The Montana Department of Public Health and Human Resources reports that 43 of 56 counties in Montana are designated as areas with shortages of primary care health professionals.
As a rural family doctor and medical educator in Montana, I have seen and experienced the consequences of this deficiency firsthand. Friends from the healthcare profession have retired early or switched to a new industry. Patients may not always receive the best quality of care or may be excluded from specialized care for several months, particularly if they live in a rural or underserved area.
November 17th marked National Rural Health Day, an opportunity to raise awareness of the rural health landscape and those who make up its fabric. It is now more evident than ever that we, as Montana residents, need to create awareness and solutions for the way rural health care is delivered, not only for ourselves but also for younger generations.
To support our current population and our state’s future, we must create a medical workforce that has the skills, knowledge, and experience to serve Montana’s needs.
Connecting medical students with rural mentors, hospitals, and communities for a significant portion of their medical school education is critical if we are to encourage students not only to study and practice medicine in rural areas, but to come back to Montana to do those things to do. Montanas Medical School, Montana WWAMI, is the public medical school partnership between Montana State University and the University of Washington School of Medicine. Since the program began in 1973, Montana WWAMI has graduated 350 medical students who have since returned to the state to practice medicine.
Retaining and encouraging medical students to practice medicine in rural Montana is accomplished through programs such as Montana WWAMI’s Targeted Rural Underserved Track (TRUST) program. While some medical schools offer rural learning experiences, Montana WWAMI is the only public medical school in the United States that connects students with the same rural or underserved community throughout their three to four year medical education.
As students learn the moving parts of rural medicine necessary to create a sustainable and outstanding rural health care system, they work directly with Montana patients and gain hands-on knowledge year after year. Additionally, integration into a rural community allows students to imagine their careers as rural doctors and the benefits of returning to a rural community.
During these four years, students form deep connections with their mentors, patients and the community at large, often becoming integral members of the community. The long-term nature of the program allows students to strengthen strong relationships and see the difference that excellent healthcare can make in the lives of their patients.
TRUST scholarship holders like Dr. KayCee Gardner are excellent examples of why Montana should provide opportunities for students to work in rural Montana communities during their school years. dr Gardner grew up on a ranch outside of Broadus and completed her TRUST experience in Lewistown, a city of about 6,000 people. Subsequently, Dr. Gardner completed her residency at the Montana Family Medicine Residency in Billings. During her stay, she completed her rural rotations in Lewiston.
dr Gardner spent part of seven years of her medical training as a rural medicine resident in Lewistown. A lifelong Montanan with training in the specific needs of Montana, Dr. Gardner is now able to rapidly build relationships with patients to provide more connected care. She now works as a family doctor in Miles City, just over an hour from her hometown.
Improving access to and quality of care should be a priority for all Montanans—citizens, policymakers, educators, and health practitioners alike. Montana’s Medical School, Montana WWAMI, has demonstrated continued success in not only training outstanding physicians, but encouraging them to come home to practice. Programs like this are why more and more Montana medical students are choosing to live and practice medicine in rural areas throughout Montana.
dr Jay Erickson is a practicing family physician at Columbia Falls and Whitefish and associate clinical dean at Montana WWAMI. He has taught and practiced as a country doctor in Montana for 33 years.