Summer of Their Content
This "hands-on" experience for first-year med students
has a powerful impact on the state's future doctors and the medically
underserved.
The first year of medical school is loaded with books and labs
and books and lectures and books and late-night studying …
and books. So when some IU School of Medicine students got the chance
to experience hands-on doctoring this summer, thirty-four scrambled
for the opportunity. They worked side by side with physicians throughout
the state in the Family Medicine Scholars Consortium.
The consortium, established in 1999, oversees the placement of
students with practicing physicians. This year it was sponsored
by Clarian Health Partners (Indianapolis), the Midwest Center for
Rural Health (Terre Haute), the Indiana State Department of Health,
the Indiana Academy of Family Physicians Foundation, Deaconess Hospital
(Evansville), Saint Joseph's Medical Center (South Bend), and the
IUSM Department of Family Medicine. One of the consortium's long-term
goals is to help curb the shortage of primary care physicians in
Indiana.
"Sponsors can tailor their programs to meet their individual
needs, but all share a common goal," says director Brenda O'Hara,
MD '86, associate professor of clinical family medicine. "The
mission is to expose young medical students to primary care in rural
and underserved areas early on in their careers."
So while some of their classmates waited tables, worked in factories
or continued taking additional coursework this summer, consortium
students gained valuable clinical experience and a paycheck. Each
student received a stipend of between $1,500 and $3,000.
Country-Side
From the rack of parenting and health magazines to the children's
toys in the corner, the waiting room looks like any metropolitan
family practice or pediatrician's office. But a glance outside -
to wide open fields and a single passing horse and buggy - reveals
a different view.
With a population of just over 4,000, Berne, Ind., is located in
Adams County, south of Fort Wayne. The surrounding farmland is home
to a large Amish and Mennonite community. The rural setting is typical
of many of the sites served by the consortium.
"The Amish community's needs are high, and our challenge is
educating them about preventive care," says Robert Judge, MD
'82. "They don't have insurance and we usually only see them
during a crisis.
"As a senior in medical school, I did a couple of one-month
rotations and I had good exposure to family practice in a small
rural area," says Dr. Judge, who has mentored several students
through the consortium.
Every morning this summer, Dr. Judge and first-year IUSM student
Nicole Dennis met for rounds at the hospital in Decatur before heading
for the Swiss Family Medical Center in Berne.
At first Dennis simply observed, but as the summer progressed she
began to participate in small ways such as taking vital signs of
expectant mothers, assisting with wound suturing and scrubbing for
surgery.
"I got to see the C-section of twins," she says, recalling
one of the highlights of her summer experience. "I didn't scrub
in for the actual procedure, but I observed it and asked questions
- and was able to check on the babies."
Dennis' primary interest before this program was obstetrics, but
after just two weeks in the preceptorship program, she was willing
to consider other options. "I really enjoyed the variety of
patients that I got to see, and that's what family medicine provides."
City Scope
Though only 110 miles separate Indianapolis' Westside Community
Health Center and the Swiss Family Medical Center in Berne, the
two practices seem worlds apart. In the waiting room at Westside,
a young Latino family huddles, speaking in hushed tones. Spanish
and English echo in the hallways. Amy LaHood, MD, assistant professor
of clinical family medicine, and her fellow staff members serve
a diverse and underserved population. Their patients come from different
racial and ethnic backgrounds, with a fast-growing population of
Hispanics. Regardless of background, virtually all who are served
here face the same hurdle: they cannot afford or do not have access
to health care.
Dr. LaHood is the preceptor of Shana Walton, a Clarian Scholar,
and Shannon Gearhart, sponsored by the Department of Family Medicine.
"When I was a first-year medical student, I did a similar
project. I wanted to give the students I worked with an opportunity
to find out about family practice and primary care," says Dr.
LaHood. "I think that if you interact with people you learn
to respect and understand their cultures and lifestyles."
Both Walton and Gearhart say their experience was invaluable. "I
don't expect by any means to walk in and to be professional during
my third year when I begin clinical rotations, but this is really
increasing my comfort level with clinical medicine in general,"
says Walton. "As first-year students, we've mostly seen books,
so it's nice to see patients."
Aside from working with the physician, the students were required
to spend half days working with social services, researching and
doing rounds at a local community hospital.
Though the consortium only began in 1999, many of the member programs
were established earlier. The Cinergy Foundation in partnership
with IUSM started a preceptorship program in 1995. Of the students
who have graduated after participating in the Cinergy program, seventy-four
percent have entered primary care. Vectren, another sponsor, had
eighty-eight percent of its graduates pursue primary care degrees.
Affirming Choices
While the preceptorship experience might change the career plans
of some physicians in training, it confirms the expectations of
others. That's what happened to Chris Ricketts, MD '98, who was
in the first class of Cinergy Scholars in 1995. He worked in a rural
care setting in Albion, Ind., with Terry Gaff, MD '79.
"The preceptorship solidified thoughts I already had regarding
what family physicians do for a living, the far-reaching nature
of their work and their role in the community," says Dr. Ricketts,
who recently began a practice in Fulton County, Ind.
In the future, Dr. O'Hara hopes that more sponsors and preceptors
will be willing to participate so that all students who apply can
be placed. "I don't know how many times I've seen tears in
the eyes of the sponsors when they hear the students talk about
a particularly emotional case that they participated in or how much
the program has changed their lives," she says. "To me
that is the most rewarding part - to see that the experience really
was important."
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