When WSU’s second-year medical students came back for the new academic year last month, they were sent out on a road trip. Before I continue, I should explain that, even though the 60 students in that class will study in Spokane this year, they’re formally assigned to four WSU campuses. So the home campus for 15 of them is Spokane, 15 are assigned to the Tri-Cities campus, 15 to Vancouver and 15 to Everett. For the road trip, the 15 Spokane students spent a week in hospitals and clinics in towns like Davenport, Colville, Usk and Pullman.
“I often joke that I came out of the womb with a Coug onesie on,” said medical student Erik Stiles.
Stiles is Coug though and through. He received a nursing degree from WSU and, as it turns out, his timing when applying to medical school was pretty good. Last year, he was accepted into the university’s inaugural medical school class.
“Our first week back, we were thrust out into the communities and it was a really nice way to get back into the mindset of school and I was actually out at Davenport, at Lincoln Hospital, and I was slotted into the ERs with one of the PAs out there and we just started seeing patients," Stiles said. "I’ll tell you, the remarkable thing, nobody was looking up a history. They knew everyone that came into the hospital at the drop of a hat. That was a very stark difference between my experience working in urban care centers, as well as family practice in the city.
That’s Stiles’s comfort zone. He’s from Lacey, suburb of Olympia, so spending a few days immersed in Davenport gave him a real education.
“I had no idea what goes on out in rural settings and this opportunity showed me that general practice doctors like family medicine doctors, they have an entirely different job in the rural setting than in an urban setting. They’re doing small procedures and triaging patients and managing in-patients, as well as an ER, while doing their own clinic and seeing upwards of 20 patients a day," Stiles said.
"You can see that they’re extremely busy, but their scope is also quite a bit wider. It’s a very attractive opportunity to both help a community that you live with, but then also do all kinds of things. I don’t know that I would ever get bored,” he said.
That’s the attraction of rural medicine, one that medical educators readily admit isn’t for everyone. Stiles says he looks forward to going back to Davenport for a week in December and a week in April.
Dr. Fred Reed was one of Stiles’s contacts in Davenport. He’s the chief of staff and a family medicine doctor at Lincoln Hospital. For him, it was a first exposure to WSU’s medical students.
“They were very engaged and it was great to have them," Reed said. "It is exciting to have Washington State in the medical education game.”
Medical students are traditionally trained in larger facilities in urban settings, places like Sacred Heart and Deaconess in Spokane. They have the people and infrastructure to handle the students who follow physicians as they make their rounds. Many small hospitals want to be involved in medical education, but…
“As a hospital, we’ve been shorthanded for the last two years, almost, and the one thing about medical education and training is it’s not the most efficient thing and when you’re just trying to keep up on a good day with the demand and students generally tend to slow things down a little bit,” Reed said.
But that’s good, he says, because students ask good questions and keep doctors thinking about what they do and why they do it. Reed says Lincoln Hospital expects to have a new physician and new nurse practitioner on board soon, which he hopes will give him more chances to teach.
Ken Roberts, the WSU College of Medicine’s vice dean for academic and community partnerships, says the new medical school initially focused on working with hospital systems in medium-sized and larger cities. But now that it’s up and running, it’s adding clinical affiliates. It now has 70, many of them small-town hospitals.
“We want our students to understand what the challenges are and to have a chance to experience those and what we’re hoping is that some of our students will embrace medicine as it’s practiced in some of these communities that have the greatest challenges and really want to go there and be part of the solution for those communities,” Roberts said.
It should be noted that the University of Washington is also engaged in training future rural doctors. It has at least three programs, including one that allows a handful of third-year medical students to spend about four months living in one small town, learning with doctor mentors there.