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Program connects students in health professions with rural areas

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PHOENIX – Samantha Varner grew up in Chandler and has always been a city dweller. But when she graduates from the University of Arizona’s College of Medicine in 2016, she intends to move to a rural area to practice family medicine.

“Patients know their doctor,” Varner said. “They’re a part of their community. I want to be a member of the community and participate in it.”

For five weeks last summer, between her first and second years of medical school, Varner shadowed a family practice doctor in Prescott Valley as part of the Rural Health Professions Program.

Across the state’s three public universities, students in medicine, pharmacy, nursing, public health and other health care fields spend at least four weeks following rural health professionals and receive additional seminars and mentorship, culminating in a 24-week clinical experience for pharmacy and medical students toward the end of their studies. After completing the program, participants can receive a notion of “Distinction Track in Rural Health” on their transcripts.

Last year, 870 students from UA, Arizona State University and Northern Arizona University took part. That number far exceeds the mandates of the 1996 law creating the program: 15 medical students, 10 nurse practitioners and four pharmacy students.

Dr. Jonathan Cartsonis, who heads the program that just launched at the UA College of Medicine-Phoenix, said the goal is getting more health professionals to work in rural parts of the state.

“We believe once they have a taste of it, they’ll be excited to practice in a rural area,” Cartsonis said.

Last year, 152 students from both UA medical schools completed at least a four-week rotation in a rural setting, funded by the Arizona Area Health Education Centers, a grant from the federal Health Resources and Services Administration and the state.

According to the UA College of Medicine, rural areas in Arizona had only 124 doctors per 100,000 residents in 2005, while urban areas had 231 doctors per 100,000 residents. Both fall below the national average.

“This is a state-funded institution, and everyone in our state is entitled to health care,” Cartsonis said. “We’re not training one type of student for one type of practice.”

Medical students working in rural areas also get much more hands-on experience than their urban counterparts, he said, because specialty doctors are rare and it’s harder to refer patients to other doctors.

“When you’re practicing in a rural setting, you feel like you’re using all the skills you learned in medical school; they’re required on a daily basis,” Cartsonis said.

Dr. Julie Lindholm, a physician and general surgeon in Page, said there seems to be a pressure on new graduates to specialize, but rural practice goes against that trend.

“To be in a rural place, you really have to stay broad and stay capable of treating common problems uncommonly well,” she said.

Sandy Haryasz, CEO of Page Hospital, said the challenges in rural practices often come down to lifestyle.

“In a small town, everyone knows everybody, so you have to be prepared to see your patients at church or at the grocery stores,” Haryasz said.

Introducing students to rural areas during these rotations is one way to make that lifestyle change easier, she said.

“It gives them an opportunity to see if small-town living is what they need or want, to see if they want to come back to a rural area,” Haryasz said. “It gives them a good flavor of the differences between rural and metropolitan.”

Varner said using all the skills she learned in medical school fueled her interest in rural health, while the Rural Health Professions Program allowed her to see the realities of beyond a big city.

“People need to be exposed early,” Varner said. “They can see the benefits and the potential challenges of it.”