Pictured is Katie Van Atta (right) and a RUOP student, Noelle Coniglio, in front of Camai Medical Center in Naknek, where Coniglio completed her RUOP rotation. (Photo provided by Katie Van Atta)
Rural Alaska is one of the most challenging and exciting areas in the U.S. to provide health care. Our state is enormous and largely inaccessible by road. Many people live hundreds of miles from the nearest hospital and their ability to travel can be limited by cost, weather, availability of aircraft, and other logistical issues.
As an Alaska WWAMI preceptor, it is my privilege to introduce medical students to the fun and challenging aspects of health care in rural Alaska. WWAMI is a collaborative medical school among universities in five Northwestern states, Washington, Wyoming, Alaska, Montana, and Idaho, and the University of Washington School of Medicine. Through WWAMI’s Rural Underserved Opportunities Program (RUOP), medical students are immersed in a four-week elective experience in a rural community the summer after their first year of medical school. Through this program, students are mentored by local practicing physicians and other health care professionals.
As a RUOP preceptor, I strive to facilitate experiences that give students as broad an experience in rural health care as possible. Students learn to perform careful histories and physical exams, which is particularly important in resource-limited areas without advanced diagnostic testing. The pace can be slower in rural clinics, which affords more time to assess patients and discuss cases in detail. In addition, students learn how to perform basic procedures such as starting intravenous lines and suturing. These skills help to build their confidence and provide a hands-on experience which is helpful in their subsequent clinical rotations. In addition, I encourage students to explore the community and participate in community activities. It is helpful for students to understand the local cultures and geographical contexts in which they are learning to provide health care.
I recently mentored an Alaska WWAMI student completing her RUOP rotation in her home state, at Camai Community Health Center in Naknek. During her four-week rotation, she experienced the breadth of health care offered in a rural community. She saw a wide variety of patients of all ages presenting for clinic visits and after-hours emergencies. She got to experience the process of medically evacuating patients to the nearest hospital by air ambulance. She visited clinics in a fish processing plant and a school and spent time with local paramedics. She gave a presentation to students on ATV safety. She met a visiting optometrist and behavioral health clinician and observed a veterinarian running a field clinic. She attended school sports events and other community activities and explored the community by foot, bike and paddle; and even learned a new fishing technique. This broad exposure to various facets of rural health care within patients’ communities is hard to match but made possible through experiences like RUOP.
It is always a hope that RUOP students (and others) will choose to practice medicine in rural areas. Indeed, my first RUOP student completed her RUOP rotation in her home community; after she completed her training, she returned to Alaska to work both in her home and other rural communities.
Through RUOP, rural health care professionals are able to pass along valuable skills and experiences to train future physicians. Even with all the challenges that rural communities face, Alaska WWAMI provides the medical education to train the next generation of physicians needed to serve rural Alaskan communities.
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