Access to health care remains one of the most pressing challenges in Alabama’s rural communities. Many residents travel long distances to see a doctor or specialist, and shortages of primary care providers continue to affect both patient outcomes and quality of life.

Irfan Asif, M.D.

In honor of National Rural Health Day, celebrated on November 20 this year, the Heersink Office of Access and Engagement spoke with Irfan Asif, M.D., chair of the Department of Family and Community Medicine, associate dean for Primary Care and Rural Health, and co-director of the UAB Comprehensive Healthy Living Research Center, to learn how UAB is expanding care and strengthening the state’s primary care workforce.

Clinics, Training, and Real-World Impact

According to a 2024 Kaiser Family Foundation (KFF) report, Alabama ranks among the lowest states in the nation for primary care physicians, with just 122.5 per 100,000 community members. In response, Asif says UAB has a multifaceted approach to bring care closer to home and to train the clinicians who will remain there. They’ve also opened new primary care clinics and partnered with existing practices to extend services into communities that otherwise would face long travel times.

“We hope to get into different rural communities,” Asif said, noting that clinics such as Gardendale and Leeds draw significant numbers of patients who live in rural areas.

Those clinics are more than places for appointments; they are also local centers for innovation. UAB works to connect research and practice, offering tools that enable clinics to perform more procedures on-site. Asif highlighted practical examples, such as cameras for diabetic retinopathy screening that can be embedded in a clinic, eliminating the need for an ophthalmology visit, and programs for remote monitoring of diseases.

“We have a practice-based network, and many of our research and scholarly innovation ideas go to support those clinics,” he said.

Medical Residents

Across programs based at Cahaba-UAB, Huntsville, Tuscaloosa, and UAB St. Vincent’s East, UAB trains roughly 175 residents who are headed into family medicine, internal medicine, and medicine-pediatrics, all routes into primary care.

Another key part of that training landscape is the UAB Selma Family Medicine Residency, one of the few true rural residency programs in the nation. For more than 45 years, the program has trained family physicians in a fully rural, community-based setting, linking UAB’s academic resources with hands-on experience at Vaughan Regional Medical Center, the referral hub for seven surrounding counties. Its long-standing presence and strong match history make it a critical pathway for preparing clinicians who want to practice in rural Alabama.

Medical Students

At the medical student level, the Comprehensive Urban Underserved and Rural Experience (CU2RE) Program gives future physicians early and continuous exposure to primary care. CU2RE is an enriched program designed to prepare students for careers in family medicine serving medically underserved urban and rural areas of Alabama. Participants receive specialized training in areas including interprofessional care, behavioral health, social risk factors, practice transformation, and telehealth.

“In the CU2RE Program, students start working in a clinic within their first year,” Asif explained. Participants are assigned a small patient panel that they follow across medical school, learning chronic disease management, motivational interviewing, and the importance of continuity.

“They get 10 patients that are their own, and they work with that 10-patient panel throughout their four years,” Asif shared. That long-term relationship building, he said, is a major reason many students decide to practice in the communities where they trained.

Regional campus programs reinforce that effect. Tuscaloosa’s Rural Medical Scholars Program, along with its Primary Care Track, gives students early, focused exposure to primary care, an approach that is still unique among medical schools.

Meanwhile, Huntsville’s integrated family medicine residency program allows fourth-year medical students to commit to a local residency early, with many even receiving scholarship support for doing so. This model not only strengthens their training, but also increases the likelihood that graduates remain in the surrounding communities.

“They’ve had 24 students who’ve opted to do that program, and 22 have actually stayed in Alabama,” Asif said.

Research

In addition to student training, UAB strengthens rural care through research initiatives that directly support these clinics. The Comprehensive Healthy Living Research Center is a key partner in this work, providing a robust infrastructure for chronic disease prevention and control through community-engaged and population health approaches. The center collaborates with community members, leaders, and organizations to develop and lead interventions that communities will trust.

Selma Clinic residents and staff providing screenings at 11th annual Get Fit Selma Health Fair

“The Comprehensive Healthy Living Research Center has amazing partnerships,” Asif said. “They are a great resource for engaging the community and co-designing projects that are done to build trust and to make sure that the impact and effectiveness of research programs are the highest possible.”

That community-centered approach also informs HEART-NET, the Health Enhancement through Access and Research in Transformative Networks. Born out of the NIH CARE for Health initiative, HEART-NET links primary care practices across Alabama, Mississippi, and Arkansas to conduct practical, clinic-based studies. By connecting research directly to patient care, HEART-NET ensures that innovations reach rural communities where they are most needed.

Asif said the network’s current projects focus on conditions that are common and burdensome in rural areas—including diabetes, hypertension, hearing loss, and obesity—so that the findings are immediately relevant to the communities participating in the work.

He compared the model to what cancer centers have done for decades, translating innovations from research into care that reaches patients where they are. HEART-NET aims to bring that same approach to primary care, ensuring rural clinics can access tools, resources, and research opportunities typically concentrated in larger centers.

Taken together, these clinics, training programs, and research networks form a coordinated strategy: make care easier to reach, make clinical teams stronger, and make research more relevant to the people it is meant to help.

2025 Rural Primary Care Health Summit panel

A path forward for rural communities

Asif is candid about the work that remains. Broadband gaps, funding limitations, and broader workforce shortages still shape what is possible on the ground. At the 2025 Rural Primary Care Health Summit, he said, stakeholders from hospitals, community organizations, policy, and clinical care came together to identify shared priorities, including technology and sustainability.

“My goal is to address that primary care shortage and to improve health outcomes,” Asif said. “We’re going to have to partner with as many people as we can to make that happen.”

National Rural Health Day highlights the importance of rural care, and UAB’s combination of clinics, training pathways, and community-engaged research demonstrates a practical, place-based path forward. The focus on relationship-based care and on training clinicians where they will serve points to a future where more Alabama residents can see a doctor close to home, and where local communities are supported by clinicians who know them well.

“I feel optimistic because of the work that’s already in motion and the people who are partnering with us to support primary care,” Asif said. “We want to support communities in the best way possible, and that means building relationships that last.”