The availability of primary health care services is an growing concern of New York's rural citizens. Many rural country doctors are approaching retirement age, while most graduating physicians choose high tech specialties rather than primary care. In November 1989, a statewide conference examined the role of New York State medical schools in addressing the shortage of physicians in rural areas. This proceedings presents the perspectives of state legislators, medical educators, rural physicians, and the New York State Commission on Graduate Medical Education, including recommendations on physician reimbursement, practice site development, and physician training. Five model programs or strategies for training and recruiting rural physicians were described: (1) the remote campus at Binghamton; (2) selective medical school admissions policies favoring rural residents; (3) the extended rural preceptorship to give medical students experience at rural training sites; (4) state government initiatives in Texas; and (5) Michigan State University's comprehensive program in the upper peninsula. Three workshop reports focus on medical school curriculum, selective admissions, and physician recruitment and retention, with recommendations about a comprehensive approach to increasing the availability of rural primary care physicians. This proceedings contains maps and charts covering availability of primary care and rural-urban differences. Appendices contain background reading materials, symposium participants, rural-urban classification of New York counties, and a summary of relevant New York state legislation. (SV)