By Laura Smith, MD
“Then why did you leave your rural practice?”
This has been a common question in the past two-and-a-half years since I transitioned from working in a rural health clinic to being full-time residency faculty. Students, residents, and peers have asked this question after hearing me extol the virtues of rural full-spectrum practice with OB. This question has at times induced a guilty feeling, but more importantly has spurred me to review my reasons and goals for joining an academic setting.
Growing up in rural southern Illinois, the only kind of doctor I knew from a young age was my family doctor. He was intelligent, capable, warm, and his demeanor and aptitude made a lasting impression on me. When deciding on a career in medicine, his career is the one that I wanted to emulate. During pre-med, I was also fortunate to follow a full-spectrum osteopathic family doctor who expanded my vision of what a small-town doctor could be (a woman!) and do.
Throughout medical school and residency encounters with other full-spectrum rural family physicians, my goal was solidified to practice full-spectrum rural family medicine with obstetric care. I was fortunate to be accepted into a medical school and residency that had initiatives to train physicians to provide full-spectrum, comprehensive care to the rural and underserved populations of Illinois. Luckily, I also enjoyed doing most aspects of family medicine and was able to find a job at a rural critical access hospital where my vision could be enacted.
During my time in rural practice, I was astounded over and over by the comprehensive nature of my training and how it was great preparation for rural practice. Not only had the faculty taught me how to do the important medical aspects of medicine, they also provided great training in billing/coding and other aspects of non-patient care medicine.
Throughout my patient care experiences, my favorite moments were when I got to provide education to my patients and saw the “ah-ha” moment of when they truly understood their medical issues for the first time. Similarly, being a community preceptor for first- and second-year medical students provided another avenue to teach and hopefully spark an interest in the specialty of family medicine in those young learners, just as my preceptors had done for me.
It wasn’t long before I realized that teaching was one of my favorite aspects of my job. With this realization, it made sense for me to change the ratio of time spent doing the important aspects of my job – patient care, procedures, OB, and teaching – to better reflect my interests. It was a difficult decision to move away from my rural patient panel, but the excitement of joining the faculty at the program where I trained was great motivation.
The answer to the question of “why I left” is that as part of the residency faculty, I am now part of a system set up to help prepare residents and medical students to provide excellent care to any patient population – whether rural, urban, underserved, or not. As part of the faculty, my passion is to make sure that family physicians who graduate from our program are prepared to treat rural or underserved populations well and have the skills needed to provide comprehensive care in any setting. And, I still get to do all of my favorite aspects of family medicine – procedures, patient care, OB, and teaching – just with a different proportion of time spent on each one.