FLAGSTAFF – Between working on class projects and studying for exams, medical student Nathalie Petein reports to Native Americans for Community Action Family Health Center at 8:15 a.m. five days a week, treating patients with chronic diabetes, hypertension and other problems. Some days she does the same thing at the county jail.
“It’s interesting to see similar diseases and how they present differently in patients,” she said.
Petein is working closely with primary care physicians during a five-week family medicine rotation that is one of several she will complete as a third-year student at University of Arizona College of Medicine-Phoenix in partnership with Arizona State University.
She’s one of 24 students comprising the first class who will complete all four years of their medical education at the Phoenix campus, which opened in 2006. Because she’s interested in family medicine, she signed on for the school’s Rural Health Professions Program to work alongside doctors who often have to do it all.
“The ability to work with rural doctors is amazing because they have a breadth of knowledge and are great teachers,” she said. “Primary care doctors in big cities have specialists around that they can refer to, so I think rural doctors know different aspects of problems greater than those in non-rural areas.”
While Petein, who grew up in Phoenix, said she doesn’t know whether she’ll eventually practice outside of a metropolitan area, school officials say her experience illustrates how having more medical students in Arizona will ultimately provide more doctors who will practice around the state.
“By the UA having two medical school campuses, we increase our odds of developing physicians to serve Arizona in both rural and urban areas,” said Dr. Carol Galper, assistant dean of medical education and director of the Rural Health Professions Program.
The Tucson campus has 110 medical students enrolled per class, and the Phoenix campus will expand next year from 24 to 48 students, said Al Bravo, spokesman for the UA’s Arizona Health Sciences Center in Phoenix.
Dr. Warren Perkins, one of those supervising Petein at the clinic here, said it’s good for students to be exposed to underserved populations early on.
“The cultural traits of the area require special skills that are beneficial to students in their careers,” Perkins said.
There is a significant shortage of doctors in Arizona, and that shortage is magnified in rural areas, according to Dr. Jacqueline Chadwick, vice dean for academic affairs at the UA College of Medicine-Phoenix.
“One of the goals of the school is to supply the state’s need for physicians,” she said.
The Rural Health Professions Program has been giving students the opportunity to complete their third- and fourth-year medical training rotations at rural sites since 1997. So far, 29 graduates from the school who were enrolled in the program are now practicing medicine in rural communities, and 21 graduates are practicing in underserved urban areas.
“Students have said they love it because they get to train with a physician in a setting without many other students competing for attention and that doctors in these areas are really enthusiastic about teaching,” Galper said.
The program also offers students housing and a stipend on essential living expenses to help offset the cost of maintaining their local residence while doing their rotations at rural sites.
Perkins, Petein’s supervisor, said he agrees with the program’s goal but noted that most opportunities in rural areas are in primary care, which doesn’t pay as well as medical specialties. Students who owe a lot in student loans often feel pressured to specialize, he said.
“A lot of students we have had here who would be great primary care doctors feel that they can’t afford to do it,” he said.
Galper said factors such as a lack of jobs available for spouses and greater education opportunities for children in metropolitan areas also influence the choice of where to practice. But she and others noted that state offers a program helping to repay the student loans of those who practice in areas deemed by the federal government as having shortages of doctors.
Petein’s other third-year rotations as part of the Rural Health Professions Program include internal medicine, psychiatry, pediatrics and OB-GYN. A surgical rotation between her first and second years took her to Show Low.
“I just like to get out of the heat, and I pick my own schedule – and just to experience living in a different type of community,” she said.