September 19, 2013
By April Blackmon
|Mary Beth Miller, M.D.; Kathy Ross-Biggs; and School of Medicine student Caitlin Butler at the Cheyenne County Clinic in St. Francis, Kan.|
Scott Rempel, a second-year student at the University of Kansas School of Medicine campus in Salina, has always thought he wanted to be a rural primary care physician. So this past summer he went to Quinter — a northwest Kansas town of about 1,000 — for a firsthand look at what it's like to be a small-town primary care doctor. After six weeks of working alongside Shelly Gruenbacher, M.D., and Doug Gruenbacher, M.D., both family physicians at Bluestem Medical and Gove County Medical Center, Rempel left knowing what his future holds.
"After this summer, I hope that my future wife — wherever she may be — is OK with living in a nice, quiet rural town somewhere in Kansas because that's where we'll end up!" Rempel says.
Rempel and 28 other KU School of Medicine students signed up for the summer Rural Primary Care Practice and Research Program, an elective rotation for medical students between their first and second years that helps them experience life as rural Kansas physicians.
Now in its 21st year, the program involves clinical training and academic research in rural primary care settings throughout the state. This summer, students traveled to 26 communities — as far west as St. Francis and Meade and as far east as Marysville and Pittsburg.
After an initial week of clinical orientation and research training at the KU Medical Center's Kansas City campus, students attended the Kansas Academy of Family Physicians annual meeting in Wichita. Students then spent the next six weeks working at clinical sites with preceptors, or physician mentors. For their research project, they gathered data on adaptive strategies used by communities to overcome rural Kansas health care shortages.
"The true richness of this program is the rural clinical experience," says Michael Kennedy, M.D., KU School of Medicine's associate dean of rural health education and the program's new director. "The students see that they don't have to live in professional isolation or deal with antique equipment and only see patients with runny noses. What they see are doctors banding together, state-of-the-art facilities and a wider range of pathology than one can imagine, treated competently by well-trained physicians and robust health care systems. This experience also helps them decide if a rural physician lifestyle is for them."
Jessica Huff says her experiences also affirmed her decision to practice family medicine in a rural community. Huff grew up in Horton, Kan. — a town of less than 1,800 — and says she knows the importance of a quality family physician to a small town. She spent her summer in Holton, about 30 minutes away from her hometown, with Malia Warner, M.D., a family physician at Holton Community Hospital. After sitting in on well-child checkups with Warner, Huff began seeing some patients on her own.
"I was rather apprehensive at first, as I have no children of my own," says Huff, a student at the Kansas City campus. "I began to counsel new parents on the dos and don'ts of childhood — when to start foods, what the newest guidelines stated and why immunizations were so important. These parents, well most of them anyway, listened intently. Some took notes even and trusted my judgment. Although this isn't necessarily a huge deal, it's when I realized that family medicine is exactly where I'm supposed to be."
Several students, including Mercedes Hoffman, say their preceptors left lasting impressions. Hoffman, who studies at the Salina campus, worked with Myra Long, M.D., a family practice physician at Salina Family Healthcare.
"I was able to get to work in a great clinic and hospital with a great mentor," says Hoffman, a native of Larned, Kan. "Rural doctors are amazing people who love what they do and work hard every day to provide excellent care to the people in their communities. I have gotten to see firsthand the dedication that these physicians have. This experience was wonderful."
Most physicians included the students in their personal lives as well, introducing them to family, friends and community members.
"Not only did I have a top-notch medical education experience, but I also received an immediate warm welcome by the entire community that persisted and grew throughout the summer. Even in my down time, I was always busy doing something with somebody from town. I truly felt like I was a part of the community and Quinter family and know that I will always have lifelong friends as a result of my six weeks there. And all this came from a town where I personally knew no one within a 90-mile radius before I showed up," says Rempel, a native of Newton, Kan.
The doctors who volunteer to work with these students, both personally and professionally, are truly what make this program successful, Kennedy says.
"We are so grateful for the participation of physicians throughout the state and want to be sure that they realize that we are all, from students to faculty researchers, in their debt," he says.
The program provides an invaluable experience, and Rempel, Huff and Hoffman all say they highly recommend this program to every medical student.
"I think everyone should experience what it's like to work in a rural region," Hoffman says. "The continuity of care that is seen in rural primary care medicine is wonderful, and it is a huge part of what this program has to offer. I think rural medicine has so many more benefits that one cannot possibly imagine unless they experience it themselves."
The Rural Primary Care Practice and Research Program is funded by the KU School of Medicine, the Sutton Family Rural Primary Care Fund, the Kansas Academy of Family Physicians Foundation and Baker Trust of Lacrosse, Kan.