From Stacy Woods (italics): At U of T we have a student lead group (Rural Health Initiative) whose goal is to encourage our class mates to consider a career in rural medicine (both Family and specialist positions).
The problem with this program is the experience is still quite artificial. Students stay in hotel rooms, not with community members or physicians, they all attend meals together, go to meetings where they are wooed by rural communities, and actually end up spending very little time experiencing true rural life.
Interactions are indeed critical, and rural people are more than willing to help out. The students interested in rural practice at East Tennessee State (medical, nursing, public health) all go out to Mountain City (pop 1500) starting the weeks before training begins and the first week is spent with a rural family in their home. Not only do they get to know the people, the people come to some of the sessions and participate. Over the course of the next two years the students go to Mountain City (75 min to 95 min bus ride one way) each Thursday. They continue contact during the 3rd and 4th years also. The program may have changed some but the concept is still there. Contact there is Joe Florence florencj@mail.etsu.edu who was a National Health Service Corps doc in Appalachia for many years, then developed the rural training programs at Hazard Kentucky before moving to ETSU. East Carolina did a rural doc visit prior to medical school, staying with the doc, Mercer does their first 2 month clinical experience with a rural doc, RPAP in MN is 9 months in the M-3 year, basically their first clinical experience and orientation to medicine. Nebraska and New Mexico have a 1 month rural experience at the end of the first year. We used to have a 1 month community project for students that were interested at the end of the M-1 or M-2 year. 70% of Nebraska medical students do some kind of international experience, rural and international are related http://www.unmc.edu/Community/ruralmeded/model/medsch/aamcdat.htm .
We have sent letters to many rural communities in South and Central Ontario, asking if a physician in the area would be willing to take a student for a week, ideally billet that student in their own home, or with a community member, and give them a one-on-one rural experience.
You have not only passion but leadership and organization skills. You have already overcome obstacles to becoming a rural doc and are trying to overcome more for yourself and others. I would make sure that you get the help of fellow students, delegate well, share the fun, etc. These will also be very important in your rural practice. One program that you could delegate to a fellow student would be the PRIME program and another would be a rural high school career fair. Details at http://www.unmc.edu/Community/ruralmeded/klein_and_prime.htm Rural middle and high school kids need encouragement and motivation so that they consider health careers. This program can do this and more. The persons who can most do this are rural students in medical school now. Just standing in front of a class of rural high school or middle school kids is enough to prove that these kids can overcome the obstacles and make it. Also for the rural medical students who participate, it is clear that success in helping the middle and high school and college students do well, is the most likely way they will be able to recruit colleagues and replacements to help them in rural practice. This also helps the guidance counselors and teachers who advise such students.
Another idea is a rural high school career fair, where high school students only from rural communities are invited. Again this is something that can be put on by the rural student interest group with some help from faculty. http://www.unmc.edu/Community/ruralmeded/model/preprof/chadron_health_career_fair.htm
Both projects above can integrate some preventive medicine stuff for teens like the PRIME algebra teaching segment showing how slow metabolism of alcohol leads to problems or showing lung and liver slices or doing pulmonary functions on smokers vs nonsmokers.
This may be an arena where the SRPC can get involved with their local medical schools
Rural faculty and medical schools can facilitate this process by helping with materials, coordination, travel costs, integrating this into rural experiences, etc.
The US federal govt sponsored a program for years getting medical students to work with rural and urban community health centers for a month or longer service project. The program was set up by the American Medical Student Association. Eventually there was far more demand than the supply, unfortunately the program was axed - For more details email Kathie Westpheling at kathiew@attglobal.net , she ran the program
I think this is another area where physicians could get involved, going and speaking to high school students about medicine.
I have nothing against this, but would rather the students interact with physicians through shadowing and community projects rather than a passive talk. Rural docs and faculty may certainly do the talks, but the medical students are younger, more dynamic and encouraging, and represent something more motivating to younger students.
You might also be interested in this piece on admissions of lower socioeconomic kids, since some of the data is from Toronto. http://www.unmc.edu/Community/ruralmeded/admissions/lower.htm
In the US we have spent far too much time creating student interest gatherings and meetings that were entertaining and educational, but not motivational and too late. The rural and underserved and service learning people have been telling them this for years.
Bob Boyer is a great rural speaker, motivational and great storyteller. Worth having up for a visit. His video is on line at http://www.unmc.edu/Community/ruralmeded/facil/research/authors/boyer_links_and_presentations.htm His closing story, Blizzard, is also at this link. Top evals of all time at student interest meetings and amazing comments and reflections. I have seen his talk 8 or 9 times and still get tears.
Initial comments and questions by Stacy Woods.
Responses by Robert C. Bowman, M.D. www.ruralmedicaleducation.org