College Doing its Part to Address Shortage of Rural Physicians

Arizona is among the states suffering most from a shortage of physicians in its rural areas. Only three others — Florida, Tennessee and Louisiana — rank lower in terms of physicians per capita, according to a report by the New American Economy.

In remote areas of the state, there are as few as 32 doctors per 100,000 residents; while in densely populated cities, such as Phoenix and Tucson, there are as many as 363 physicians per 100,000 residents.

The University of Arizona College of Medicine – Phoenix is doing its part to help solve this problem. Clinical rotations for medical students include rural hospitals, and four years ago, the College began a Rural Health Professions Certificate of Distinction. The Class of 2017 had three students graduate with the rural health honor in May. Interest in the program is growing, and 16 students are now working toward the certificate of distinction.

“My duty to the state of Arizona is to motivate more future physicians to practice in the underserved areas where they are needed most,” said Jonathan Cartsonis, MD, director of the Rural Health Professions Program at the college. “We make it easy to participate, returning rural Arizona students to their home towns and supporting all students with covered housing and a stipend to help with the extra living expenses.”

Dr. Cartsonis said research shows that the longer a student learns clinical medicine in a rural area, the higher the likelihood that they will practice in a rural setting.

“Our students are getting great experience connecting with rural doctors and diverse communities, performing well academically, and having fun in the process,” he said.

Many medical students who are not even working toward the rural health distinction are also taking advantage of clinical rotations, Dr. Cartsonis said, adding that last year, 65 students completed clerkships and rotations in rural areas.

Three of the Class of 2017 medical school graduates who earned the Rural Health Professions Certificate of Distinction this year discussed why they joined the program.

Brock Bennett, MD

Brock Bennett, MD, completed rural health rotations at Silver City and Deming, New Mexico, under the mentorship of Victor Cruz, MD.

“I would absolutely recommend this experience to other students,” Dr. Bennett said. “The patients are very appreciative, and the attending physicians are wonderful. Throughout medical school, I have found that learning opportunities become exponentially improved when the attending trusts the learner.”

Dr. Bennett grew up in Southern Oregon, a rural area. He enjoyed the environment and interaction with people there, saying he was excited for an opportunity to work with physicians that treated problems spanning multiple specialties.

“My experience was wonderful,” Dr. Bennett said. “I will always remember the impact physicians can have in smaller areas, as just about every patient would remind me of their doctor's importance.”

Dr. Bennett is a general surgery resident at Baylor Scott & White Health in Texas.

Patrick Kishi, MD

Patrick Kishi, MD, spent 15 weeks working in Yuma, Arizona, under the mentorship of Husnu Evren Kaynak, MD.

“This was a great opportunity that allowed me to experience a different face of medicine,” Dr. Kishi said. “I was able to work closely with physicians who were excited to have a new student and eager to teach. They provided an exceptional educational experience.”

Dr. Kishi said he always had an interest in working with underserved and lower socio-economic populations, so the rural health program offered him a perfect opportunity. It also allowed him to work one-on-one with several attending physicians, which he said strengthened his clinical training and improved his critical-thinking skills.

“One thing that will stay with me through residency and beyond is the importance of finding a mentor that you can build a relationship with throughout the experience,” Dr. Kishi said. “I still stay in touch with my mentor, and I appreciate all of his support and advice. I will always remember how grateful and kind patients can be, especially in underserved and rural areas.”

Dr. Kishi is an emergency medicine resident at Advocate Christ Medical Center in Illinois.

Alexa Williams, MD

Alexa Williams, MD, spent time in several Arizona towns during her rural health rotations. She was in Page for her first-year summer experience; then in Show Low and Snowflake, where she worked with Chad Brimhall, MD, for her third-year rural clerkship rotations.

“One of the greatest parts that came out of my rural experience was how much confidence I developed in my health care skills during my rural internal medicine clerkship,” she said.

She liked the “continuity experience in the community and with patients, which is rare to come by as a student in the other clerkship experiences in Phoenix.”

Dr. Williams decided to work for the certificate in rural health because she grew up in South Dakota, where she experienced rural medicine firsthand.

“Rural medicine embodies the physician-patient relationship that we all dream about: where you truly know your patients on a personal level, and your patients, in return, trust you so fully,” she said. “That mutual, trust-based physician-patient relationship is the key to real healing for patients and physicians.” 

Dr. Williams is an OB/GYN resident at Mercy Hospital St. Louis in Missouri.