How DMU-COM prepares students to practice rural medicine

Second-year osteopathic medical student Brianna Wilcke hasn’t made a final decision on which specialty to pursue, but a career path is calling.

“Having grown up on a small farm in northwest Iowa, I knew coming into medical school that I wanted to practice in a rural area,” says Wilcke, who attends the Des Moines (Iowa) University College of Osteopathic Medicine (DMU-COM).

If Wilcke chooses family medicine, she’ll have lots of company. DMU-COM was recognized last fall by the American Academy of Family Physicians (AAFP) for having the highest percentage—and number—of graduates entering ACGME-accredited family medicine residencies among all the DO and MD schools included in the analysis.

This year, nearly half of DMU-COM’s graduates will enter family medicine or internal medicine residencies. Among the 14% of DMU-COM grads who matched into residency programs in Iowa, that proportion is even higher, at 73%.

Rural medicine at DMU-COM

Encouraging future DOs to practice in rural Iowa is part of the school’s mission, says Mark Danes, DMU-COM’s chief strategic communications officer. All but one of Iowa’s 99 counties are home to at least one health care professional who graduated from Des Moines University’s College of Osteopathic Medicine, College of Health Sciences or College of Podiatric Medicine and Surgery.

To achieve that mission, the career path is introduced early. First- and second-year students can choose a rural medicine elective that involves shadowing at small area hospitals and taking part in simulated medical emergencies.

“This fall, we brought a grain bin to campus and staged a rural accident so the students could practice rescuing a person who was stuck,” explains Bret Ripley, DO, who heads up the school’s family medicine department.

Life in the country

Rural medicine gives physicians the chance to tackle an unusually wide range of clinical challenges because there are fewer medical professionals in the area. The most recent survey of graduating osteopathic medical students by the American Association of Colleges of Osteopathic Medicine found the “intellectual content of the specialty” was the biggest factor students consider in making a residency choice.

Also, with student loan debt top of mind for new graduates, some rural states like Iowa offer loan repayment programs to make it easier for new physicians to choose life in the country.

DMU-COM assistant family medicine professor Noreen O’Shea, DO, spent 20 years practicing in rural settings—an experience four of the school’s five family medicine faculty members have in common.

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“Along with doing clinic hours Monday through Friday, it’s common for rural medicine docs to spend one night each week or one weekend each month as the ER doctor on call,” she explains. “You’re doing everything, so you gain a wide breadth and depth of both inpatient and outpatient knowledge.”

Connection with patients

Because they’re so deeply embedded in small communities, Dr. O’Shea notes, rural medicine physicians also have a unique opportunity to connect with patients. That sentiment is echoed by William J. Burke, DO, the dean of the Ohio University Heritage College of Osteopathic Medicine at Dublin.

“I’ve had a practice in a rural underserved setting. I’ve had a practice in a suburban community that is a part of a larger metropolitan area,” Dr. Burke recently told U.S. News & World Report. “And while I have loved the patients that I have taken care of in both areas, and most of them were incredibly grateful, I found that there was something very special about those patients that I worked with in those rural areas.”

For Brianna Wilcke, OMS II, caring for and connecting with underserved patients is one of the biggest draws of rural medicine. “I know the need for rural doctors firsthand, and the opportunity to form long-standing relationships with patients is really appealing,” she says. “I’m keeping my mind open as I start rotations next year, but I’m excited to call myself a family medicine prospect.”