September 22, 2017

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This is Where I Belong: Multi-Specialty Experiences at ACMC

Sarah Eisenschenk, 4th Year Medical Student

I’m currently starting my 4th year as a medical student and spent the last 9 months of my schooling at ACMC under the Rural Physician Associates Program (RPAP) that is organized through the University of Minnesota.  I’ve had previous experiences with ACMC with my brother being an RPAP student here last year, and I also had a two-week summer internship at ACMC-Willmar a couple years ago.  From that experience, I knew that I wanted to come back because I really liked the community and the staff here are really focused on medical education and training.   I also liked the diversity of the patient population so it seemed like it was a good fit for me. Coming to ACMC, I wanted to try on the “life of a rural physician” because that’s what I’ve always seen myself doing.  Even though in my mind I know that is what I’m interested in, it’s hard to know what’s right for you until you get an opportunity to try it out.

Experiencing Rural Medical Practice

The RPAP program is designed to help get future physicians in the rural community.  In my 9 months here, I really wanted to strengthen my knowledge foundation and clinical skills; especially in obstetrics.  I wanted to deliver babies and be involved in the care of pregnant women and children afterwards.  I’ve been involved in several deliveries here and just assisted in a really special delivery.  A couple weeks after I came to ACMC-New London/Spicer, I started caring for a mom that was in the early stages of her pregnancy and so I was able to follow her care through until delivery.  It was a really special moment for me; you develop such close relationships with your patients. I have been very impressed with the learning experiences that I have been allowed to have at ACMC.  In a rural facility, you have a lot more autonomy than in a metro facility and at larger facilities, medical students are at the bottom of the totem pole and so what we are allowed to do and expected to do is much more limited.

My Clinical Rotations

Dr. Rick Wehseler, Family Practice Physician from ACMC-New London/Spicer was my primary preceptor.  Dr. Wehseler wears many hats in the community and so I was able to be involved in some of those experiences as well.  He serves as coroner and so I was able to go along with him doing coroner work which was very interesting.  As coroner, you are investigating the truth in death, so going from delivering babies to coroner work gave me such a broad spectrum of care.  While Dr. Wehseler served as Chief of Staff at the hospital, we worked together doing administrative work.  I also spent 6 weeks with Dr. Joe Vogel in pediatrics, who was an excellent teacher; my general surgery rotation was with Dr. Steven Kidd.  Surgery rotations in the rural areas are much different as well.  Here I got the opportunity to be first assist on most of the surgeries so I got lots of one-on-one teaching with the surgeon and that extended into urology and orthopaedic surgery as well.  I also spent some time in the Wound Clinic and helped Dr. Robert Boyd with jail medicine.

A Typical Day

A typical day for me during my Family Practice rotation would start by going to the hospital to round on patients.  I would then make an assessment, develop a plan of care and review it with Dr. Wehseler; then we would head over to the clinic for our daily visits.  In the evenings I was able to participate in several different committees and had time to study.  Since we are affiliated with a larger clinic, we shared the call rotation with the ACMC-Willmar physicians so our call schedule was very spread out.  My schedule was pretty regular here and I really appreciated that.  Of course babies come when they want to, so there were times when we would be up all night with labor and delivery then in the clinic all day, but the adrenaline and excitement of introducing life into this world was enough to keep us going.  During my surgical rotation, I was busier since the staff was smaller.  I just planned on being busy and if I had some free time it was a nice surprise; if not, I knew I was helping people.

ACMC Teaches Medical Students

ACMC does an excellent job of teaching health care providers and medical students.  They really excel in rural medicine and it is unusual to have a program as developed as they do.  As medical students, we have weekly lectures that are led by a semi-retired family practitioner that teaches us pertinent, clinically applicable topics.  Education is also a key component in each department and here medical students are allowed to give grand rounds which are usually done by residents.  We are really considered a part of the medical community and we have more flexibility with our time.  Every year ACMC holds a Spring Symposium, a day of teaching, fostering collegiality and providing care to the people in our communities that is consistent with current research.

Developing Relationships with Patients

 

Confirming My Beliefs

Working at ACMC has confirmed my previous thoughts that rural physicians are incredibly important in meeting healthcare needs; rural communities can often be underserved and there can be access to care and health insurance issues.  It has been a joy to practice in this great environment that ACMC fosters in that we are able to care for community members; it is really a beautiful experience. I think that ACMC is an excellent practice to learn and work in.  It is a physician-owned practice and they really are focused on medical education and teaching. It takes a lot of time out of their schedule for someone to do the teaching so there is an opportunity cost for them, but at the same time it helps them stay current on latest research and keeps their minds sharp having that “fresh eye” walking along side them.  The primary care providers and specialists also work well together and family practice and primary care is very strong in this area.  Family Practitioners have an opportunity to have a very broad scope of practice and their schedules can be very flexible.  There are physicians that teach in universities and those that take sabbaticals to learn medical experiences elsewhere to bring back that knowledge to ACMC.

After Medical School

After medical school and residency I want to come back to the rural community; my nine months at ACMC-New London/Spicer has confirmed this.  I grew up in Avon, MN which is a small town on a Hobby Farm and I loved living in the country.  I think there are advantages to both urban and rural practice but it really comes down to your personal values, your training and what kind of lifestyle you desire.  Some of the people you meet are so unique and they come to know you and remember you when they come into the clinic.

Someday I would love to practice in a medical community like ACMC where you have a multi-disciplinary facility that strongly supports primary care, so I guess I found out that this is where I belong!