Medical students get real-world experience

MOSES LAKE - The math does not add up, at least in the forecast. More patients who will need more treatment, plus a shortage of hospitals where doctors can get the required post-graduate experience. Add to that the doctors who will opt to practice in urban areas, rather than going to medium-size cities or rural areas.

It all adds up to a minus, the forecast of a doctor shortage in eastern Washington. Dr. Hollie Matthews said the region could be as much as 3,000 physicians short of the number it needs by 2025, according to statistics provided in continuing education classes at the University of Washington.

The WRITE program is designed to address that.

Actually there are two programs, both with the goal of encouraging doctors to practice in rural areas. Students spend time during medical school working, and learning, in rural and smaller-city hospitals.

Matthews is a family practice physician at Confluence Health's Moses Lake clinic, and the primary preceptor (instructor) for the program in Moses Lake. Each year one medical student spends six months in the clinic, working with and learning from the doctors. Students also spend time in the clinic during their first and second years.

Nemo Ordonez, of Seattle, is the student in 2014. "It's been a good experience," he said. If patients agree, the student is part of the treatment process, in the room during examinations and discussing medical options along with the doctor.

"Here you work more closely with the doctors," Ordonez said. That doesn't always happen in medical school, he said. "Everyone is just so friendly here. The doctors have been very welcoming." Knowing the doctors, especially Matthews, makes it easier to ask questions, he said.

In Moses Lake, the doctors are engaged with students, want them to learn and will share their knowledge and experience, he said. "They'll come and get me if there's something interesting," Ordonez said.

During medical training, students are required to go out to a hospital or clinic and work in six specific areas, family medicine, internal medicine, obstetrics, pediatrics, psychology and general surgery, Ordonez said. But each specialty session is relatively short, which makes it difficult to get to know the doctors and get the maximum benefit from the training, he said.

But in Moses Lake he's working alongside the doctors for six months. "She (Matthews) is throwing me in there. The other places don't let me do this." The lessons are learned, he said. "You never forget it, that's for sure."

"I really do believe (the students) learn better," Matthews said. She cited her own experience in the program and the six months she spent in Colfax. Matthews said she would've described herself as an average medical student before her six months in Colfax, but she was a great student when she returned to class. "It was an extreme learning curve for me.

"I would tell you it's the best thing I ever did in my medical education."

Matthews said she thinks the program is good for the patients and the doctors as well. "I think it makes me a better doctor," she said. Although the teaching takes time, "they (the students) make me challenge my knowledge base all the time. And every now and then I have a medical student come up with an explanation I haven't thought of."

Patients must give permission before the medical students can participate. Matthews said in her opinion it's an opportunity for the patients as well. "You might get something out of it you weren't expecting," she said.

The setting gives students who are considering family medicine a look at the realities of practice, she said. "It's more like being a family medicine doc in that you don't know what's coming in the door," she said.

Ordonez is an Army veteran who worked treating wounded soldiers, and that got him interested in medicine, he said. He found he liked smaller-town life during his Army service, he said, and the program has given him a chance to look at rural medicine. ""It definitely made me appreciate the smaller area. I definitely like it more than I thought I would."

Matthews said doctors who participate are not required to work in rural medicine. But it's a good way to show doctors the opportunities available in smaller towns and hospitals, she said.