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UNIV OF RHODE ISLAND COLL OF NURSING
MED UNIV OF SOUTH CAROLINA COLL OF MEDICINE
UNTY OF SOUTH CAROLINA COLUMBIA NURSE PRACT
MED UNIV OF SOUTH CAROLINA
UNIV OF SOUTH CAROLINA
UNIV OF SOUTH CAROLINA COLL OF SOC WORK
UNIV OF TENNESSEE KNOXVILLE NURSE PRACT
UNIV OF TENNESSEE KNOXVILLE
UNIV OF TENNESSEE KNOXVILLE AUDIOLOGY/SPEECH
BAYLOR UNIV DENTAL SCH
UNIV OF WISCONSIN MADISON SCH OF SOC WORK
WEST VIRGINIA COLL OF OSTEOPATHIC MEDICINE
Senator BUMPERS. I assume you do not talk to students about Corps scholarships until you are reasonably certain they are going to be admitted by some medical school. Is that correct?
Dr. GASTON. Yes; that is correct.
Senator BUMPERS. You cannot just find someone and give them the money before you know whether they are going to be admitted
Dr. HARMON. No; they must be admitted to a medical school.
Dr. GASTON. There is an established process through which they apply, and are interviewed. There is an application designed to really see, No. 1, who is going into primary care, because it is important to be sure that we are supporting the family doctors, the internists, the obstetricians, the pediatricians.
That process also seeks to determine who is more likely to serve the underserved and not go into a high-tech subspecialty. So based on a number of different factors that are ascertained during the interview, scholars are ranked and go on a scholarship list.
Then the next step in the process, following completion of training, is that they match to a specific site from a list of available sites in high-priority, underserved areas.
Senator BUMPERS. Of the 71 scholars in 1990, how many were minorities?
Dr. GASTON. In 1990, 44 percent were black, 11 percent were Hispanic, 1 percent was an American Indian, and 4 percent were Asian.
Senator BUMPERS. Forty-four percent or forty-four people.
Dr. GASTON. Forty-four percent.
Senator BUMPERS. And Hispanic were 12?
Dr. GASTON. No; 11 percent; 4 percent were Asian; 34 percent were white; and 6 percent were unknown.
Senator BUMPERS. I am not sure I understood the process a while ago. If somebody comes to you and says, look, I am not interested in making money. I want to be in the Public Health Service, or I want to go into unserved areas, or the inner city, or the Mississippi delta, or whatever, that is the first consideration, I take it. At least it is a primary consideration with you in awarding a scholarship, right?
Dr. GASTON. Yes; the first consideration is that they go into a primary care specialty.
Senator BUMPERS. But of course they have to be needy, I guess. They have to need the money.
Dr. GASTON. Yes; that is a consideration.
Senator BUMPERS. Do you have an income criteria?
Dr. GASTON. Yes; former exceptional financial need [EFN] scholarship recipients have preference.
Senator BUMPERS. Of a household, just like we do on Pell grants and so on?
Dr. GASTON. Yes; because we give preference to former EFN scholars.
Senator BUMPERS. I will tell you what I am driving at. If you have minority students in my State who qualify for this, I do not want them to feel obligated to go out of State. I want them to feel
free to go to the University of Arkansas Medical School. Do they have to have been admitted or accepted to a medical school before you will talk to them? I never did get that straight in my mind.
Dr. GASTON. Yes; they have to be in a medical school before they can even apply. And you know, it is very difficult. Let me just take 1 minute and talk about this.
Last year we received over 1,000 applications for scholarships, and we could only award around 70, so that it is very difficult. As we experience increased funding for recruitment, we can begin to award more scholarships and make more placements. We have had to make very hard decisions with the limited resources we have had in the last several years.
NHSC PLACEMENT SITES
Let me also add that there are priorities, in terms of the sites where scholars can place, those are prioritized according to the highest need areas. We have to make hard decisions on that side, too, in terms of what sites get on the list. There is a three-step process in terms of deciding. First, where are the HPSA's, the health professional shortage areas. Then we prioritize those HPSA's based on high infant mortality, low birthweight, access, poverty to develop a more restricted listing. This listing is further prioritized after that, the high priority HPSA's, into the high priority sites to which obligors match for service.
Senator BUMPERS. Well, where do the doctors, for example, who graduate from Howard Medical School, where do they go to practice? You have plenty of areas right here in D.C. that are considered underserved? Do you have National Health Service Corps doctors here in the District?
Dr. GASTON. Yes; we do have a few placements. Let me just say that, historically, when you look at the data, minority students are more likely to go into primary care, as compared to other students. Minority students are also more likely to go to an underserved area, and certainly more minority students are in need of scholarship and loan repayment help.
Let me also mention, too, that if you want to talk about Meharry, which is another school where we have scholars, they emphasize service to the underserved, so that their students are already being trained in that arena, and a high percentage of the Meharry graduates do go into unserved areas, especially into the rural areas of the South.
Senator BUMPERS. Well, I do not want to pursue this too long, but first of all I am a great champion of this program. There are areas in Arkansas that would be totally unserved, if not for Corps doctors. But I am concerned about what proportion of the applications you received last year were from applicants who deserved funding.
Dr. GASTON. The majority of them would have been funded. Some of those 1,000 applicants did not indicate a commitment to primary care and service to the underserved and we would not have funded them.
Senator BUMPERS. Boy, it is a tragedy we do not have the money to do that.