCH rotation, DAENYA EDWARDS, a dental student

at the University of Connecticut, spent 13 weeks involved in a program

that brought basic dental services to migrant farmworkers. As part of a

team that included other dental students, faculty dentists, and volunteer translators, Edwards conducted dental

exams and dental hygiene instruction with

workers on a number of farms located a distance from the Charter Oak and Rice Heights

Health Centers in New Haven, Connecticut.

Edwards quickly learned that routine dental

care was considered a luxury beyond the

means of most of her patients who saw dentists only for emergency extractions, dentures,

or when they were in excruciating pain. As a

result, she and another student colleague designed an information

brochure to teach general dental hygiene and the care of dentures.

"I learned to be understanding and nonjudgmental of the farmworkers’ situations and practices," Edwards says of her SEARCH experience. And although uncertain of where she will practice after graduation, her experience among the farmworkers has turned her in the

direction of "spending some, if not all, of my time providing care for

and educating an underserved population," she says.

continued on page 4

In SEARCH of Real-Life Experiences Working With Underserved Communities
4

health fair, community

needs assessments, or

development of resource

libraries. The remainder of

their time is spent shadowing physicians, observing

triage over the telephone

with nurses, and spending

time with pharmacists.

Students in the preclinical

programs are usually in their

first year of medical school,

and although the programs

are generally not for academic credit, some students have arranged for the

preclinical program to count

as an independent study.

In year-round clinical

rotations, the participants

usually are third- or fourthyear students or residents

so their training tends to be

more in-depth. Medical students and nurse practitioner

and physician assistant students are represented in

approximately equal numbers. In addition to increasing their cultural sensitivity

through community-based

projects, these students are

often asked to develop a

care management plan for a

patient identified by the

health center or 

clinic. These community members tend

to be elderly and

homebound, with an

array of medical and

physical challenges.

As part of an interdisciplinary team, a

student in a clinical

rotation may give

injections or draw

blood for the first

time during the

SEARCH program.

These duties, in addition to taking vital

signs and patient histories, give students

a real opportunity to

connect with their

patients.

For students in

both the preclinical

and clinical rotations,

the overarching

theme is one of

interconnectedness.

The Maine SEARCH

program is an interdisciplinary model, just as rural

medicine tends to be.

Preceptors want their students to work with home

health aides, emergency

room staff, pharmacists, and

anyone else the preceptor

interacts with on a daily

basis. Every plan that is set

up between preceptor and

student is flexible, and

every plan can be revised

according to changing

needs. Although this need

for students to be jacks-ofall-trades is not necessarily

by design, the end result for

the student is a very real

experience of how rural priSEARCH Program... continued from page 3

mary care unfolds on a dayto-day level. Clinicians need

to be able to work together

as interdisciplinary teams,

and the teams need to work

as part of the community.

As one SEARCH participant

commented, "Rural medicine is not a lower standard

of medicine, but a different

type of medicine." 

Consistent with the

interdisciplinary nature of

SEARCH programs, students and residents come

from many different health

professions programs

across the country.

Students and residents do

not need to be NHSC

Scholars, although those

who have NHSC scholarships must be given priority

for SEARCH experiences.

Interconnectedness is a

What Is SEARCH?

The Student/Resident Experiences and Rotations in Community

Health (SEARCH) program provides opportunities for health professions students and residents to serve on interdisciplinary health

care teams in underserved areas. Through SEARCH, participants

are placed in a community where they learn to meet the needs of

medically underserved patients with health care that is responsive

to their cultural beliefs and practices. Sites are located in rural and

urban communities across the country. A vital aspect of the program is that it enables communities to build lasting relationships

with academia. And, conversely, it allows academia to provide 

real-life experiences for its students. 

Benefits for students and residents:

• Training in culturally diverse community-based systems of care 

• Working with patients and communities to help them reach 

beneficial health decisions 

• Learning about culturally competent, community-responsive 

health care

• Gaining skills in delivering primary health care services by 

working with mentors

Benefits for communities:

• Gaining access to academic resources

• Networking with State and regional organizations

• Recruiting health professionals to increase access to 

primary care

SEARCH opportunities vary from State to State and include activities

such as working on health promotion and disease prevention community projects, assisting clinicians with routine screenings, and working with local health departments. 

To find out more about SEARCH opportunities, speak with the

appropriate State or regional sponsoring organization. A list of contacts for these organizations can be found on the NHSC Web site

at http://nhsc.bhpr.hrsa.gov/, or by calling the NHSC toll-free help

line at 1-800-221-9393. 

continued on page 5

Dan Anderson worked closely

with Atul Limaye, M.D., during

his 4-week summer preclinical

rotation at the St. Croix Regional

Family Health Center in

Princeton, Maine. "My SEARCH

experience in Maine was awesome. I learned a lot, met many 

wonderful people, and had some

great weekend trips," says Dan,

a medical student at the

University of North Dakota

School of Medicine and 

Health Sciences. 
5

SEARCH Program... continued from page 4

Maine’s SEARCH program is an innovative solution for stimulating student interest in pursuing primary health care careers in underserved communities. Fortunately, the notion of providing health professions students

with a significant hands-on community experience has been embraced by

23 other States throughout the country. 

The SEARCH program in Montana, which is coordinated by Montana’s

Area Health Education Center (AHEC) office at Montana State University,

is another model of success—despite the fact that Montana does not

even have a school of medicine. 

According to Sharon Kott, administrative assistant for the Montana

AHEC office, "This program gives students a genuine opportunity to see

how medicine is truly practiced in rural and frontier areas. Our intent is

that they will be smitten when they come out here and will want to practice here."

So where do the students come from, given that there isn’t a medical

school in Montana? A wide variety of places—due in large part to the

cooperative efforts of the Montana AHEC office and the extensive array

of partnerships that have been established with other organizations. One

of the key partners is WWAMI, a cooperative program of the University of

Washington School of Medicine and the States of Washington, Wyoming,

Alaska, Montana, and Idaho, from which it derives its name. 

WWAMI is a program that makes medical education accessible to students in the northwestern United States by decentralizing the educational

process and by sharing existing facilities and personnel in universities

and communities in the WWAMI States. Support of WWAMI by the State

of Montana allows 20 qualified Montana residents to be admitted to the

University of Washington School of Medicine each year. A large number

of the 50–60 students and medical residents who take part in Montana’s

SEARCH program each year come from the University of Washington. 

Melissa Rockefeller is one of those University of Washington students.

For her, the SEARCH program, which placed her in Libby, Montana, was an

eye-opening experience. "I suffered under the delusion that all the good

docs were in the big cities. Not so. These docs were all top of their class

and could have practiced anywhere. They chose Libby." Rockefeller goes on

to describe how helpful it was to work with doctors in a real-world setting:

"They were amazingly helpful and wonderful teachers. After a tough first

year of basic sciences, this experience reminded me why I went to medical

school and made me really excited about being a doctor."

Kraig White, an NHSC Scholar who is also from the University of

Washington, served in Havre, Montana, and echoes that sentiment. "The

time spent in Havre served to energize me for my second year and helped

me to further develop a platform of practical experiences that I can build

my knowledge base around." According to White, Havre has "a great integrative system that provides a unique collegial atmosphere for the physicians and other health care providers who work in the community. As a

student, I felt I benefited from being able to see how health care

providers can work together."

According to Frank Miller, M.D., one of the health professionals at the

Northern Montana Medical Group in Havre, the clinicians have benefited

as well from the participation of White and other students over the years.

"These are superior students. They seem to be the cream of the crop,"

says Miller. "I enjoy seeing how the health care system is seen with new

eyes. It helps us as practitioners realize how we fit in with the grand

scheme of things."

The fact that such experiences are the norm in 24 separate SEARCH

programs around the country is very encouraging, not just for rural medicine but for medicine in general. Kudos to all the students, administrators, and dedicated clinicians for making SEARCH such an enticing program, and for their commitment to improving access to medical care for

underserved communities!

To learn more about the WWAMI program, go to 

http://www.washington.edu/medical/som/wwami/. The Rural/

Underserved Opportunities Program (R/UOP), which provides early exposure for medical students to medical care in rural and urban underserved

environments, has received financial and organizational assistance from

the Area Health Education Centers (AHECs). For more information, go to

http://www.fammed.washington.edu/predoctoral/ruop/.

During the summer of 2000,

Kraig White (left) worked closely

with Frank Miller, M.D., as part of

an interdisciplinary team at

Northern Montana Hospital in

Havre, Montana. "In June, Dr.

Miller took me to Glacier National

Park for a weekend of hiking,"

says Kraig, who is a medical

student at the University of

Washington School of Medicine.

"Dr. Miller felt that enjoying the

wonderful nature around his practice site was one of the many

perks of being a rural practitioner."

From Maine to Montana...

Big SEARCH Opportunities in Communities Throughout the Big Sky State

big part of how students

are accepted into the program and then placed. On

the SEARCH application,

students are asked where

they would like to go geographically as well as what

their personal and professional goals are. According

to Dowling, in referring to

students in the summer

programs, "Almost all want

to work on history-taking

skills, which works out great

for everyone—clinicians,

students, and patients have

a lot of synergy that way." In

most cases, Dowling is able

to match students with particular programs so that

interests overlap. For example, a student with a strong

background and interest in

computers can be matched

with a site trying out medical records software. Or, a

site seeking help with

measuring and tracking intimate partner violence can

be linked with a student

continued on page 6
6

whose forté is statistical

analysis and epidemiology.

Students are welcomed

not only by the clinicians,

but also by the communities. "When people in a

small town see that a student has arrived, they take

pride in their community

and in themselves," says

Dowling. "The great majority

of patients are happy to be

seen by students as well,

and, in fact, they often take

pride in teaching the students a thing or two 

themselves." 

A big part of the students’ acceptance into the

community is a result of the

Maine SEARCH program’s

housing arrangements. In

most cases, a student is

presented with two or three

housing options, ranging

from rooms, to bed and

breakfasts, to hotels. A

stipend is provided for housing and basic living expenses, and students are generally charged a very low rate

($100 per week or less) for

their accommodations.

Sometimes the housing

providers are actually

SEARCH employees, and

most people who are hosts

do so in the spirit of making

a contribution to their community. These efforts by the

communities give students

a real insight into rural culture and help strengthen

their commitment to serving in rural areas. As Sekon

Won, a SEARCH participant

from Boston University

School of Medicine put it, “I

had the pleasant surprise of

just how much the family

model exists in family medicine there. Not only would

we oftentimes see different

members of the family at

different times, but I’d bump

into them at the grocery

store, bookstore, barber

shop, etc. Most importantly

for me, however, was the

friendliness... It was both

fun and a great learning

experience, and I couldn’t

have had a better start to

the clinical years.”

The Maine SEARCH program has accomplished a lot

in its more than 8 years of

existence, but there is

always more to be done.

One key area that is being

addressed is dental care.

Currently, there is an acute

SEARCH Program... continued from page 5

A Message from

Elizabeth M. Duke, Ph.D.

Administrator

Health Resources and

Services Administration

U.S. Department of Health

and Human Services

The Health Resources

and Services Administration

(HRSA) has moved oversight of the National Health

Service Corps (NHSC) from

the Bureau of Primary

Health Care (BPHC) to the

Bureau of Health

Professions (BHPr).

Additionally, the former

Division of Scholarships

and Loan Repayments has

been merged into the

NHSC, and the functions

of the former Division of

Shortage Designation have

been placed in BHPr’s

newly named National

Center for Health

Workforce Analysis. 

These moves make

sense because they put in

a single bureau—BHPr—

the full spectrum of HRSA’s

recruitment, training, loan,

scholarship, and placement

programs for health 

professionals.

This consolidation of

responsibility within BHPr

HRSA Reorganization

NHSC Moves to the Bureau of Health Professions 

increases the internal coordination needed to ensure

that the right number of

health professionals serve

in the right places. It

allows BHPr to offer them

a "menu of options" for

their development through

both the NHSC and the

Title VII and VIII programs.

And it will improve HRSA’s

ability to deliver quality primary and preventive health

care to needy Americans.

The restructuring also

helps BPHC by streamlining its responsibilities and

enabling the bureau to target staff and resources on

its core responsibility—the

Health Centers program. 

Why is this important?

Because over the next 5

years, President Bush’s

Health Centers Presidential

Initiative intends to add or

expand 1,200 health center

access sites. This expansion—which will be a top

priority for HRSA for many

years to come—will

increase the number of

people served annually by

health centers to a projected 16.6 million by 2006.

That’s an increase of more

than 50 percent in just 5

years. BPHC’s leadership

in building and maintaining

the Health Center network

is respected nationally. This

restructuring allows BPHC

to turn its full attention

toward making the planned

expansion a success.

The shift of the NHSC to

BHPr also gives the bureau

responsibility for another

Presidential initiative that is

designed to improve

continued on page 7

need for dental students in

the SEARCH program.

Sliding-fee clinics are in great

jeopardy throughout Maine,

and some community dental

clinics are on the verge of

closing. Because there are

no dental schools or dental

residency programs in

Maine, MACC is now working on creating a bridge

between a preceptor and a

dental school in another

State. If the previous record

of the Maine SEARCH program is any indication,

access to dental care may

be available to residents of

rural Maine in the very 

near future. 
shortage area definition to

include non-physician clinicians and J-1 and H-1C visa

clinicians practicing in communities. These reform

efforts will revitalize the

NHSC, enabling it to more

accurately define shortage

areas and better target

placements to areas of

greatest need. 

These changes have a

common impetus: to further HRSA’s mission to

expand access to quality

health care for all

Americans who need it.

We are duty-bound to take

actions that will strengthen

our ability to provide direct

medical care for the people

who rely on us. 

HRSA Reorganization... continued from page 6

NHSC’s service to

America’s neediest communities. The initiative will

examine several issues,

including the ratio of scholarships to loan repayments,

and will consider amending

the health professional

Florida may be the land of

resort areas and vacation

spots, but it is also home to

many rural poor and medically

underserved populations.

Even though some areas of

the State may have an abundance of medical specialists,

numerous poor, elderly, and

migrant workers in other

parts of Florida lack access

to primary care clinicians. 

Joseph Scherger, M.D., a

former National Health

Service Corps (NHSC) clinician, is leading Florida’s

effort to tackle this problem.

Scherger is the dean of

Florida State University’s

(FSU) new College of Medicine in Tallahassee, which is

now in its second year of operation. For the dean, FSU’s

mission is to provide excellent medical care by training 

primary care physicians and focusing on serving people 

in underserved areas such as rural communities and 

inner cities. 

Scherger’s appointment is a natural progression of his

continuing interest in primary care and preventive medicine. He received his medical degree from the University

of California at Los Angeles School of Medicine and then

did his residency in family practice and received a master’s

degree in public health at the University of Washington.

Following his residency, Scherger served 2 years in rural

Dixon, California, providing health care to migrant workers. 

After he completed his commitment to NHSC, he and

former NHSC physician David Katz set up a private practice in the area. For 14 years, the two physicians and their

fully bilingual staff were known for their "open door" policy

and continued to serve Medicaid and immigrant patients.

Scherger then became the associate dean for primary care

at the University of California at Irvine, a position he held

until he came to Florida. 

In retrospect, the dean sees all of this experience as

preparation for his position in Florida. "I’ve always believed

in the purpose of the Corps and wanted to serve in a community where I could use education to make a difference,"

says Scherger. "I also found it fascinating that the fact that

I was an NHSC physician appeared to make a difference

(in helping him gain his position at FSU)." 

Florida faces a tough situation with its current physician

supply. Forty percent of the State’s counties have less

than one-half of the national average of physicians (224

physicians per 100,000 population), and 13 counties are

designated federally undeserved counties, with less than

33 physicians per 100,000. Ninety percent of Florida’s

physicians are trained outside the State, and slots for

medical school positions are among the scarcest in the

country. And they don’t completely provide what the State

desperately needs—primary care physicians willing to

work with rural and elderly populations. 

Since 1971, FSU had offered its medical courses,

"Program in Medical Sciences (PIMS)," as an expansion

program of the University of Florida College of Medicine.

PIMS has always been geared to encouraging nontraditional students—minority, older, female, and economically

or educationally disadvantaged students. The Florida legislature then decided that there was still a lack of primary

care physicians to meet the needs in the State’s medically

underserved areas and those of the State’s growing geriatric population, so it created the FSU College of Medicine

program in 2000. 

Building on the ideals and goals of PIMS, the FSU program is based on a "nontraditional distributed model" (similar to Michigan State University’s successful College of

Human Medicine and programs at 16 other accredited

medical schools). Students spend their first 2 years training in the basic sciences at the Tallahassee campus. Then,

as in Michigan, the students will rotate among community

campuses throughout the State, studying and training in

physicians’ offices, clinics, hospices, and hospitals. The 

benefit in this distributed model is twofold—it gives students

wide exposure to providing medical care in rural and

Educating the Next Generation to Care for the Underserved

Former NHSC Clinician Appointed Dean of New College of Medicine in Florida

continued on page 8

Former NHSC clinician

Joseph Scherger, M.D., 

has been named dean of

Florida State University’s

new College of Medicine.

7
8

Educating the Next Generation... continued from page 7

underserved areas, and it

saves the State millions of

dollars in operating costs

by not having to build a

new teaching hospital on

the Tallahassee campus.

“Florida’s population is

growing in diversity, and

we hope to match that

diversity in our student

population and program,”

says Scherger. The school

accepts only Florida residents and has full-time

recruitment programs

directed toward underrepresented minority populations. “We have a science

pre-college and college

education program,

SSTRIDE, (Science

Students Together

Reaching Instructional

Diversity & Excellence) that

reaches into minority

schools from seventh

grade through college, and

a bridge program that is a

specifically minority, 1-year,

post-baccalaureate transition program.”

Scherger’s first goal for

the school is to gain

accreditation. The program

will eventually grow from

the first class of 30 students to 120 students per

year or 480 students total

in the 4-year program. "We

offer the same courses and

specialty training as any

approved medical school,"

Scherger notes, "but our

emphasis will be finding

and encouraging Florida

students who are dedicated to serving the underserved in their State." 

The Continuum of Contact: Recruiting and Retaining Primary

Care Clinicians Throughout the Professional Life Cycle

The National Health Service Corps (NHSC) remains dedicated to the "continuum of contact," a strategy that was

established in the early 1990s with the goal of improving

access to primary care services for all Americans nationwide. The strategy encompasses attracting and retaining

primary health care professionals to practice in underserved communities by fostering a relationship with them

early on in their education and sustaining that relationship

throughout their careers, even after their NHSC commitment has ended. It is believed that this long-term contact

that spans the professional life cycle of these individuals

will lead to greater access to quality health care for all. 

"We must begin early in the educational process to

attract more caring health professionals and remain in 

contact with these students throughout their lifetime of

learning," says Donald L. Weaver, M.D., director of 

the NHSC.

In the first stage of the continuum, the NHSC establishes

a relationship with school health careers programs in

order to foster the growth of a community-oriented

mind-set in aspiring clinicians at the pre-undergraduate

and college levels. In the second and third stages, the

NHSC works with students who are training as physicians, dentists, dental hygienists, nurse practitioners,

physician assistants, certified nurse-midwives, and mental and behavioral health professionals by sponsoring programs that offer hands-on experience in underserved

areas such as Student/Resident Experiences and

Rotations in Community Health (SEARCH). Through

SEARCH, students and other health professionals in training work on interdisciplinary health care teams providing

care in an underserved community where they can make 

a difference.

In the fourth stage, the NHSC serves as a support network for practicing clinicians in order to give them an

incentive to remain in an underserved area and also to

help them provide the best health care possible to their

patients. In the final stage, the NHSC uses the experiences of former NHSC clinicians, who are truly the "influencers" of the next generation, to improve the program. 

Students ‘Try Out’ Working With the Underserved 

SEARCH Program in Virginia Links the Community With Academia 

For some Virginia health

professions students, the

chance to work side by

side with a primary care clinician in an underserved

community has led to longterm rewards. Since the

inception of the student

rotation program, known as

Students and Communities

Exchanging Professional

Training, Experiences and

Resources (SCEPTER), at

least seven students have

been hired by their host 

rotation site. 

While these instances are

still few, the opportunity to

gain firsthand experience

providing health care 

services to underserved

populations in a small town

or rural setting can be a real

factor in how and where

students may eventually

practice. The challenges

they encounter are real, but

to many, the rewards are

often just what it takes to

solidify their commitment

to serving underserved

populations.

In 1994, the Virginia

Primary Care Association

(VPCA) established

SCEPTER as an official program and linked it to the

National Health Service

continued on page 9
ture. Some students, like

Allison Tobias, a nurse practitioner student, are quite

fortunate. She was sponsored by Mattiline Starks of

Bastian, Virginia, who also

took Allison into her home,

taught her about the community, kept her company,

and provided meals. At

another site, the local hospital offered SCEPTER students housing on an unused

floor, and, through its food

service, provided meals,

including bag lunches. The

hospital staff even helped

with the students’ laundry.

A partnership that 

benefits the underserved 

Ultimately, the SCEPTER

program makes everybody

involved a winner. For the

student, a SCEPTER rotation guarantees a wealth of

clinical opportunities within

a diverse set of patients.

And the experience of working as a valued team member with highly motivated

and creative health professionals is often the deciding

factor for choosing a career

in primary care and service

to the underserved. For the

medical and health care professions schools and programs, SCEPTER represents the best possible way

for a student to lock in the

skills and theory learned in

the classroom. For community health centers (CHCs),

having the student there

means having extra hands

to deal with the endless

details of an active worksive rotation. In addition to a

clinical preceptor, SCEPTER

tries to provide a community sponsor for each student

to help him or her understand and adjust to the local

lifestyle. 

During their 2- to 6-week

rotation, students conduct

patient histories and assessments for the physicians,

work with office staff,

review charts, and where

possible, spend time at a

public health facility such as

a well-baby clinic or family

planning clinic, and accompany a nurse or social worker on a home visit. Because

community involvement is

emphasized, students might

also speak at local schools,

provide blood pressure

checks for community residents, and attend civic

meetings. Some students

become inventive in what

they do during their rotation.

One student, for example,

took it upon himself to help

organize files and charts for

the clinic’s upcoming 

Joint Commission of

Accreditation of Healthcare

Organizations review. 

"My SCEPTER internship

offered a far more diverse,

up-close, and hands-on

opportunity for learning

about the integrated health

care delivery system than

other rotations," says former

SCEPTER participant 

Dan Woodford.

For many students, their

SCEPTER internship will be

the first time living and

experiencing life in a rural

area. They are provided with

reduced-cost or free housing—sometimes with a

member of the community.

The community sponsor

helps them understand the

community’s history and cul9

Alison Gilbert, P.A., has experienced both sides of a

SCEPTER rotation. As an NHSC Scholar, Gilbert did a

rotation in 1997 at Lunenburg Medical Center in

Victoria, Virginia, which then hired her after she graduated from Howard University. As a student, Gilbert

had been interested in practicing in a rural community, and her SCEPTER rotation, she says, "helped

solidify what I wanted to do." Now employed at

Boydton Medical Center, about 35 miles from

Lunenberg, Gilbert continues to work with the

underserved. As a preceptor to student Richard

Ulstead, she had the chance to "pass along the favor"

of a SCEPTER experience to another NHSC Scholar. 

Corps (NHSC) program

Student/Resident

Experiences and Rotations

in Community Health

(SEARCH). "It was a natural

partnership for us," says

George Deebo, VPCA’s

deputy director. "We have

always stressed providing

care through a primary

health care team—a major

focus of the NHSC program—and it also helps 

educate NHSC Scholars

about Virginia as a good

place to practice."

A wealth of experience 

in a short time

From its well-organized Web

site to its dedicated staff,

VPCA’s SCEPTER program

takes a thorough approach

to recruiting students for

community rotations.

SCEPTER targets Virginia’s

three medical schools, the

State’s physician assistant (PA)

and nurse practitioner (NP)

programs, and medical

schools in neighboring

States. To date, students

from 16 States, the District of

Columbia, and several international locations have completed SCEPTER rotations.

The program also reaches

out through its Web site—

which is linked to NHSC’s

site—by direct mailings to

NHSC Scholars, and by oneon-one networking. When

recruiting students, the staff

tries to carefully match each

recruit with a program that

will supply the experience

he or she needs. It also

offers students year-round

placement and some financial assistance to help

defray travel, meals, and

other expenses. Once

recruited, every effort is

made to ensure that students have a comprehenStudents ‘Try Out’ Working With the Underserved... continued from page 8

continued on page 10
10

place. This, in turn, translates into clinicians being able to

spend more time with their patients. Moreover, in many

instances, students strengthen the outreach capabilities of

the CHC by conducting community projects and patient education programs, such as conducting free blood pressure

screenings at local pharmacies.

For communities, the student placement program has

been invaluable to their recruitment efforts. Hiring a clinician

who is already a familiar face and known in the community

represents the best possible solution to matching need with

effective resources. 

"SCEPTER may be different from other programs because

we have reached out to students in other States to interest

them in practicing in Virginia," says Deebo. "Some resources

say up to 80 percent of Virginia physicians were trained out

of State." 

Along with those already hired by sites that hosted students, at least 15 additional SCEPTER students are working

in medically underserved areas outside Virginia.

"While PA and NP SCEPTER participants have been hired

by Virginia clinics, we are just beginning to see what effect

the program will have on physician students since they must

finish school, internships, and residencies before coming

back to practice," Deebo points out.

For the health centers, having students rotate through

their facilities can mean an added workload for staff.

Preceptors are responsible for working with students for 

40 to 50 hours a week and providing activities such as:

• Matching students with receptive patients for specific

learning activities such as taking patient histories or performing differential diagnoses

• Having non-patient learning activities available—slides,

audio cassettes, and working with lab technicians and

office staff 

• Having a daily "review" session to answer student questions and provide feedback on the student’s activities

• Introducing the student to colleagues and hospital staff

There are even health center directors who work to identify

community projects that students can do and leave in place

when their rotation ends.

SCEPTER program officials recognize the commitment

preceptors make in working with the students. To prevent

them from being overwhelmed by their added responsibilities and to "help keep the teaching relationship healthy and

enjoyable," SCEPTER provides support to them through a

variety of sources on its Web site. Preceptors are encouraged to assign students to other worthwhile educational

activities, including community interaction as part of the

overall SCEPTER experience. 

According to Andrea Arthur, VPCA’s coordinator of student

placements, the program tries to be sensitive to which sites

are asked to take students and how often. "We don’t want

our sites to burn out on accepting students," says Arthur. Up

to 40 students are placed each year, with preference going

to NHSC Scholars and then Virginia-based students. 

A taste of the future 

According to Deebo, the partnership with NHSC has

enabled VPCA to expand its services as NHSC provides

grants to student recruitment programs. In the future, he

hopes that the program will be able to increase mental

health and dentistry rotations. 

And for NHSC Scholars, SCEPTER provides the chance to

"try out" providing primary care to medically underserved

communities. As one Scholar noted after his SCEPTER rotation, "I do not know of any other opportunity that affords students that much variety in learning in a small enough setting

to take it all in and not lose touch with the patients."

For more information about VPCA and SCEPTER, visit 

their Web site at http://www.vpca.com or call Andrea Arthur 

at 1-800-966-8272, ext. 14. 

Working With the Underserved... continued from page 9

Oregon Campus Offers Support Network for Students

Committed to Working With Underserved Populations

Many students choose a

career in the health professions because they want to

care for the underserved—

the homeless, the poor,

those in isolated rural

communities. But often,

while students progress

through medical school,

their altruism and noble

intentions can become

blurred or even derailed

by the sheer workload and

a general feeling that caring for the underserved

can be difficult. 

Oregon Health & Science

University (OHSU) medical

students and nursing students, and students from

neighboring physician

assistant and nursing programs have found a way to

keep those ideals alive and

clear. During a yearly luncheon of several OHSU

National Health Service

Corps (NHSC) Scholars, the

attendees acknowledged

that other students on

campus were also interested in helping the medically

underserved. Why not get

them all together? 

And so they did. In 1998,

with the support of two

OHSU faculty—Rebecca

Landau, M.P.H., and Bruce

Goldberg, M.D.—the NHSC

students invited other interested first- and second-year

students to set up the

Association of Students for

the Underserved (ASU).

Landau, a former member

of the National Advisory

continued on page 11
11

Council on the NHSC, 

is an instructor in the

Department of Family

Medicine and a private consultant. Goldberg, an associate professor, is a former

NHSC Scholar. He and his

wife, also a former Scholar,

spent almost 6 years working on the Zuni reservation

in New Mexico. 

Matthew Breeze is

one of the association’s

founders. During his first

year of medical school, he

explains, he felt frustrated

because it was difficult to

find role models and other

students who felt the way

he did about wanting to

work with the underserved.

He now sees ASU as providing that support for students who share similar

values and ideals. “Person

after person would tell me

that they thought they

were the only one who

thought about working 

with the underserved,”

says Breeze. 

Now, incoming students

interested in working with

the underserved can join

ASU and find like-minded

students, faculty, and clinicians practicing in the community. “They don’t have to

spend the first year reinventing the wheel,” he

says. This support also

includes opportunities that

allow ASU members to participate in various community projects and to learn

about educational programs, including those of

the NHSC.

Breeze has also been

selected as a member of

the board of directors of

the Association of

Clinicians for the

Underserved. He provides

student input for this nonprofit interdisciplinary

organization whose mission

is to improve the health of

underserved populations by

enhancing the development

and support of clinicians

serving these populations.

Joining the ASU gave

Jonna Derbenwick a variety

of ways to help underserved people—not just

with health care. Through

the association, she worked

at the Clark Center, a rehabilitation center for homeless men; helped build and

paint houses; and cooked

for large groups of people.

“Although we weren’t providing health care, these

activities gave me a better

understanding of the challenges these people face

every day and an appreciation for other professions,”

explains Derbenwick. NHSC

Scholar Amber Sharp found

ASU supportive of the students in many ways, including providing access to

numerous faculty members

who are involved in underserved population issues.

Currently, more than 130

members—students, interested faculty, and community clinicians—are on the

group’s electronic mailing

list, which allows members

to stay connected and provides information on activities and lectures. In addition to regular evening

potlucks and discussions,

ASU students sponsor

informal discussions with

local clinicians who work in

community/migrant health

centers, volunteer for projects with groups such as

Habitat for Humanity, serve

meals to the homeless, and

help at local free clinics. 

The group has also held

formal lectures on campus

given by local and national

health care advocates,

including David Rutstein,

M.D., of the NHSC. The 

discussions are open to the

entire OHSU campus and

are well attended. 

To the ASU members,

their two faculty advisors

are good role models

whose commitment to the

association has helped it

remain cohesive and vital to

the community. Landau,

until recently, was the manager of program planning

and development for the

Oregon Area Health

Education Center (AHEC)

and currently serves on 

several committees of the

Oregon Primary Care

Association. Goldberg, in

addition to his faculty 

position at OHSU, is the

medical director at

CareOregon, which 

administers Medicaid 

managed care in Oregon. 

Both Goldberg and

Landau agree that ASU has

created a presence that is

recognized by the university

community. For example,

ASU was asked to participate in an OHSU anniversary program of the Center

for Ethics and Health Care. 

“It gives students the 

legitimacy to maintain their

focus on the underserved,

says Landau. In fact, ASU’s

reach has grown even

broader. “We’ve even 

had inquiries from other 

schools about our group,”

says Landau.

To learn more about the

Association of Students for 

the Underserved (ASU), 

visit the ASU Web site at

http://www.ohsu.edu/som-student/

Organizations/asu.html. 

Oregon Health & Science University medical students Ben

Gmelch (left) and Benton Fong help prepare a meal for 

the homeless men of Clark Center in Portland. This 

monthly activity is one of the ways in which they and 

their fellow members of the Association of Students 

for the Underserved get involved in helping 

underserved communities. 

Oregon Campus Offers Support... continued from page 10
12

The National Health

Service Corps (NHSC) has

long known that its

Scholarship Program is an

important catalyst for launching and sustaining careers in

health care for the underserved. However, a statistical

study, conducted by Howard

K. Rabinowitz, M.D., professor of family medicine at

Jefferson Medical College

(JMC) of Thomas Jefferson

University in Philadelphia,

Pennsylvania, demonstrates

that this premise is wellfounded in fact. 

As long-time director of the

school’s Physician Shortage

Area Program (PSAP) and former director of its third-year

family medicine clerkship,

Rabinowitz is uniquely qualified to study the characteristics

that define an effective clinician-community match for the

underserved. In a paper published in the Journal of the

American Medical Association (JAMA), Rabinowitz and his

colleagues, James J. Diamond, Ph.D.; Fred W. Markham,

M.D.; and Nina P. Paynter, B.S.; identified a set of five 

factors independently predictive of providing primary care 

to rural populations.1

These were:

• Growing up in a rural setting 

• Being enrolled in the PSAP program

• Having an NHSC scholarship

• Planning as an entering medical student to go into 

family practice

• Taking an elective senior practice rural preceptorship

Rabinowitz also found that overall, male gender showed a

small predictive tendency but for those students in the PSAP,

who entered medical school already committed to rural family practice, there was no gender difference.

The study also demonstrated that the likelihood of physicians choosing rural primary care service increased with the

number of predictive factors attached to them. What this

indicates is that a physician who had all of the factors was

roughly four times more likely to serve in a rural setting than

those with no predictors.

“Of particular interest to us,” Rabinowitz points out, “was

that most of the factors that emerged as significant were

identifiable before students were admitted to 

medical school.” 

This observation was also borne out in a prior Health

Resources and Services Administration (HRSA)-sponsored

study conducted on a nationwide sample of physicians who

graduated from U.S. medical schools between 1983 and

1984.2 Here Rabinowitz used a different methodology to

look at the predictive factors for generalist physicians’ 

service in underserved populations, both rural and urban.

In this study, the four self-reported predictive factors 

for providing care to underserved populations were:

• Growing up in an underserved area 

• Being a member of an underserved 

ethnic/minority group

• Having a strong interest in practicing in an underserved

area before attending medical school

• Having participated in the NHSC

For Rabinowitz, the implications of the findings in both

studies for the recruitment and retention of clinicians for

rural and underserved areas are wide-ranging.

“What we need are more physicians choosing careers in

underserved and rural areas,” he says. “If we know what

predisposes incoming students to this particular career path,

why not include these characteristics in our selection criteria

at the point of admission?” 

Rabinowitz notes that while socioeconomic status did not

emerge in either of his studies as a significant determinant

of eventual career choice, availability of financial support for

students coming from rural settings or underserved populations would always be an important issue. 

“Financial support, wherever it comes from, provides the

student with the freedom to follow a career path based on

personal and professional avocation rather than financial and

debt considerations.” What results, then, according to

Rabinowitz, is that the more financial support either in the

form of scholarships or a commitment to paying off loans

that can be offered to medical students with rural and underserved predictive factors, the more likely it will be that they

will practice where they are most needed.

1. Howard K. Rabinowitz, et al., “Critical factors for designing programs to

increase the supply and retention of rural primary care physicians.” Journal of the

American Medical Association, September 5, 2001, v. 286, no. 9, pp. 1041–1048.

2. Howard K. Rabinowitz, et al., “The impact of multiple predictors on generalist

physicians’ care of underserved populations.” American Journal of Public Health,

August 2000, v. 90, no. 8, pp. 1225–1228. 

Study Findings Indicate NHSC Scholarship Predictive 

of Commitment to the Underserved

In a study published in

JAMA, Howard K.

Rabinowitz, M.D., and his

colleagues at Jefferson

Medical College in

Philadelphia concluded that

having an NHSC scholarship increases the likelihood that physicians will

choose to practice primary

care in a rural area.
13

Special News: What Happens When an NHSC

Clinician Is Called to Active Duty? 

Some NHSC clinicians with service obligations who

are also in the military Reserves have been notified that

their Reserve units may be activated. Clinicians called

to duty must send a copy of their notification letters to

the NHSC In-Service Support Branch. Their NHSC commitments will be suspended for the period of time

while on military duty. It will be up to the individual site

to hold the position for the clinician. When the clinicians

are released from active duty, they must send a copy of

the release to the In-Service Support Branch. Once clinicians resume full-time employment, their NHSC service end dates will be recalculated to reflect the time

they were absent. It is important to note that the time

clinicians spend serving their military duty does not

count toward their NHSC commitments. Contact information for the In-Service Support Branch is: 

National Health Service Corps

In-Service Support Branch

4350 East West Highway, 8th Floor

Bethesda, Maryland 20814

Telephone: 1-877-605-5349

Fax: 301-594-4077

Bright Futures Case Studies for Primary Care

Clinicians Now Available

Bright Futures is a series of manuals designed to

help clinicians who work with children and adolescents

build partnerships with their patients’ schools, families,

and communities. Three new volumes are now available: A Guide to the Case Teaching Method: Growth in

Children and Adolescents, Child Development and

Behavior, and Adolescent Health. These manuals translate clinical guidelines into useful training modules for

health care professionals. They include case narratives,

teaching guides, and other useful materials, such as

growth charts. The case studies encourage clinicians 

to discuss and explore the best ways in which they 

can work with patients and their families, promote

patient health and safety, solve problems, and 

diagnose conditions. 

Bright Futures is supported by the Health Resources

and Services Administration’s (HRSA) Maternal and

Child Health Bureau and the Genentech Foundation for

Growth and Development. It was developed by the

Bright Futures Center for Pediatric Education in Growth

and Development, Behavior, and Adolescent Health at

Children’s Hospital in Boston. To order copies, 

call 1-888-ASK-HRSA.

New Resources Address African American Health

A new Web site launched by the Congressional Black

Caucus Foundation, www.cbcfhealth.org, provides 

information about public health issues that affect

African Americans.

Another resource for African Americans is the new

national radio campaign, “Closing the Health Gap,”

which is made possible by a partnership of the

Department of Health and Human Services and the

ABC Radio Networks. This campaign provides lifestyle

tips and information on local sources of health care and

public health programs to help inform, challenge, and

empower African Americans to take charge of their

health. Visit the campaign’s Web site at

http://www.healthgap.omhrc.gov/ for more information. 

Empower Your Patients

Five Steps to Safer Health Care and its companion

piece in Spanish (Cinco Recomendaciones para Recibir

una Mejor Atención Médica) provide patients with the

tools for making them active members in their health

care and their health care team. These easy-to-read 

fact sheets will be welcome additions to your health

promotion activities. The English version can be

accessed at http://www.ahrq.gov/consumer/5steps.htm,

and for Spanish go to http://www.ahrq.gov/consumer/

cincorec.htm.

New Resource Helps Clinicians Put 

Prevention Into Practice

The Agency for Healthcare Research and Quality’s

(AHRQ) Put Prevention Into Practice program has

released A Step-by-Step Guide to Delivering Clinical

Preventive Services: A Systems Approach. This guide

will help health care professionals develop a system for

delivering clinical preventive services in the primary

care setting.

To learn more about the guide and the Put

Prevention Into Practice program, visit the AHRQ Web

site at http://www.ahrq.gov/news/press/pr2001/

steppr.htm. You can also download copies of the

resource guide at http://www.ahrq.gov/ppip/manual/

manual.pdf, or get copies by calling 1-800-358-9295.

NHSC Resource Corner
14

On any given lunch hour, somewhere in a southern New

Hampshire health care unit, clinicians gather together to

hone their skills in a particular subject area. Between bites

of a sandwich, they might be participating in a simulated

patient encounter, reviewing their current diabetes care

processes, or getting a heads-up on the dynamics of

domestic violence. At the end of the session, it’s back 

to the real world where chances are great that they will

encounter a patient that very day whose case will draw 

on these recently learned skills.

The Lunch & Learn series is only one of the educational

activities sponsored by the Southern New Hampshire Area

Health Education Center (SNHAHEC). And the practicing

clinicians are only one of their target audiences.

SNHAHEC organizes and facilitates an impressive array 

of well-organized programs and educational experiences

for health professions students, practicing clinicians and

their administrators, and community middle and high

school students.

Established a mere 5 years ago, SNHAHEC came into

existence under a federally funded initiative of the Public

Health Service Act. According to Section 781 of the Act,

the purpose of an Area Health Education Center (AHEC) is

“to assist health professional schools to improve the distriNew Hampshire AHEC Combines 

to Ensure Top-Notch Health Care

bution, quality, utilization, and efficiency of health 

personnel in scarcity areas through the efficient use of

regional educational resources.” Although initially funded

and supported through grants administered by the Health

Resources and Services Administration (HRSA) of the U.S.

Department of Health and Human Services (DHHS),

AHECs are expected to evolve into self-sufficiency within

5 years as integrated entities, drawing financial support

from local, State, national, and private funding. 

In order to achieve fiscal independence, AHECs develop

dynamic partnerships and collaborative relationships with

all levels of government, educational institutions, local and

national health organizations, and private businesses. In

fact, it is this directive to become self-sufficient that eventually positions AHECs at the epicenter of the Nation’s,

the State’s, and their communities’ health care activities.

New Hampshire's AHECs were born out of a collective

vision of the State's community health centers (CHCs),

including Lamprey Health Care, the State's oldest and

largest CHC, and two of its academic institutions. For a

long time, CHCs had wanted to add professional education to their programs and activities as a means of recruiting and retaining clinicians. They determined that fortifying

their relationships with academic institutions through an

AHEC intermediary would strengthen their ability to

attract health care professionals to underserved areas in

The Southern New Hampshire Area Health Education

Center (SNHAHEC) shares office space with Lamprey

Health Care as an independent yet interconnected entity

with its own advisory committees at local, State, and multidisciplinary levels. Lamprey, a National Health Service

Corps site, is the State's oldest and largest community

health center.

"The Corps has been an intimate

part of the birth and growth of

Lamprey Health Care. The NHSC

helped us recruit the critical

mass of clinicians who were

instrumental in Lamprey's longterm success."

—Ann Peters, executive director of Lamprey

Health Care in Raymond, New Hampshire,

which has been in operation for more than

30 years
15

Forces with Education Institutions

for Underserved Communities

New Hampshire. A collaborative effort between the CHCs,

University of New Hampshire, and Dartmouth Medical

Center soon led to the birth of the northern and southern

New Hampshire AHECs. It was this partnership that propelled SNHAHEC into existence.

SNHAHEC was established in 1997 and settled into

Lamprey Health Care’s Raymond medical office so that it

could share the community health center’s well-established administrative infrastructure as well as its office

space. Representatives from the collaborative group

recruited Paula Smith to serve as its director and made

sure that it would develop as an independent yet connected entity with its own advisory committees at the local,

State, and multidisciplinary levels. 

Five years down the road, the founders are quick to

admit that SNHAHEC has grown well beyond their original

vision. Through its mission “to develop, promote, and

coordinate community and academic multidisciplinary

partnerships for health professions education” and with a

special focus on underserved communities, it has managed to work itself deeply into New Hampshire’s health

care education and health promotion fabric.

Within SNHAHEC’s mission statement, one that Smith

would like to pare down to a short and snappy “mind

byte,” are three distinct areas of focus: 

• Facilitate continuing education for clinicians in the field 

• Provide clinical and community placement support for

area health professions students

• Direct promising middle and high school students 

into health careers and promote diversity in health 

careers training

A large part of SNHAHEC’s facilitation function involves

taking on the lion’s share of administrative duties for

organizing and running programs for those institutions and

organizations that participate in their programs. In the

words of Debra Nichols, SNHAHEC’s program manager,

“We like to think of ourselves as exercising a clearinghouse approach with our partners and target audiences.

With all of our programs and initiatives, we remove the

administrative responsibilities of enrollment, venue, and

continuing education credits from our clients so that they

can concentrate fully on developing the skills that will 

benefit their patients.”

In the spring of 2001, SNHAHEC hosted its first-ever

“Champions in Health Care” event at the Frisbie Memorial

Hospital Community and Education Conference Center.

Designed to bring together health care professionals, students, and other community members to foster health

career awareness, SNHAHEC also used the evening as an

opportunity to recognize some outstanding achievers.

Community participation was again highly encouraged as a

team of objective reviewers from southern New

Hampshire assisted the AHEC by reviewing all entries and

choosing the award recipients.

With five awards presented that evening, Lamprey

Health Care was delighted and honored to have its own

Rosemary Smith, advanced registered nurse practitioner,

presented with the Preceptor of the Year award. 

To Ann Peters, Lamprey’s executive director, watching a

member of the Lamprey Health Care team step up to the

podium was an affirmation of the importance of this integral piece in the delivery of top-notch health care to all residents of southern New Hampshire. And to Paula Smith, it

was a powerful symbol of the importance of community

partnership and collaboration in renewing and replenishing

the health care professional resource for the State. 

Lamprey Health Care’s Rosemary Smith, an advanced registered nurse practitioner (right), receives the “Preceptor

of the Year” award at SNHAHEC’s first-ever Champions in

Health Care night. Presenting the award is Tiffany Terrill,

AHEC health career and promotion coordinator. 
The NHSC Vision

The National Health Service Corps (NHSC) is committed 

to improving the health of the Nation’s underserved:

• Uniting communities in need with caring 

health professionals

• Supporting communities’ efforts to build better 

systems of care

The NHSC provides comprehensive team-based health

care that bridges geographic, financial, cultural, and 

language barriers. We will not stop until all Americans,

everywhere, have access to quality health care, especially

for health issues that have the highest racial, ethnic, and

socioeconomic disparities in treatment success: HIV/AIDS,

mental health, dental care, cardiovascular disease, 

cancer, diabetes, childhood and adult immunizations, 

and infant mortality.

Because the NHSC is part of the “access agency”—the

Health Resources and Services Administration (HRSA)—

we work closely with other HRSA bureaus and programs

to recruit primary care clinicians for communities in need. 

Through our combined efforts, we are seeking to provide 

access to care for upwards of 53 million Americans who

might otherwise do without.

Our strategies for achieving our goal include:

• Forming partnerships with communities, States, 

educational institutions, and professional organizations.

• Recruiting caring, culturally competent clinicians for

communities in need.

• Providing opportunities and professional experiences

to students through our Scholarship and Loan

Repayment Programs and our SEARCH

(Student/Resident Experiences and Rotations in

Community Health) program.

• Establishing systems of care that remain long after 

an NHSC clinician departs.

• Shaping the way clinicians practice by building a 

community of dedicated health professionals who 

continue to work with the underserved even after 

their NHSC commitment has been fulfilled.

DEPARTMENT OF HEALTH & HUMAN SERVICES

U.S. PUBLIC HEALTH SERVICE

HEALTH RESOURCES AND SERVICES ADMINISTRATION

BUREAU OF HEALTH PROFESSIONS

NATIONAL HEALTH SERVICE CORPS

RECRUITMENT/RETENTION MARKETING PROGRAM

SUITE 300

6101 EXECUTIVE BOULEVARD

ROCKVILLE, MD 20852

——————————————

Official Business

Penalty for Private Use $300

VISIT NHSC’S WEB SITE! 

http://nhsc.bhpr.hrsa.gov/

First-Class Mail

Postage and 

Fees Paid

PHS/HRSA

Permit No. G-286