By David Rebedew
Before starting medical school, this Wisconsin student traveled from town-to-town to shadow every doctor in every specialty he could find. Looking for the specialty he'd one day like to practice, he discovered where he'd like to practice, too.
While I was only in my third year of medical school, I delivered a baby and the placenta in a hospital in rural Whitehall, Wisconsin, while the attending watched in the background. That same year, I helped deliver triplets and subsequently repaired the c-section incisions. This is unheard of among my classmates doing rotations in Madison, but on rotations in rural towns with populations sometimes under 2,000, I was the only student, so when there was an incredible surgery or an especially interesting case, I was one of the first people to know about it.
I didn’t always know I wanted to practice medicine in a rural area. I had tried to determine what specialty I wanted to pursue before medical school. I shadowed ER physicians, internists, anesthesiologists, neurologists, and family practitioners in various cities around Wisconsin with populations ranging from 1,000 to 50,000 people. Although my original intent was to figure out what I wanted to do “when I grew up,” I also found out where: rural Wisconsin.
Traveling all over Wisconsin, I fell more in love with medicine with each job shadow. But it wasn’t until I was shadowing a family physician in Kiel (population: 3,500) that I also fell in love with the place. I just knew I wanted to do small town family medicine.
It wasn’t the physician’s skill as a diagnostician or his prestige that won me over. It was how much he cared about his patients: not just about what ailed them, but also their families and their everyday lives. I wanted to have those kinds of relationships with my patients. In all the physician shadows I had done up to this point – and trust me, there had been many – this was the first time I was shown patients as people rather than an amalgam of symptoms and diseases. This is how I want to continue seeing patients for the rest of my career, and I believe I can do this best practicing family medicine in a rural area.
So I applied to the University of Wisconsin School of Medicine and Public Health (UWSMPH) -- one of the few medical schools in the country that offers a rural training track. Though the program was in its infancy when I applied, I knew that the Wisconsin Academy for Rural Medicine (WARM) was the program for me.
WARM students follow the same medical school curriculum as any other UWSMPH student, except with a twist. And it’s the twist that excited me. During the first two years of medical school, we participate in a Rural Health Interest Group to learn about different specialties in rural areas, loan repayment options, and many other topics relevant to those who plan to practice in rural areas. During one of those four semesters, we take a Rural Health elective to learn about specific health issues facing rural Americans (with free food in every class to boot!). Then, while our classmates who are not on the rural track complete most of their clinical rotations in Madison, a city of over 200,000 people, we complete the majority of our rotations in rural areas including Green Bay, Rice Lake/Marshfield, and La Crosse.
Those of us based in La Crosse leave the town of roughly 52,000 to complete an eighteen-week primary care rotation in an even more rural area. The rotations, which include pediatrics, family medicine, and internal medicine, typically take place in towns with populations a small as 2,000 or less, such as Whitehall.
The clinic in Whitehall was always busy enough that time flew by while also allowing for chitchat with patients about their families and local activities. I was particularly struck that the patients rarely, if ever, complained about being seen by a med student. They were grateful for everything that could be done for them. And I was grateful to already be building just the kinds of relationships I had envisioned ever since that shadow in Kiel.
As the only student in the rural clinic, without the hierarchy of fourth-year students, interns, chief residents, and attending physicians, I had more time to individually talk with and work alongside physicians, which made me feel much more like a colleague than a trainee. Moreover, it offered me the opportunity to absorb their wisdom from years of practice.
With the increased exposure to the lifestyle of a rural physician, graduates from this program are more likely to pursue careers in rural medicine, but there are no written obligations to do so. WARM is open to Wisconsin residents who demonstrate a commitment to practicing in a rural area.
David Lee Rebedew is a fourth-year student in the WARM program at UWSMPH. He is interested in community support programs and mentoring aspiring health professionals. Click here to learn more about WARM.