Charles Rhodes, M.D., shown here working with a young mother and infant in the Dominican Republic, was thrilled when fourth-year medical student Patrick Williams (right) agreed to join the recent medical mission trip.
Charles Rhodes, M.D., of Cabarrus Family Medicine in Mount Pleasant, N.C., has been practicing medicine for some 30 years. He describes family medicine as a "specialty of relationships" between a physician and his patients.
"Family medicine chooses you; it's just something that fits your personality. I'm on fire for it and have been since I started medical school," said Rhodes in an interview with AAFP News Now.
Rhodes exemplifies the kind of mentor that the North Carolina AFP had in mind when it launched its Family Medicine Interest and Scholars Program in June 2010.
The program is a joint effort aimed at increasing the number of North Carolina-trained medical students who enter a family medicine residency program and remain in the state to practice. The program is funded by a six-year grant of nearly $1.2 million from the Blue Cross and Blue Shield of North Carolina Foundation(inspirednc.org) and a $600,000 North Carolina chapter commitment.
- A student interest and scholars program launched in 2010 by the North Carolina AFP with financial help from the Blue Cross Blue Shield of North Carolina Foundation is beginning to show positive results.
- Ten of the 12 members of the first class of the scholars program have chosen family medicine, primary care or other specialties of need in North Carolina.
- Student membership in the state chapter and student attendance at the annual meeting have surged to new highs.
Two years into the program, the NCAFP is seeing an explosion of interest in family medicine. Chapter EVP Gregory Griggs, M.P.A., said the program is just now getting to the point where real outcomes can be measured. "We have a lot of early data that shows we're moving in the right direction," he said.
The first class of student scholars selected to participate in the program in 2010 are just entering the residency interview process, and 10 of the 12 students will enter the 2013 National Residency Matching Program. The other two students are completing master's degrees and will enter the Match in 2014.
Of the 10 students matching in 2013, five intend to choose a family medicine residency program, and three others intend to select primary care areas or other specialties of need in North Carolina. Just two students chose other specialties.
Additional NCAFP statistics add credence to the argument that the chapter is bringing students into the family medicine fold. Numbers tell the story.
- Student membership numbers swelled from 180 in November 2010 to 478 in the spring of 2012.
- Student attendance at the chapter's annual meeting nearly doubled from an average of about 37 students each year from 2004 to 2009 to 78 students in 2011.
- A total of 30 rising second-year medical students had some kind of family medicine clinical experience in the summer of 2012; in years past, the chapter typically funded four summer experiences.
Patrick Williams is a fourth-year medical student at East Carolina University's Brody School of Medicine in Greenville and one of the 12 medical students selected for the scholars component of the chapter program in 2010.
"I was not committed to family medicine, but it was an option I was interested in," said Williams. He added that, before entering medical school, he had been leaning toward general surgery. But his long-standing relationship with Rhodes -- "the model mentor," according to Williams -- tipped the scales in favor of family medicine, and Williams will soon be interviewing with family medicine residency programs.
According to Rhodes, Williams has done so many rotations at Cabarrus Family Medicine that "He has patients who think he is their doctor."
Rhodes and Williams were introduced the summer after Williams completed his first year of medical school. "He didn't just show me the medical aspects of family medicine, but also the other things that are important -- the value of knowing patients, families, situations and how that can affect patient care," said Williams. Rhodes introduced him to family and friends and connected with Williams at annual chapter meetings three years in a row.
The scholarship program footed the bill for Williams to attend national and state academy functions, including the AAFP's National Conference for Family Medicine Residents, the NCAFP's annual meeting and the chapter's Family Medicine Day.
Ten medical students selected by the North Carolina AFP for a two-week rural health experience in the summer of 2012 take time off to enjoy a day of white-water rafting.
David Lee, M.D., of Lewisville, N.C., is involved with the scholars program as a year-round preceptor at the Wake Forest University School of Medicine in Winston-Salem. He mentored Brian Sanders during the final three years of Sanders' medical school training.
"Brian is a success story; he has selected family medicine at a critical time when the nation is facing a looming primary care shortage," said Lee.
Sanders completed multiple rotations in Lee's practice and saw the practice transform itself into a patient-centered medical home. He also watched the difficult transition to an electronic health record. Sanders showed an interest in health care policy at the state and federal level and, according to Lee, "carved out time during fourth-year electives to meet with chapter staff and leaders to learn what they're doing on behalf of family physicians in our state."
Sanders represents the type of leader family medicine is going to need, said Lee. "In medical school, we don't get enough about the business of medicine or public policy and how to effect change, and having somebody like Brian take a keen interest in that -- even as a student -- is really remarkable."
For his part, Sanders admitted that until about eight months ago, he was considering the subspecialty of otolaryngology. He said the experiences he shared with Lee and the NCAFP "afforded me the opportunity to discover everything that family medicine provides."
"Truthfully, had I not had those experiences with the NCAFP, it would have been less likely that I would have considered family medicine," said Sanders.
Ditto for Amy Nayo, a third-year medical student at the University of North Carolina School of Medicine in Chapel Hill and a 2011 member of the scholars program. She said that a summer externship confirmed that family medicine had the breadth of scope that she was seeking. "Perhaps most importantly, it will allow me to forge ongoing relationships with patients. I really can't see myself practicing any other kind of medicine," she said.
Christopher Danford, a fourth-year student at Duke University School of Medicine in Durham, N.C., represents another win for family medicine. Danford was chosen as one of the winners of the AAFP's "Tomorrow's Leader" awards at the 2012 National Conference and leads a family medicine interest group at Duke.
Danford's attraction to family medicine was nurtured through the student interest component of the NCAFP initiative. He attended chapter events, CME meetings and the annual Family Medicine Day. Through his chapter affiliation, Danford was privy to presentations given by notable family medicine speakers and was invited to attend the chapter's quarterly council meetings, including those of the Council on Advocacy and the Council on the Health of the Public.
"Without the North Carolina chapter, I might not be where I am today," said Danford. He admitted that family medicine was not on his radar when he started medical school.
"I really didn't know what I wanted to do. Neither of my parents is in medicine so I didn't have a lot of preconceived notions about it," said Danford. "I only had an inkling that I wanted to do primary care."
Danford liked the idea of caring for patients for the long haul as opposed to "just swooping in when someone is acutely ill, patching them up and sending them on." Today, Danford looks forward to matching with a family medicine residency program and eventually practicing in North Carolina.
A newer element of the NCAFP's student interest outreach, the rural health experience, launched this past summer. The two-week program was the brainchild of Geoffrey Jones, M.D., residency director of the Mountain Area Health Education Center Family Medicine Residency Program in Hendersonville, N.C. Medical students were welcomed into the homes of FPs and family medicine residents for the duration of their experience to give the students a realistic look at the life of a rural doc seven days a week.
"We piggy-backed onto the NCAFP's medical scholars program," said Jones, who was also able to use some grant money left from another rural health project.
A total of 10 students spent the first of two weeks in didactic activities at the Hendersonville residency as well as visiting home-bound patients, touring rural community hospitals and free clinics, and bonding with family medicine residents.
During the second week, students worked with family physicians in rural practices.
Rebecca Harnish, a second-year student at Wake Forest, admitted that before her summer experience in a rural setting, family medicine had held little attraction for her. Her medical school experiences up to that point had been top-heavy with chronic disease management.
However, immersion in a rural family medicine setting "really pushed me toward family medicine," said Harnish. "I left there feeling so inspired."
And although Harnish has yet to commit to family medicine as a career choice, she certainly is beginning to talk the talk of a family doc.
"What's strange to me is that as a (sub)specialist, you might become very keyed into just one specific skill set. But with family medicine, I have to learn all of this material and hang on to it because some day there will be a patient who needs it. We have to have such breadth of knowledge."
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