Students learn about life and health care in rural Colorado
By Andy Gilmore | University Communications
The students immunized. They branded. They castrated.
Those activities—all with cattle—were part of the many experiences of 14 students from Anschutz Medical Campus who traveled to Lamar in June, as part of the 2014 Rural Immersion Week.
The students, from the schools of medicine, including the MD and physician assistant program, pharmacy and nursing, visited Lamar, for five days to gain an insight into rural life.
A trip to Lamar
Now in its fifth year, the Rural Immersion Week saw this year’s cohort visit the smallest community so far. Lamar, with some 7,000 residents, sits near Colorado’s eastern edge.
Mark Deutchman, MD, director of the School of Medicine’s Rural Track and associate dean for rural health, explained that the goal of the week was community immersion.
“The students get plenty of health care experience while on campus,” said Deutchman, a professor in the Department of Family Medicine. “The immersion week removes students from their health care comfort zone and requires them to think about what it’s like to be living and working in a rural community. A major goal of the week is to have students test their assumptions. To ask themselves, ‘What would it be like if I was living and working here?’”
Kevin McAllister, a medical student, explained that he wanted to participate in the Rural Immersion Week to gain an insight into aspects of a rural town that are not directly related to health care, and into hurdles the inhabitants of a rural town face.
“It was refreshing to talk with people from the community about things that they enjoy, instead of the health-focused interactions with strangers I am accustomed to in the health care setting,” McAllister said.
“I chose to take part in the Rural Immersion Week to help expand my view of rural living beyond the medical issues,” said medical student Garrett Urban. “To really be an effective rural medical provider, it is vital to learn how rural towns function and understand the multiple factors that play into the lives of those who live there. Only then will we be able to effectively integrate ourselves into rural life and become functioning members of the community.”
Urban says it is vital that a physician understands the unique culture of a rural town.
“The culture in many small towns is very strong, and the ability of a physician to understand the culture of a specific town can make or break a rural medical practice. It is important to be a good physician, but arguably more important to be an active member of the community.”
Meeting the community
Throughout the week, students engaged with a range of members of the rural community. Support of the local community is crucial to the success of the Rural Immersion Week, said Deutchman, who previously practiced medicine for 12 years in a town of just 2,000 people.
“Local knowledge and expertise is vital to the success of the week, and we have a tremendous amount of community support,” he said. “For so many members of the community to turn up and each talk to us for 20 or 30 minutes at a community introduction session on the first day of our visit is invaluable. Then, throughout the week they all make themselves available to the students. It happens each year and we’re so grateful.”
At the end of the week, students were divided into groups (business and agriculture, health care, education and natural resources) and required to present their thoughts and findings to the other participants and Lamar community leaders.
The groups expressed concerns and highlighted struggles for Lamar, including a lack of sex education leading to high instances of teenage pregnancy, low exposure to health care professionals for students, lack of medical insurance coverage for residents, and the challenge of recruiting and retaining new teachers.
Medical students Kristy Puls, and Matt Wood, and pre-med student Emily Moll reinforced the challenges faced by education professionals in Lamar by highlighting David Tecklenburg’s first day in his role as district superintendent. On that fateful first day, Tecklenburg had to expel a student, close a school, fire 34 teachers, and find a way to cut $500,000 from the town’s education budget.
The students in the business and agriculture group – pharmacy students Sierra Hill, Jade Bryant and Jim Bougie, and physician assistant student Kali Saxton-Shaw – told of their visit to Grenada Feeders. The group explained that farmers are often at the mercy of markets, oil and gas prices, crop price fluctuations and the weather. The plight of farmers and the difficulties they face was highlighted to the group during their visit by feedlot owner Ronnie Brown, who stated, “animals are easy; they are predictable. Humans are the problem.”
Despite the many struggles faced by rural populations, the students discovered many positive aspects of Lamar. Child immunization rates in Lamar are almost 15 percent above the state average, the area has excellent emergency response, and there is little violent crime in the community compared to metro areas.
The rewarding aspects of working in a rural community, and the unique qualities posed by members of a rural community, were summed up by an emergency room nurse whom some of the students met. The nurse informed the students that he would not go back to a larger medical center because “I make a difference every day, I don’t care if it is for lower pay.”
Deutchman believes that the experience is invaluable to students as it helps to test their assumptions and figure out what they want to do.
“The decision to go into a rural community is a lifestyle decision,” he explains.
“It’s partly a work and professional decision, but it’s also a family and lifestyle decision. Our goal is to enable students to make an informed decision about whether this is the kind of life and work that they want to pursue.”
Deutchman believes that very few students have been deterred from following a rural career path after participating in the immersion trips. “In the previous four years I’ve only had two students tell me that the rural immersion experience has convinced them not to ‘go rural,’” he said.
McAllister and Urban found that the Rural Immersion Week reinforced their desire to pursue a career in rural medicine.
“The people of rural communities find innovative ways to survive and even thrive and I realized that the ‘simple life’ of rural citizens is actually quite complex,” Urban said. “They often run into the same problems as us big-city folks, but with an added layer of complexity.
“I learned that even in difficult conditions, small towns are able to pull through,” Urban added. “The people find innovative ways to survive and even thrive, and they have my greatest respect. The week reinforced my desire for rural medicine; I hope to one day be able to serve the people of a town such as Lamar.””
McAllister found the experience to be eye-opening in a number of ways.
“Some of the things I learned may not help me ace a board exam, but they will definitely help me better understand my patients if I end up practicing in a rural town like Lamar. The trip certainly strengthened my desire to eventually work in a rural area.”
Deutchman is already thinking about locations for the Rural Immersion Week in 2015. Students wishing to gain further information should contact Mark Deutchman MD at 303-724-9725 or Rural Track Program Coordinator, Melanie DeHerrera , at 303-724-0340.