Medical students spend time with Weiser doctors learning about rural health care

Two Idaho medical school students visited Weiser this summer as part of a program that provides future doctors with early exposure to the challenges and rewards of practicing primary care medicine in a rural setting.
    Both of the students – Joseph McNeal and Samia Munayirji – are from Boise and will be entering their second year of medical school this fall.
 The future doctors each spent a month with Dr. Lore Wootton and Dr. Suzanna Hubele at the busy Two River Medical Clinic.
    Their visit to Weiser was arranged through the Rural Underserved Opportunities Program, or RUOP. The program is a four-week, elective immersion experience for medical students that allows them to work side-by-side with local doctors. One of the program’s objectives is to interest medical students in pursuing primary care.
    The students live in rural communities throughout Washington, Wyoming, Alaska, Montana and Idaho. RUOP is a collaborative effort of the University of Washington School of Medicine and WWAMI campuses, including the University of Idaho, which both students attend.
    Both Drs. Wootton and Hubele have been hosting students in the RUOP program for many years, sharing their expertise as primary care physicians working in a small community. They usually host one or two RUOP students each summer. Each doctor works with one of the students during the rotation.
    While in Weiser, the students stay at a home owned by Weiser Memorial Hospital and used by visiting doctors at the hospital. WMH lets the RUOP students stay there for the month of rotation at no charge.
    Hubele is familiar with the RUOP and promotes the program for what it can do to interest students in rural medicine. She is a former WWAMI student who did a month-long RUOP rotation and wanted to give back to the program that helped shape her interest in primary care medicine.
    “I enjoy having students, letting them get a taste of clinical practice and experience, very early in their careers.  It helps them stay focused and remind them why they wanted to go to medical school in the first place, to take care of people, when so much of their first two years of school is classroom and book based,” she said.
    Hubele said she hopes she can instill in them some desire to go into primary care versus going into a specialty. There is an unfulfilled need in Idaho and elsewhere for more family practice doctors to take care of populations in rural areas.
    “It is often very difficult for many of these folks to drive the 70 miles to Boise to see a doctor, whether due to limited resources (money, car, time, insurance) or limited abilities (no longer driving, too difficult to go that far/spend that much time, aging making it difficult to get around, etc).”
    Wootton said she has been working with visiting medical students since she arrived at Two Rivers Medical Center in 1997. She has hosted RUOP students for at least the past 10 years and probably closer to 15 years.
    Several doctors who have come to practice in Weiser first visited as students or residents, including Dr. Hubele. So having students is also a potential recruiting tool, Wootton said.
    She enjoys having the students at the clinic for a month and her patients are willing to participate in their education. They shadow the doctors during the day and do some hands-on, simple procedures under supervision that helps them practice their patient skills.
    Wootton also wants to educate the medical students about rural medicine and to expose them to the wide variety that family medicine has to offer. Even if they go on to be specialists or work in urban areas, they will know the challenges and rewards of rural medicine.
    “I want them to have an understanding of where their patients from rural America come from and the challenges their doctors in those area face. Some of them fall in love with family medicine. Whether they practice in rural or more metro areas, they will have seen the full spectrum of rural family medicine,” Wootton said.
    The two medical students said it was too early in their education to know exactly what type of doctors they planned to become after medical school. Both said participating in the RUOP rotation in the clinic was an important experience for them.
    Samia Munayirji said she opted to sign up for the RUOP and come to Weiser to be immersed in a rural setting and to see what challenges doctors face in delivering medical care. In small towns, doctors are providers and members of the community.
    “I think the doctors here are pretty popular with everybody,” she said.
    She said she liked the social aspects in addition to the medical care. With primary care, doctors really get to know their patients and see them for years for their health care. She was able to observe a C section and draw blood.
    Joseph McNeal is getting his medical school education paid for by the U.S. Air Force on scholarship. In return, he will have to do a certain number of years in the service as a doctor. After that, he doesn’t know what he might do for a medical practice.
    He said working with the doctors at the Two Rivers Medical Clinic in Weiser allowed him to practice basic interaction with patients and that was valuable.
    Hubele said because WWAMI is a state program it is significantly more affordable for students, which in turn makes it easier for them to go into primary care as doctors.
 Students who attend a private, for-profit medical school can acquire significant debt and find it nearly impossible to go into primary care as the income is not enough to pay off their loans/debt and get established as a new physician in a practice.  
    Idaho’s WWAMI Medical Education Program is a partnership with the University of Washington School of Medicine and the states of Washington, Wyoming, Alaska, Montana and Idaho. Started in 1971, WWAMI is currently in its 47th year of educating Idaho’s physicians. Students who enter the program are dual enrolled at the University of Idaho and the University of Washington School of Medicine.
    Through its affiliation with the University of Washington School of Medicine, WWAMI has a long track record for producing exceptional primary care physicians and has been ranked No. 1 in primary care by U.S. News and World Report for several years, Hubele said.
    One of WWAMI’s primary goals is to increase the number of primary care physicians, especially in underserved areas. It has an excellent rate of return with over 50 percent of its graduates returning to Idaho, she said.
    Lucia Carbajal is a Weiser High School graduate currently in the WWAMI program, attending medical school and doing a RUOP rotation in Nampa at the Terry Reilly Health Services.
    She is currently a WWAMI TRUST Scholar. She grew up in Weiser and graduated from Arizona State University. After spending a few years in Arizona and participating in medical volunteer trips to South America, she discovered rural medicine was what she wanted to pursue.