A new generation of country doctors

Rural-PRIME prepares physicians for rural service with blend of skills old and new

For all of their allure, rural areas host most of California’s “doctor deserts.”

Patients there often face long wait times for appointments with heavily impacted physicians, and then long travel on dangerous roads to reach them. They suffer from higher rates of chronic conditions, hospitalizations and cancer deaths. Their doctors juggle many hats and ever-increasing demand driven by reform, while grappling with locally endemic issues such as high rates of illicit drug and alcohol use.

Launched in 2007, the Rural-PRIME track at UC Davis School of Medicine seeks to prepare primary care physicians and general specialists for the unique clinical, social, technical and leadership challenges of rural medical practice.

An initial two years in Sacramento include a mix of traditional education and rural-focused work, such as telemedicine training and doctoring courses led by rural physicians. Third-year clerkships in a mountain or agricultural community offer on-the-ground exposure to the ins and outs of small-community practice.

“You have to be well-versed in many things and provide patient-centered care to everyone,” said Suzanne Eidson-Ton, program director and UC Davis associate professor of family and community medicine. “You are more isolated as a provider, and you may have to be the one to deliver the baby, or to do the suturing. Our students get hands-on experience with many types of care.”

They also learn cultural sensitivity and how to handle the nuances of being a de facto public figure and secret-keeper in a small town, where patients may include your child’s teacher or your hairdresser.

“A big part of being a ‘country doctor’ is learning how to manage that professionally,” Eidson-Ton said. “But it’s also such a huge opportunity to be a leader in community health and lead initiatives, because people know you and trust you. It’s a lot of responsibility.”

The program accepts nine to twelve students per year. PRIME students are encouraged to pursue a master’s in public health, informatics or a related subject to enhance their leadership capabilities, though funding assistance is currently limited.