Rural placements for medical students feed ‘pipeline’ for new family docs

(Press-News.org) EDMONTON — New research shows an innovative education program is helping to address Alberta’s rural doctor shortage by making it more likely medical students will set up a rural family practice after graduation.

The University of Alberta was one of the first medical schools in Canada to set up its Rural Integrated Community Clerkship program back in 2007. It sends up to 25 third-year students for 10-month intensive work experiences with a single or small number of teaching physicians. 

Instead of rotating to a new specialty placement every four to six weeks as in an urban clerkship, the students learn about surgery, pediatrics, internal medicine, psychiatry, obstetrics and gynecology in an integrated fashion in one community such as Bonnyville, Peace River, Hinton or Camrose.

“The biggest advantage the rural clerkship students have is the relationships they develop with their teachers, with their patients and with their community,” explains principal investigator Jill Konkin.

In a recently published study, researchers tracked 1,105 U of A medical grads from 2009 to 2016. Of that cohort, 195 chose to become rural practitioners and 510 became family practitioners. Taking part in the rural clerkship was found to be a more reliable predictor for those choices than having a rural background.

“Integrated Community Clerkship participation had more influence than rural background on students’ choice of rural and/or family practice,” the authors report. “Our results show that the rural pipeline principle works.”

“We know how to make rural physicians,” concludes first author Darren Nichols, associate professor of family medicine, noting the students develop “adaptive expertise” that allows them to be ready to treat a variety of patients, rather than seeing a limited set of problems repeatedly as a specialist. “We can take any student, regardless of background or future career plan, and provide them the opportunity to have their life changed,” Nichols says. “They know how to approach any problem. That’s much harder than being a specialist.”

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