UW students learn rural medicine in Grand Coulee

Grand Coulee is gaining a reputation among University of Washington students interested in rural medicine.

Coulee Medical Center is among the smallest of a handful of facilities used by the university in its five-state area for a set of programs designed to introduce medical students to rural medicine.

"This is true rural medicine, where the doctors do it all," said Tara Olson last week at a Rotary Club luncheon.

The third-year medical student has spent plenty of time at CMC, working her way through various components of the program that fall under the umbrella acronym of "WWAMI" - Washington, Wyoming, Alaska, Montana and Idaho Medical Education Program. UW is the only school training medical doctors in those five states.

To address the need for doctors in rural areas, the UW school of medicine introduces students to communities for several years in a row, each step giving them an understanding of rural medicine, rural communities and rural needs.

Olson, a little over a year from getting her "MD" title and starting a residency somewhere, is currently studying at CMC in the WRITE program (WWAMI Rural Integrated Training Experience) under Dr. Andrew Castrodale.

Her husband, Dan Person, has also jumped into the rural lifestyle, volunteering at the high school and fire department.

This is the third year Olson has spent time learning in Grand Coulee, which makes other possible sites - Moses Lake, Ellensburg - "seem metropolitan," she said.

She regards Castrodale and Dr. Jacob Chaffee as mentors, and arranged last year for a whole class of students from Spokane to tour CMC and the Indian Health Services clinic in Nespelem.

"Grand Coulee is definitely getting a reputation in the medical school as a place to go if you want to do a lot, learn a lot, meet great people," she said.

The Targeted Underserved Rural Track (TRUST) program Olson is following sets students up to return repeatedly to a community - starting with about a week in August before starting med school, three to four visits each semester in the first year, more visits in the second year, and 18 to 20 weeks of experience in the third year in the WRITE program.

CMC has hosted five students in the program, including four currently active in it.

Dr. John McCarthy, an assistant UW dean in the WWAMI program, based in Spokane, said Tuesday that Grand Coulee is "a great site." Students return with "a profound respect for the physicians and mid-level (health care providers) there," he said.

Castrodale championed the idea of bringing the program to CMC several years ago. A market study done before building the new facility in 2010 recommended bringing two more physicians on board.

"It's tricky to recruit physicians to rural communities," McCarthy, from Tonasket, noted, calling CMC's involvement in the program "very savvy."

"Andy and Jake are in it for the long run," he added.

Students are also savvy about the tactic. Olson laughed that the experience sometimes feels like "one big job interview."

"I know from talking to Dr. Castrodale his hope is, down the line, you get that reputation and people will start to come back when they know what it's like," Olson said. "We talk about that a lot."

She noted that this year she is seeing children for whose births she had been present during her visits here over the last three years.

"The thing I hear most from most of the students," noted Debbie Bigelow, CMC's director of community outreach, "is the relationship they are able to form with their patient. That's the thing they love most about rural."

The UW program has yielded 129 resident doctors, 33 percent of whom have returned to rural areas, Bigelow said.

"Our chances are pretty good, we might get one," she said.