What it’s like to do your clinical rotations in Alaska

Many think of Alaska as a barren, snowy expanse of wilderness. The brutal cold and relative isolation can make it a difficult place to live, much less practice medicine, given the resources available and the distance some patients have to travel to get care.

Fairbanks, just east of the center of the country’s largest state, is Alaska’s second largest city with a little over 30,000 residents. It is the largest city, by far, in a 350-mile driving radius.

But for pediatrician Anne Hanley, DO, who grew up in Seattle and trained in Massachusetts, Fairbanks is a tight-knit community she calls home. Dr. Hanley oversees a one-year clinical rotations program at Fairbanks Memorial Hospital as Pacific Northwestern University of Health Sciences’ regional assistant dean, a program she herself completed as an OMS III student.

Teaching and learning medicine in the “Last Frontier” can be both challenging and rewarding, namely because of what Dr. Hanley refers to as a wide “amplitude of clinical variety.”

Due to limited medical resources in the area, students are often confronted with situations outside of their rotation’s specialty and have to learn and adapt on the fly. She recalls one recent emotionally difficult day when a student was doing an exam on a healthy newborn and then immediately afterward was called to a code for a child who eventually died.

In this edited Q&A, Dr. Hanley provides insight into those rotations and life 200 miles below the Arctic Circle.

How are clinical rotations in Fairbanks different than those in other locations?

It’s pretty similar to those at most of the schools that have community-based rotation settings. We have three to four students at a time. Some of them know what they’re getting into in Fairbanks, but some of them don’t. Here they have a lot more hands-on exposure than you would get at a bigger academic center. Whereas other third-year medical students are often doing kind of fly-on-the-wall things and just watching and learning and absorbing as much as they can.

For some students it’s great, and for some students it can be hard, because it’s just emotional. You kind of have to be ready and willing to take on anything. Some folks love it and some folks need a little bit more warning of that coming down the pike.

Is this open to any DO student or only PNWU students?

Medical students are just from PNWU. But we do have students from [non-PNWU] schools coming up periodically to do a single rotation here and there. We haven’t had students come up to do a whole year of clinical rotations. We haven’t really talked about if we’d be able to take students from another school because it’s hard to get everybody set up with the rotations they need. We’re a small community, but on an ad hoc basis, if someone was interested, we could talk to them.

What are some other challenges specific to Fairbanks?

On the non-clinical side, it’s cold and snowy and isolated and milk costs a little more up here. Avocados aren’t as good here. From a clinical standpoint, since we don’t have a large academic center and residents (or more than one at a given time), it’s not a big teaching service. So a lot of the attending physicians don’t schedule their day around teaching, and you kind of pick up your learning where you can.

The students who really take the initiative and do a lot of reading and ask questions and get involved as much as they can tend to do really well. The students who are a little more passive in their learning and expect it to be set up for them tend to not enjoy it here as much because we teach, but it’s not set up as a teaching hospital.

What advice would you give for someone who wants to do medical training in Alaska?

The biggest thing is that it’s really important to be ready and willing to take on anything, and be enthusiastic about learning as much as you can. Even if you don’t think you want to learn about that one thing, it could be the most interesting thing you ever see. So it’s important to just keep an open mind and have an adventure both personally and clinically.

What do you like about living in Alaska?

It’s kind of a raw place. When it’s 40 below in the winter, it’s 40 below for everybody, and you all kind of go through it together. And it just feels like a really tight-knit community.

I was at the grocery store this morning and I saw a bunch of my patients and their parents and siblings. It feels like you’re a part of something. When I got here, I got this sense that this is a place like no other.

What are some things people don’t understand about Alaska?

There’s a lot of incredible research and culture that stems from here. And we’ve got an incredible education system that is not all that well-publicized.

We’ve got geologists and seismologists and wildlife biologists who would rather be here than anywhere else because of the quality of research they can do. And we’ve got an opera. My relatives think that we just sit on our couches and watch Netflix all the time, but we’ve got people contributing to society in a lot of different ways.

Related reading:

5 tips on using VSAS to apply for elective clinical rotations

7 ways to thrive during clinical rotations