I had an amazing time rotating at the Family Medicine Residency of Idaho in Caldwell! Caldwell is a city about twenty minutes from my hometown. It has a population of about 30,000-40,000, with Boise being the closest major city. It has a small liberal arts college in town and plenty of farmland surrounding the city. Needless to say, when I was given the opportunity to rotate there, I was very excited.
However, I didn’t have high expectations before I got there. I was expecting a small hospital, poor organization, and limited resources. This was a small city compared to Omaha, Nebraska where I had spent the last three years in medical school. What I found was the complete opposite. As a student, I was given the same resources and respect as any other physician in the hospital. We were able to order any test or lab that was appropriate. There was a diverse population, and the quality of healthcare given was outstanding. And the rotation was just as good, if not better than any of the rotations at my home institution.
My days consisted of arriving at 7 a.m. for inpatient rounds. This was always a great time for learning since it was just the attending, the resident, and myself. I followed 2-3 patients every day and wrote notes on those patients. Anytime the resident or I had a question about a patient or treatment, we were literally only a few steps away from asking the attending physician. What a great benefit that larger hospitals can’t offer!
Variety of patients and experiencing hands-on training
After rounding and lunch, there were usually patients to see in clinic. Since I was there for only four weeks, I didn’t have my own patients, but I did see many patients, and was even able to perform a few procedures such as lipoma removal, hemorrhoid thermoplasty, and circumcision. Even though I had done just a few procedures in medical school, the attendings were very willing to teach me. They knew that I needed practice and were much obliged to give it to me.
Once a week there was an endoscopy day. During that day, we would perform colonoscopies and upper endoscopies. In medical school, I had seen many endoscopies but had never actually run the camera. In Caldwell, it was expected that I would learn how to do a colonoscopy from start to finish. At first I was nervous, and I couldn’t keep the camera centered, but with practice I can proudly say that I have now performed a handful of colonoscopies myself!
The other amazing aspect of this rotation was that I was given the freedom to go anywhere in the hospital which exposed me to a wide variety of cases. For example, there was a day that was fairly slow in clinic, and I asked if I could see what was happening in the operating rooms. The physician that I worked with personally introduced me to the surgeons and anesthesiologists. I was then allowed to first assist on a handful of cholecystectomies and also a C-section. Being in a rural setting, the doctors and nurses were happy to have an extra set of hands during these procedures and were glad that I was willing to help. It was a great feeling to be able to participate and joke with the surgeons and OR team.
In conclusion, my time spent in Caldwell was a great experience. Yes there were some downsides to the rotation, such as a recent migration to electronic records which prevented me from accessing lab data, but overall the learning, the variety of patients and specialties I was able to interact with were fantastic. Has this rotation changed my view on rural medicine? Absolutely! I wasn’t planning to practice in a rural setting before this rotation, but now I couldn’t imagine practicing anywhere else.