A rural calling

New clinical experience “embeds” medical students for a year in rural Klamath Falls

September 16, 2014

They say the best way to learn a language is to immerse oneself in the country where it’s spoken. If the idiom holds true for medical school, a new clinical experience for OHSU medical students will prepare them like no other for their career calling as physicians practicing in rural settings.

Oregon FIRST – Family Medicine Integrated Rural Student Training – is an individualized fourth-year medical school curriculum new in academic year 2014-15. Joe Volpi and Stephanie Laudert are the first two students spending a year at Sky Lakes Medical Center in Klamath Falls. The city of 21,000 is also home to the Cascades East Family Medicine Residency Program, which is a valuable pipeline to develop rural Oregon physicians (see sidebar).

Klamath Falls MD students Joe Volpi and Stephanie Laudert

Volpi and Laudert have had family medicine in their sights for years and have taken steps to become “fluent” in the field. After this extended experience in Klamath Falls, they hope to be that much more prepared for post-graduate training. If the match process goes well, both Volpi and Laudert will remain in Klamath Falls for a residency in family medicine.

“Improving health care access in rural communities is a vitally important issue. While solutions to the problem must be multi-faceted and community-based, one strategy is to increase the number of physicians who elect to practice in a rural setting,” said George Mejicano, M.D., senior associate dean for education in the OHSU School of Medicine. “The Klamath Falls intensive experience is a good example of a new program designed to ensure students interested in rural practice receive the education and support they need to realize that goal.”

Volpi grew up in Prineville, Ore., and after six years in the Navy as a nuclear engineer, earned a degree in human physiology and then decided to become a doctor. “Family medicine is always what I saw myself pursuing,” Volpi said. “When you live in a small town, that’s what you have – family doctors – so from the very start family medicine fit my expectations about what a doctor should be.”

Laudert finds her work in Klamath Falls to be a dream come true, “Speaking with faculty at OHSU, I learned what kind of doctor you can be in a rural versus an urban setting. Having lived in Shelton, Wash., I knew I wanted to raise my family in a small town and be a part of that kind of community. When I visited Klamath Falls, the people and the beauty of the area were just perfect. Here, I get the best of both worlds: I get academics and experience outside of an academic health center.”

Just a month into his embedded experience, Volpi recognizes the value of longitudinal training alongside small-town physicians. “Continuity of care is a big part of family medicine; it’s the relationship building piece. I’m so lucky to be learning medicine in the context of the challenges rural communities face.”

These extended clinical experience also impacts a fourth-year medical student’s pocketbook – in a positive way. Students in Oregon FIRST forego the travel costs, sometimes up to $10,000, associated with finding a residency program. Other financial assistance, such as a tuition waiver or loan forgiveness, could await students in exchange for a service requirement.

For Volpi, the life of a rural physician can’t come soon enough. “I can’t wait to be that kind of small town doctor who makes a personal connection. When you’re from a small town, there’s an expectation that you’re involved. I want to be the kind of doctor who is the same person in my practice that I am as a school board member or a Christmas parade volunteer.”

“Students will develop a wide range of skills in this curriculum that will be needed for tomorrow’s rural physician, including chronic disease management, population-based health and familiarity with a primary care medical home,” said Joyce Hollander-Rodriguez, M.D., assistant professor of family medicine in the OHSU School of Medicine and Cascades East program director. “We hope to share the successes of Oregon FIRST with other family medicine educators and to be a model for schools nationwide.”