7 things I learned on rural family medicine

Friday, June 28, 2013


Lake that I visited close by my rural rotation
Last night I drove away from the town of just over 1,000 people where I lived the last two months. Yesterday was the last day of my rural family medicine rotation and it's hard to put into words the impact that it's had on me. I'm not going to try to put it in words now, but I am going to share 7 things I learned on rural family med (joining Jen).

1. Delivering babies will never cease to be amazing. If you've been following along at all, you probably already know that delivering babies (or being involved in a patient's pregnancy and/or birth in any way) is my favorite thing and nothing really compares to it. On family med I got to help parents hear their babies heartbeat for the first time, see women through their pregnancies, do the delivery, and then see their baby afterward in clinic for a well-baby check.

2. The value of caring for the whole family. Family doctors have a role like no other specialty since they care for the whole family. It wasn't uncommon on a clinical day for us to see a new baby and his/her mother postpartum, then that baby's siblings, grandmother, and great-grandmother. The doctors that I worked with also all grew up in the community where we worked and so they had a unique understanding of the challenges and strengths of many of the families we saw in clinic.

3. The art and importance of the physical exam. Despite my background as a nurse, I admit that I felt like I was going through the motions when I did my physical exams during first and second year (and it was not much better in the beginning of third year). The doctors I worked with on rural family medicine did a thorough exam on every.single.patient and I learned firsthand how crucial this is. During the rotation, I got to feel an abdominal aortic aneurysm and realize the necessity of a thorough abdominal exam, listen to many heart murmurs and finally feel comfortable diagnosing one, discover a mass that would never have been found without a complete physical exam, and diagnose a brain tumor that only manifested itself by a subtle change in the patient's eye movements.

4. The difference it makes when a physician truly cares for his/her patients.  The physicians I worked with on rural med were both incredibly knowledgeable and genuinely compassionate. They listened to their patients, comforted them, did everything they could to help patients in difficult situations, and treated their patients like their own family. 

5. The role of spirituality in medicine. Despite how important my Catholic faith is to me, there is a part of me that has always been afraid to mention prayer to patients. But too often there is an end to what we can do as physicians for a patient. The doctors I worked with weren't afraid to tell patients that they would pray for them or encourage them to lean on their spiritual beliefs when there was no longer anything that medicine could do. And I saw how this gave patients tremendous comfort.

6. Medicine is a vocation. Small towns don't have the luxury of having a doctor on every corner, and our clinic didn't just serve the town that we were in (we had patients frequently come from an hour away). There were some days that we would be at the hospital in the early hours of the morning to round on patients, see 30 patients in the clinic, and then go back to the hospital to admit a patient and round again. The doctors on rural med sustained this lifestyle by viewing their job as a vocation.

7. Do what you're passionate about. The doctors that I worked with during my rotation were at the top of their medical school classes and could have had a more 'glamorous' and high paying job than a small-town doctor. But they chose to become a family doctor because they wanted to return to the communities they grew up in and serve the people they knew and loved. And they're happy with their decision (in contrast to some of the highly-paid and prestigious specialists that I've met). Seeing them helped me to make my decision against going into dermatology like I'd been encouraged to do by many, many people I respected. During my rural medicine rotation, I re-discovered the importance of pursuing a specialty that I'm truly passionate about and will find meaningful for years to come.


I admit that I've looked at this picture of myself at my White Coat Ceremony the day before medical started and wished for that girl back. I was passionate about becoming a physician to help the underserved that I'd encountered in various places around the world. As I continued in medical school though, I sometimes questioned why I embarked on this journey. It's challenging, sometimes isolating, often discouraging; and I've found myself forgetting at times why I started this in the first place. But these last two months helped me remember again why God called me to be a doctor.




18 comments:

  1. Absolutely beautiful. Reminds me to pursue my passion as well and not stay "stuck" in my current job.

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    1. Thank you. Saying a prayer for you to be able to pursue your passion! It makes all the difference.

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  2. my dad was the only doc in our small 1000 person community, no others in a 20 mile radius, so a lot of what you wrote about I know about through him. I think it was needed for you to see the reach you can have, and coming back to why you are going through all of this. keep up the great work lady :)

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  3. This post is amazing and inspiring. What a beautiful experience.

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  4. This post was so touching and very inspiring. As a fresh second year med student it's so comforting to hear older students experiences. Thank you for sharing. Now excuse me while I spend the next few hours reading your whole blog. :)

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  5. Congrats, Erika! I can tell you're going to be an amazing doctor. You have the heart and soul for it!

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    1. You are so sweet, Shannon. Thank you!

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  6. Great post. My BF's dad was a general surgeon that ended up "retiring" into family medicine back in his little hometown and he loves being close to the people. You really get a hands-on feeling to things and really get to know the people.

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  7. Nice prospective! Sounds like you have maybe found your calling!

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  8. Do you think you will practice in a small town? If you don't, volunteering overseas is very rewarding. I have sponsor children in Colombia and Cameroon and the satisfaction in helping others is something that can't be explained. I hope you have continued success and I'm visiting from Medical Mondays.

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    1. I'm not sure if I will practice in a small town (though I'd love to) due to my husband's job. I really hope that I can volunteer overseas as a physician! I did quite a bit of overseas work as a nurse which was influential in my decision to go to med school. That's beautiful that you have sponsor children in Columbia and Cameroon!

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  9. I loved this post. I don't remember if I commented, but when I read about your OB/GYN vs derm dilemma, I was definitely hoping you'd follow your heart. So glad to hear you've been reminded to do what you love! :)

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  10. I loved this entire post. I'm so glad you've found your love of medicine again and are going to follow your heart! As you know, OB/Gyn is something that really interests me so I look forward to hearing your experiences applying to residency & beyond.

    I wish you all the luck as your finish out your last year and I will be praying for you and your family!

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  11. #6 "Medicine is a vocation"- So true and I believe it is for any doctor. If you are a doctor in a busy clinic or hospital you can believe you will be working insane hours!
    This is a fantastic post! Thanks for linking up for MM!! I hope to see you next month!! :)

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