A Promise for Rural Medicine

The concept of giving back to others is nothing new to third-year medical students Rivers Woodward and Brittany Papworth. As Albert Schweitzer fellows, they wanted to encourage students in rural communities to seek careers in health care while fostering a spirit of pride among them. This year they designed an academic enrichment program to reach out to local students in rural, western North Carolina, in hopes of sparking interest in medicine.

A Promise for Rural Medicine click to enlarge Rivers Woodward and Brittany Papworth at the National Conference for Family Medicine Residents and Medical Students. (Photo courtesy of Rivers Woodward and Brittany Papworth)
A Promise for Rural Medicine click to enlarge Students from PROMISE mapping out the counties that are experiencing shortages in the number of health professionals working in them. (Photo courtesy of Rivers Woodward and Brittany Papworth)

by Hannah Crain - hannah.crain@unchealth.unc.edu

“Volunteering and community involvement have become a way of life for me,” says Woodward, whose service projects include working as a Public Service Scholar while an undergraduate at UNC, coaching softball, basketball, and soccer for Special Olympics of Orange County, and being a Big Brothers Big Sisters mentor. “In my mind, it’s a way to become connected to a community.”

For Papworth, her passion for service blended with medicine when, as an undergraduate at UNC, she volunteered for Carolina Pediatric Attention Love and Support (CPALS),  during which time she developed close relationships with two pediatric cancer patients at UNC Hospitals.

“We had some really good times despite the difficult circumstances,” says Papworth, who plans to specialize in family medicine because of the broad perspective of medicine and patient interaction it offers. “The experience strengthened my desire to go to medical school.”

Together, the students have taken their commitment to service and recently applied it to their other shared interest:  rural communities. Last year, as Kenan Primary Care Medical Scholars, they provided care for underserved rural communities near Asheville. As a result of their experience, the students, who are spending this year as Albert Schweitzer fellows at the School of Medicine’s Asheville campus, have designed PROMISE, an academic enrichment program for 14 students at Mitchell High School and Mountain Heritage High School in rural, western North Carolina.

“Although 45% of residents live in rural areas in the state, only 16% of our physicians practice in these areas,” Woodward said. “It is this fundamental inequality in access to healthcare in our state that is the stimulus for this project.”

PROMISE stands for Providing Rural Opportunities in Medicine through Inspiring Service and Education. The program curriculum includes training in clinical skills such as taking blood pressure and basic suturing. In other sessions they talk about different careers in healthcare, exploring the educational path, a typical day and salary, and schools in the area that offer that degree. Each high school student is also paired with a second or third year medical student for bi-monthly mentoring. Students are asked to complete a health-related project in which they give back to their communities.

The goal of the two Schweitzer fellows is to encourage students to seek careers in health care while fostering a spirit of pride among the students in their community. That combination, Woodward and Papworth believe, may one day facilitate their students’ return to rural communities to work as health care providers.

Woodward has seen positive results from their students so far and has gained valuable perspective as a medical student.

“I love hearing the students discuss their perceptions of different issues in health care because it helps me to step outside of the medical culture that I live and breathe each day,” says Woodward.

For one of their class lessons, the students were presented with a map of North Carolina to visualize and understand which counties are experiencing shortages in the number of health professionals working in them. As a group they discussed how the distribution of health professionals related to the location of medical schools, major cities, interstates, and urban areas.

As part of PROMISE, students take field trips to places like Linville Gorge for an outdoor session on wilderness and emergency medicine and to a local simulation lab to give students hands-on experience with IV sticks, blood pressure readings, and acute crisis management. At the end of the year the students will participate in a retreat to the Mountain Area Health Education Center (MAHEC) in Asheville, where they will present their projects to faculty and students from the UNC School of Medicine.

“We are excited about the daylong retreat at MAHEC, where the students will have more direct interaction with a variety of health professionals,” says Papworth. “It will be great for professionals in Asheville to also realize what a positive impact they can have on area youth by promoting health careers in western North Carolina.”

Despite the tedious planning and complicated schedules that result from being medical students and Schweitzer fellows, the two look forward to enhancing views of medicine in the local community. The long hours of clinical work, studying, and regular exams, along with the demanding schedule of the community service project, haven’t deterred Woodward and Papworth, who gives herself reminders when things aren’t going to plan.

“Always remember why you originally wanted to do the Schweitzer fellowship,” she says. “Keeping focused on making a positive impact on the people that you were excited to help initially is what will be important to maintaining a productive attitude throughout the good and not so good times.”