Rural medicine program proves its worth

(Edmonton) Five years ago, the Faculty of Medicine & Dentistry at the University of Alberta sent seven nervous medical students out to rural communities for their third year of medical education.

They were the first to take part in the Rural Integrated Community Clerkship, a program set up partly to encourage medical students to take up rural practice to help fill the void in those communities. The students go through the core rotations in a rural setting.

“They were pioneers, having taken the risk of being in the program,” says Jill Konkin, associate dean of community engagement in the faculty.

Just five short years later, the program is proving its worth. In Sylvan Lake there is a new practising physician, Jordan Larue, who was one of the first seven to give the program a try. In addition, the community hosts a resident who also went through the clerkship program, and two students, Ikennah Browne and Tara McGrath, who are doing their clerkships there.

“We’ve got people who have been through the program mentoring each other at all levels, which is quite exciting,” said Konkin. “From a faculty point of view, now that we have people at varying stages it’s easier for the rest of the profession to understand what this program is about, as well as to find new ways of supporting students. When we started out, we had expectations and hopes that this is exactly what would happen.”

“The mentorship is incredible,” said McGrath. “With both a physician and resident having gone through the program, I have gained excellent advice on how to shape my learning. They also are great to talk to about any challenges I was having both as a student and as a newcomer to the community, because they have gone through the same process.”

“It is like having two phases of ‘learners’ represented at our clinic,” said Browne. “Both have already passed through our stage of learning and are therefore able to put things into perspective for us. It’s great being able to hear about their experience to this point, and to be able to get an idea of how to get the most out of the program.”

Brad Bahler, a practising physician in Sylvan Lake, says he feels very lucky to have been asked to take students for this program since its first year.

“I think as preceptors we like it a lot better, compared with the old model,” said Bahler. “We get a chance to work with the students for a longer time and they get to know us and get more comfortable in the working environment and teaching environment.”

Bahler has Larue working with him now. Larue was placed in Hinton for the clerkship but then matched in Sylvan Lake for his residency. The proverbial shoe fit, so he stayed.

“Having experienced the balance was a big deal for me,” said Larue about his clerkship in Hinton. “Doing a bit of this and a bit of that and having a lot of hands-on experience—it’s definitely something I would’ve missed [had I not done the rural clerkship].

“I think I’m pretty fortunate because I’m not sure I would’ve made that choice, not having had much time doing rural medicine. It took me probably six months to make that decision, so I wouldn’t have had that opportunity otherwise.”

The University of Alberta was the first to implement a rural integrated community clerkship in communities with populations of less than 10,000. The first students headed to four communities in September 2007. Now there are 20 students in nine communities in northern Alberta. The program was developed with the University of Calgary, which sent students to rural communities in the spring of 2008.