Exposure to rural family practice is a key component of the Faculty of Medicine’s curriculum for third-year medical students. Often, it can have a transformative effect on students who are at a pivotal stage charting their future career paths.
The Rural Family Practice Clerkship is a mandatory four-week rotation completed in a rural BC community aimed at showcasing the wide range of skills, expertise, and advocacy that are core to the life of a rural family physician. Within the BC Interior, there are approximately 130 rural family physicians teaching these rotations in 34 different communities.
The educational experience of third-year Southern Medical Program (SMP) student Kirsten Mossington is typical:
They say it takes a village to raise a child. One of the strongest messages I got from my rural family practice rotation was that it takes an entire community to train a physician. This past winter, I was placed in Christina Lake for one month to experience rural family medicine. Each morning, I would meet my preceptor at the hospital in Grand Forks where we would see follow-up patients, perform minor procedures, round on in-patients, and see long-term care patients before heading off to the clinic in Christina Lake, or completing a shift in the emergency department. This was the case for each of the family physicians in the area, as well as the rural family residents who were in Grand Forks for their placements.
I was lucky to have had the opportunity to spend time with each and every one of them. As such, I was able to see a wide variety of patients and problems. I spent time learning about chemotherapy from the family physician that runs the oncology clinic. I was called into the trauma room several times to watch (and press the button for) electrical cardioversions and learned a lot about arrhythmias. I was invited to observe stress testing performed by one of the other family physicians and had great discussions about ECG interpretation. One of the resident physicians led me through performing a thoracentesis on a patient with a large pleural effusion; the other took the time to review the FAST (Focused Assessment with Sonography in Trauma) with me, among other things. It was such a great experience that each and every one of these doctors took me under their wing and imparted some of their wisdom.
Furthermore, none of these experiences would have been available had it not been for willing patients. The people of these small communities were agreeable and often quite pleased to chat with me. It was evident that they had a lot of trust in their physician, and therefore trusted me. One of the clearest lessons that I learned was how important it is to listen to your patients, because oftentimes, even if they don’t leave with a diagnosis or prescription, they leave feeling a bit better.
The flip-side of the experience is that of a rural family physician such as Dr. Bob Lewis who has been teaching students in Christina Lake for the past six years. Dr. Lewis’s teaching emphasizes the differences in small town practice versus larger centres, the various roles physicians play within the community, and an in-depth understanding of the health care costs and resource limitations of rural practice. Aside from contributing to the education of future physicians, the students can positively impact both the rural physician and their practice:
Every student brings new insights into my practice and I learn what is new in medicine from the students’ up-to-date learning. Teaching also keeps me on my toes with all the questions these keen students ask. It also makes me think about not just what I do but why I do it.
Kirsten made an impact on my patients. Many of them stated how pleasant she was to talk to and what a great listener and communicator she was. She voluntarily stayed up late with me when I was on call to get as much exposure to as wide an array of medical cases that she could. She was always well prepared and asked great questions.
The SMP is recruiting new preceptors to join our network of rural physicians to grow medical education opportunities across the BC Interior and help expose students to the rewards and challenges of rural practice. To learn more about how to get involved, contact Dr. Marjorie Docherty, Clerkship Site Leader, Rural Family Practice at firstname.lastname@example.org or 250-469-2858.