I recently finished a four-week rotation with the Mad River Family Practice Rural Track Training Program in Bellefontaine/West Liberty, Ohio. Dr. Randall Longenecker is the director. Briefly, my rotation was set up on a weekly schedule. On Monday, Tuesday and Wednesday, I performed inpatient care (including obstetrics, gynecology, and newborn nursery), and operating room time with general surgeons, orthopedic surgeons and one urologist at Mary Rutan Hospital in Bellefontaine. Thursday was a day of clinic at the Mad River/Oak Hill family practice location in West Liberty, with emergency department service at Mary Rutan Hospital on Friday.

During the last two weeks of my rotation I was able to follow adult psychiatrist Dr. Griffith in Bellefontaine for a half day and child psychiatrist Dr. Wallenbrock in Urbana, Ohio, for a half day. These psychiatry experiences were especially tailored for me as I plan on pursuing psychiatry training with the eventual goal of becoming a child and adolescent psychiatrist.

I had an excellent four weeks working with Dr. Longenecker and the various other attendings and residents of not only the Mad River Family Practice but also of Mary Rutan Hospital and area clinics.

Sharpening skills
I came into this rotation with the expectation of receiving a varied case load and broad exposure to large portions of primary care and common surgical conditions, and I was pleasantly provided with all of that and more. Because I plan on becoming a psychiatrist, I wanted to develop basic competencies in the care of an “average” hospitalized patient, that is, one who is not so critically ill as to warrant admission to the intensive care unit or transfer to a larger urban institution. I also wanted to further my communication skills as they relate to interactions with patients, and my Thursdays at the clinic provided wonderful opportunities for me to do just that. I saw patients from five to 95 years of age, from well-dressed to uniquely malodorous, teens, expectant women, rashes, depression; the list goes on. If child psychiatry did not have such a draw for me, I probably would have become a family physician.

Witnessing dedication
The rural component of this rotation added another dynamic to this rotation in a way that enhanced my experience. I developed an appreciation for the dedicated physicians who don’t think twice about being on-call for what seemed like days on end, who drive for hours to set up shop and see patients in a neighboring town for a few days, then head back to their primary residence only to repeat the trip the following week, and the week after. I witnessed a genuine care and devotion to the patients of a rural community, and concluded that these people were fortunate to have this small group of committed family doctors provide quality and up-to-date primary care. I’m still in the early stages of my medical career, but my feeling is that rural communities throughout the country will be increasingly hard-pressed to find such medical care as the profession trends toward specialization.

Great value
Although I will not become a family physician in the foreseeable future, assuming my plans run their course, I will still value the four weeks I spent with the Mad River program. I learned and experienced a little of what rural medicine is and what it means to practice as a rural physician. Being committed to the Army, I probably will not be stationed in as rural a setting as Bellefontaine/West Liberty, but the skills I honed and experiences I had will serve me well as I encounter patients from all walks of life and all corners of the country. It’s not often medical students are even offered the chance to rotate through a rural clerkship, which is why I am privileged to have had this exposure and education. As a future psychiatrist, one of my greatest challenges will be building patient rapport. My rural rotation provided me invaluable experience in this aspect of my training and I will continue to build on this foundation.

Daniel Tseng is a medical student at The Ohio State University College of Medicine. His rotation in Bellefontaine/West Liberty, Ohio was from August 29 to September 23, 2011.