Select rural Arizona physicians are volunteering for four to six weeks this summer to mentor medical students from the University of Arizona College of Medicine and give them a "push" in the direction of practicing medicine in small Arizona communities.
The physicians are rural faculty members in the UA College of Medicine's Rural Health Professions Program, or RHPP, established in 1997 by the Arizona Legislature to encourage medical school graduates to practice medicine in rural communities. Today, RHPP graduates are practicing in rural communities throughout Arizona, and some are RHPP mentors to the next generation of rural physicians.
RHPP physicians volunteer as preceptors – or mentors – to UA medical students between their first and second years of medical school. Several of the physicians are UA College of Medicine graduates who participated in RHPP as medical students and now are serving as RHPP mentors.
The medical students work with the physicians at their practice sites and reside in their communities for four to six weeks between the end of May and early August. Students are matched with preceptors based on medical specialty interest and community preference.
Physician specialties include family practice, pediatrics, internal medicine, obstetrics and gynecology and surgery. The students continue to work with their preceptors over the course of their three remaining years of medical training, returning to the rural communities in their third and fourth years.
Communities hosting students this summer include Bisbee, Douglas, Flagstaff, Fort Defiance, Lakeside, Payson, Polacca, Prescott, Prescott Valley, Safford, Sedona, Show Low, Snowflake, Tuba City, Winslow and Yuma.
"This program helps nurture students' interest in a rural practice," said Carol Galper, assistant dean for medical student education at the UA College of Medicine-Tucson.
"Many of the students grew up in rural towns in Arizona and have a desire to practice in small communities, perhaps even returning to their hometowns. Their RHPP experiences help them understand the unique health-care needs of rural populations as well as strategies to address these needs, and help them decide about where they want to practice in the future."
By working side-by-side with a physician – consulting with patients, discussing lab results, helping to diagnose childhood ailments, attending surgeries – students learn about the unique health-care needs of rural populations and how to meet them. By returning to the same community during each year of medical school, students learn to appreciate the area's culture and community character and begin to experience the lifestyle of rural residents.
This year, 16 students attending the UA College of Medicine-Tucson and six students attending the UA College of Medicine-Phoenix were selected for RHPP, using a combination of funds from the Arizona Area Health Education Centers (the Arizona AHEC Program) and the state of Arizona.
"With the expansion of the medical school to include the Phoenix campus, AHEC funding enables us to provide RHPP opportunities to Phoenix-based students as well," said Galper.
RHPP students receive intensive preparation, including a course, "Issues in Rural Health," covering health care and access-to-care issues, challenges of rural practice, referral needs, the impact of poverty and lack of health care, environmental health concerns, the influence of culture and the role of physicians in rural communities, as well as topics not taught until their second-year curriculum. This helps bring them up-to-speed and allows them to be well prepared for their initial rural rotation.
RHPP students learn to use telemedicine technology in communities linked to the Arizona Telemedicine Program, or ATP, a health-care telecommunications network that allows rural physicians and patients to have real-time online medical consultations with specialists at the UA College of Medicine in Tucson.
The system also allows rural physician-preceptors and their students to attend grand rounds lectures "virtually" at the UA College of Medicine. The RHPP course is teleconferenced between Tucson and Phoenix, with instruction originating alternately in Tucson and Phoenix.
Rural physician-preceptors enhance their teaching skills by attending faculty development and continuing medical education programs conducted by the UA College of Medicine. To minimize disruption of the physicians' medical practices, the programs are offered regionally by video links provided by ATP to the UA College of Medicine.
RHPP students develop long-term relationships with their rural physician-preceptors, who act as medical and career counselors, helping the students make informed choices when they decide where they will practice medicine.
Initial follow-up of the 97 graduates of this program who have completed residency shows that 42 percent have practiced in rural Arizona, 30 percent are in current rural Arizona practice and eight percent are in rural practice in other states.
"We have graduates throughout the state," said Galper. "The RHPP is creating rural physicians for Arizona, and these physicians now are mentoring the next generation of rural doctors."