For Chrys Djatche de Kamgaing, a medical student at The University of New Mexico, the value of spending six weeks of his summer at a hospital in Las Vegas, N.M., was obvious.
“No matter what you do, you’re going to be working in an underserved area somewhere at some point in your life,” he said.
He would know: He’s originally from Cameroon, Africa. Rural medicine, he says, is what he’s been around most of his life.
Rural health centers with limited resources and not enough doctors on staff also are a way of life for many people in New Mexico.
According to a 2016 report from the New Mexico Health Care Workforce Committee, a group that provides research on health care professions to the state Legislature, the numbers of medical providers in most areas of the state are below national recommendations. The 34 percent of New Mexicans who live in rural areas are most acutely affected by the shortage.
This summer, 90 first-year UNM medical students were dispatched to 33 locations around the state to experience medicine in rural and underserved communities for themselves as part of UNM’s Practical Immersion Experience, or PIE, program. They spent six weeks getting hands-on experiences in clinics, learning about the communities they lived in and forming a sense of whether practicing medicine in rural New Mexico might be the calling for them.
“Definitely, one of our agendas was to get students, by seeing rural New Mexico and health care in rural New Mexico, to go back,” said Dr. Anthony Fleg, who coordinated this year’s PIE program.
About 40 percent of the doctors practicing in New Mexico are UNM grads, Fleg said. “But we also know that we can continue to do more to get UNMers to stay right here in our state, especially in rural communities.”
Whether students return to rural New Mexico depends on a lot of different factors, like where their family is from, where they do their residency and what kind of medicine they want to pursue, Fleg said. The students in the program still have three years of medical school and a residency before they are full-fledged doctors. But the hope is that exposing them to rural medicine might influence them to consider that path down the road.
But emphasis of this year’s program went beyond recruitment. Fleg’s goal was to teach students to get to know the communities they served.
“Being an active participant in your community, being a good listener, not just holing yourself up in the walls of your clinic, is important,” Fleg said, “and ultimately much more effective in improving health in communities.”
To establish those standards, Fleg ramped up the time students in the program spent asking community members which issues were most affecting the health of their community and working with community health programs.
If nothing else, Fleg wanted to teach medical students how to listen.
For Ricardo Galicia, who worked with family practitioners at La Familia Medical Center in Santa Fe, the depth of listening required of clinic workers took him by surprise.
For his community immersion experience, he shadowed providers in the Suboxone program, a medical-assisted treatment for opioid addiction.
“Intakes for some of the new patients were completely different from what I was expecting,” he said.
In describing their substance abuse disorders, many of the patients recounted traumatic experiences that influenced their use. It was more personal and emotional than he had anticipated.
Looking back on the six weeks, one of the experiences Galicia valued most was having patients confide in him.
“I think a lot of the time patients mostly need an ear and someone to listen to,” he said. “I enjoy the aspect of knowing I have their trust. They would be willing to share such emotional information with me. That meant I was doing my job.”
Djatche de Kamgaing took his listening to the streets, interviewing mail carriers and bookstore clerks and custodians in Las Vegas. He was familiar with the town, after completing his undergrad degree at New Mexico Highlands University, and knew that there was mistrust between locals and Alta Vista Regional Hospital, where he was working with emergency room doctors and specialists.
What he discovered was that negative perspectives had the potential to influence health care outcomes. If community members expected a negative experience and let that deteriorate their trust in the doctor, they might not follow recommendations. Alternatively, doctors who interacted routinely with patients who didn’t appreciate their work likely had trouble keeping a good attitude, he said.
Before he left Las Vegas, Djatche de Kamgaing put together recommendations on how to increase communication between the hospital and the community through advertisements, the radio and other media.
“It was cool to see how all these things fit together,” Djatche de Kamgaing said. “Sometimes in medical training, you get too focused on only the technical aspect and forget that a physician can be much more of an asset in the community.”
Contact Sami Edge at 505-986-3055 or firstname.lastname@example.org.