By James Barnett, MD

Dr. Barnett

TellezI recently met Dr. Maoxiim Tellez for breakfast at a favorite Springfield restaurant—Incredibly Delicious. (Indeed, it was that!)  I set out to see how the Rural Student Physician Program (RSPP) had influenced Maoxiim.

Maoxiim and I caught up on each other’s families.  We had not seen each other since 2004.  She completed the RSPP in 2003 before I joined the program in 2005.  Maoxiim is married to Andreas, a teacher.  They have three kids:  Abby, Demaris, and Sam.

The RSPP is a longitudinal integrated clerkship (LIC).  I would like to introduce you to LICs and give you a taste of the LIC impact through meeting Dr. Tellez.

The RSPP is Peoria’s LIC—an optional program for third-year medical students at the University of Illinois College of Medicine in Peoria (UICOMP). RSPP is the only longitudinal integrated clerkship for the University of Illinois College of Medicine’s three campuses.

LICs may be a partial pendulum swing or a kind of back-to-the-future moment for medical education. In the 1800s and early 1900s, there were stronger apprenticeship models, but the education had less scientific rigor. After the Flexner report in 1910, a four-year medical school became the norm, with the first half filled with academic lectures and the second half with clinical block rotations.

The movement toward LICs began around 1971 with the Rural Physician Associate Program (RPAP) in Minnesota.  Programs emerged in Canada, Australia and other countries.  Prior to 2000, there were about five known LIC programs. By 2015, about 35% of US medical schools had an LIC—indicating that LICs were moving from innovative novelty to mainstream education.

LICs often bring together experiences in Internal Medicine, Pediatrics, Family Medicine, Psychiatry, Surgery, & Obstetrics Gynecology. A simplified schedule looks like: two-three days a week in Primary Care; one day a week in Surgery, and one day a week in Obstetrics Gynecology.

Maoxiim appreciated getting a good sense of what the specialties were like. It reinforced her desire to enter Family Medicine.

“I got to do a lot of procedures—and now I do a lot of procedures in my office because I feel comfortable doing them,” Maoxiim said. If you do enough (procedures) with someone kind and who makes you feel comfortable—you become confident.”

After residency in Springfield, Maoxiim and her husband decided the area would be a good place to settle. At the time, there was not a job offer in Springfield, but rather an opening in Petersburg, a rural community northwest of Springfield — about a 30-minute drive.

Petersburg clinic

“Without RSPP, I would not have been open to rural practice,” Maoxiim said.

She grew up in San Diego, and she and her husband anticipated returning to California. But when the door opened for the rural Illinois job, she was very willing to go for it, thanks to her experiences in RSPP.

A rural practice can be an extended family.  Her RSPP preceptors and nurses in Galesburg were kindhearted and nurturing.  It seemed like a more welcome environment for students than in the large medical center.

And now the family focus continues in Petersburg, where those in the community have become like family.

“There is such a huge need (in rural areas) and people don’t realize how rewarding it is (to practice rural medicine),” Maoxiim said. “If you don’t expose students to rural practice, they may never know.  But after RSPP, a student is likely to say, ‘I can do this!’”

Thank you, Dr. Maoxiim Tellez, for meeting with me and sharing your story!  And thank you to the team of dedicated teachers/mentors across Illinois who continue the fine work of nurturing our RSPP students.

Perhaps the pendulum swings in a way toward a future of more LICs.  This could help in the process of bringing scientific healing and humanism together.

About the Author

Dr. James Barnett is the Rural Student Physician Program Director and a Clinical Associate Professor in the Department of Family and Community Medicine.