Why I chose to become a rural primary care doctor

My mom always told me she gave me the “doctor name” (apparently my name looks good with an MD after it), so in some ways I knew from an early age that this was going to be my profession. Though I toyed with the idea of being a bank teller in kindergarten, I realized after a while that this was really not the job I thought it was (no offense to bank tellers, but you don’t actually get to keep any of that money and the little vacuum tubes for the drive-thru probably lose their wow-factor eventually).

Now, I don’t come from a medical family, or any other kind of “old money,” which quite frankly seems to be where a lot of our medical professionals come from (well, a lot of our plumbers come from plumbing families too, and I don’t necessarily mean anything more sinister than that).  In fact, I was the first college attendee in my family.  I didn’t realize how atypical this was until after I had been accepted to medical school, so it was never a discouragement.  I also didn’t realize how few doctors come from towns with 1 stop light.  As far as I was concerned, my good test scores and extracurricular activities were the only parts of my background that mattered in deciding if I would succeed in college or medical school.  Maybe this is correct, but I certainly have a different perception now than I did then as a rural high school student.

In the summer before my senior year of high school, I spent 5 weeks on the UA campus taking classes with 25 of my peers in the Rural Health Scholars Program.  Basically, this is a group of 25 students selected from rural areas all over the state that have some interest in medicine as a profession.  After returning home for my senior year of high school, I was pretty much checked-out of that part of my life and couldn’t wait to get out of high school and go to college.  I had been taking classes at the local junior college during high school, but being 3 hours away from home on a major college campus was a world of difference.  I applied several places and had some [looking back] impressive scholarship opportunities mostly out of state, but I enjoyed my summer at UA so much that I chose to go back.  The peers, counselors, and staff of the RHSP were the primary reason for this.  I felt that this program understood me and had mutual goals, and I knew I would walk in to a support group on day 1 of college that would stick with me for the rest of my educational experience.

My expectations were well met, and I got some part-time work, volunteer experiences, and some meet-and-greets that I would have never had without RHSP.  I was continually encouraged to stay after my goals, and was later accepted to the Rural Medical Scholars Program as part of the “Pipeline” that was created at the College of Community Health Sciences for students just like me.  This program gave me early admission to medical school and a year of graduate work in community medicine, environmental and occupational health, epidemiology, etc… basically things that a doctor out in the country might need but won’t get in medical school.  As peers from my RHSP class drifted away, peers from RMSP took their place as friends with similar goals and challenges ahead.  So, I entered day 1 of medical school with a group of peers that I had already spent a year with… a helpful advantage in a class of 160 ruthlessly competitive type-A young adults.

I completed medical school, entered residency, and am now less than 6 months away from starting practice as a rural family doctor.  In the meantime I have continued to have opportunities to incorporate my ruralness into my profession because of the Pipeline programs at UA.  I have met many of the RHSP and RMSP students behind me, and hopefully have been as helpful to them as some of those ahead of me were in getting me to this point.  I have, since medical school, seen and heard a lot of discouraging things about rural medicine and primary care in general, but I have never felt pressured to change my goals or lost in the wilderness of medical education because of the support I have continually received from these programs.

Without the rural programs early in my career, I probably would still be in medicine but I’d likely have uprooted to a place far from home, and I can’t imagine that I’d be doing rural primary care like I set out to do originally… considering all the deterring factors that most urbanites focus on.  I encourage students to participate in, legislators and administrators to support, and peers to cultivate the rural health programs in their area.  I owe a particular debt to the programs at UA, and I can imagine there are similar stories for other programs that have followed this model.  This is the life I chose, but without the support I had from the Pipeline I might be living someone else’s dream instead of mine.

Josh Bell is a family medicine resident who blogs at Primary Care Progress.

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  • disqus_JpoT0zpTcS

    Thank you for sharing this, it gives me some much needed motivation/hope. I grew up on a farm in a very small town. I was the first girl in family to complete college (my older brother was first boy to complete college). I’ve wanted to be a rural doctor since 6th grade after attending a “Science IS for girls” program. In high school, I attended a few summer programs at state medical school and colleges for students interested in health professions. These programs strengthened my interest and dedication. In college, I was blessed to get a part-time job with a local, rural family doc, who taught me a lot about running an office and caring for patients.

    Fast forward to medical school…I’ve honestly felt very discouraged and often times, alone in my passion. I applied to NHSC twice, and to my medical school’s Rural Physician Program (the very reason I picked this medical school), and was not accepted to either. I realize that the medical student pool is competitive, but it has been hard to keep striving for a goal when it appears doors leading to that goal close/have been unavailable. My experience has been that fellow classmates accepted into the RPP are more interested in the one-on-one experience in clinical years than actually practicing rural medicine.

    Specific program acceptances aside, my interest and passion of rural family practice medicine is continually met with all the reasons NOT to pursue it. This wears on me, and has caused me to doubt the goal I’ve been striving for. Then, I take a weekend and go back home. The time flies by, peacefully and joyously, as I tend the ever-growing weeds in the garden, have relatives catch me up on the latest farm and crop mishaps, and also hear about and see the poverty, the latest business closing, the lack of health insurance coverage. My determination to become that doctor who really understands and can relate to issues first-hand is revived.

    I can hardly wait for the day I can return home and open my own rural clinic. I wish I had more classmates with a mutual passion, and more encouraging mentors. In the meantime, my support is carving out time to garden and reconnect with rural america in between medical school tests.

    -An M2

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