How a unique Peoria medical program introduces students to rural medicine
The decline of professionals practicing medicine in rural America isn't a new one. Rural hospitals around Illinois and the nation are eliminating services or closing altogether amid staffing and financial difficulties.
The long-running Rural Student Physician Program at the University of Illinois College of Medicine Peoria introduces third-year medical students to working in a rural setting - and hopefully, becoming inspired to start a career there.
Dr. James Barnett is the director of the program. He spoke to WCBU's Tim Shelley. This interview was lightly edited for length and clarity.
BARNETT: We're trying to increase the interest in placing physicians in rural areas, first of all in Illinois, but in other areas, as well. And also the awareness for other physicians about what it's like to be in a rural setting.
So what are some of the challenges historically, of bringing doctors to rural settings?
About 20% of the population lives in a rural setting, and 10% of doctors work there. So there's kind of a, I suppose, drain of doctors away from there. And perhaps it's the perception there's not as much to do or, or maybe there's more demands. So those are some of the barriers that we have.
I kind of think of the old example of the country doctor. I mean, you don't really see that too much anymore, the doctor who comes to a rural community, and they stay there for decades.
Not as much, but as I go around rural Illinois, there certainly are those doctors, and there are a few that still practice all the aspects of family medicine.
So for young people who are just starting their careers, what do you tell them to demonstrate to them that practicing in a rural area could be valuable to them?
I think what the goal of our program is not just what to tell them, but to what to experience. So they get out for six months, and in one of the very formative times of medical school education in their third year, and work alongside the physicians that are there and see how fulfilling it is. And I think it's the experience that convinces them what the value of it is.
So when they're there, they're living in this community, they're working in this community, they're really becoming a part of this community for six months.
Exactly. They, for the most part, all move into the community and work alongside up to about five physicians, and in a sense, have a return to an apprenticeship type of experience, and discover the rewards of loving a community loving the patient, seeing them multiple times, often maybe not experienced as much in an urban setting.
How long has this program been going on? And what kind of results have you seen from it?
We started in 1997. There's been a lot of, especially recently, I think, returns from our students into rural settings. Overall, our percentages aren't that high. In he rural setting, they're about 25%. So we're certainly not at the norm of the 10% low, but we're trying to move higher than that.
So about 25% of the students who enroll in this program go on to practice in a rural setting. Is that about where you'd like to be goal wise? Would you like to see that increase?
I'm looking closer to 50%. Yeah, I think that's more realistic. There's so many influences on a person's time. And we take students, not just like (those who) grew up in a rural setting, but those that have grown up in urban settings. So trying to create an opportunity for those who haven't been rural just to get a vision for it.
What are some of the differences between practicing rural medicine and urban medicine?
I think that, you know, one of the one of the issues, for instance, is having enough support, let's say for obstetrics, obstetric practice. That's one of the struggles that's going on right now.
There's hospitals across the nation that are stopping their obstetrics practice for probably for various reasons, whether it's not financially feasible or they don't have the support they need for either backup for enough gynecologists for instance in the area, or family physicians doing obstetrics, or even the pediatric support when the child is delivered.
So that's one of the challenges getting enough support where you have enough surgeons there to support each other. There's a whole shift nowadays from the tradition single family doc that does inpatient work and outpatient work. And now there's kind of a shift to hospitalists. But having an adequate crew of all those folks, is a real challenge, though.
And the obstetrics issue you mentioned, that seems to be a real problem in a lot of rural areas, with those departments, and in a lot of cases being cut altogether from rural hospitals.
It does shift our rural population to having to drive pretty far sometimes to get the care they need.
And I guess that's the problem. If you have to drive 50 miles for care, that can be a significant barrier.
And I think that various entities in government see that. And so there's different programs, probably many I'm not familiar with, but there's critical access hospitals, for instance, that you get enhanced reimbursement to stay in the more rural sites so that our rural neighbors don't have to drive so far.
So for a doctor who's looking to participate in the rural medicine program, or maybe even one who hasn't even considered it yet, what's your pitch to them on why this is a worthwhile thing for them to do?
First, I think it's, we we should be considering serving in areas of need. And so this is just a wonderful opportunity to see, well, what is it like to work in an area where there's more need for physicians.
Rural areas aren't the only places but exposes a student to that area, but also, we have a unique aspect in our program of being able to work one on one with a few physicians for six months. And these days, that doesn't usually happen, where you develop such deep relationships with your teachers. And I think there's just generally a lot of good that comes from that.
And then that extends out to your patients because you see multiple patients back in the clinics or see them in the clinic and then in the hospital, or out in the grocery store or something. But there's a an opportunity to just develop that love for not just your teachers but your patients and even the whole community. So I think it's pretty unique.