The doctors that ROME built
ROME, RuralMed, and other rural immersion opportunities help build a strong physician team in Devils Lake.
Providing training to health profession students in rural areas is a top rural recruitment recommendation, according to Dr. Dave Schmitz, chair of the University of North Dakota (UND) School of Medicine & Health Sciences (SMHS) Department of Family and Community Medicine.
“Training in the sticks….sticks,” as he likes to say.
Nowhere is this notion truer than in Devils Lake, N.D. The Altru Health System clinic in Devils Lake has been a longtime training partner with the SMHS, hosting students for the School’s Rural Opportunities in Medical Education (ROME) program and other training modules, including hosting former students taking advantage of North Dakota’s RuralMed program.
ROME is an extended rural training program that sends around eight medical students per year to rural healthcare facilities for 20-24 weeks during their third year of school. Likewise, RuralMed is a state-sponsored program wherein the cost of medical school tuition is reimbursed to SMHS graduates who commit to practicing in rural North Dakota for a minimum of five years.
Altru Clinic in Devils Lake employs eight full-time physicians. Of those, six are UND SMHS graduates and four completed ROME in Devils Lake specifically.
To participate in ROME, students are selected from a pool of applicants and assigned to one of six locations. Students may prioritize which communities they would like to train in, but they are ultimately assigned based on preceptor availability. Devils Lake has been a ROME site since 1998. A total of 36 students have trained in Devils Lake through the ROME program since its inception, including current physicians Dr. Candelaria Martin Arndt (’04), Dr. Stephanie Foughty (’12), Dr. Elise Dick (’19), and Dr. Ashlyn Kamrath (’20).
Dr. Derek Wayman (’03), who completed ROME in Hettinger, N.D., also practices in Devils Lake.
Other ROME sites include Jamestown and Dickinson in North Dakota, and Benson and Ortonville in Minnesota.
ROME has played a pivotal role for the physicians who now practice in Devils Lake. For some, the path to ROME started with the decision on where to apply for medical school in the first place. Martin Arndt and Wayman are from Montana and New Mexico, respectively. Both sought out UND’s medical school specifically for rural training programs like ROME.
“I chose UND because they had a ROME program and it fit my interest in eventual practice in a rural area,” Wayman said. “ROME helped me determine that I wanted to serve in a rural area where medical care is most needed.”
Martin Arndt was motivated to come to UND for similar reasons.
“Having an Indian Health Service (IHS) scholarship commitment to fulfill, I wanted to do medical school and ROME in a location that would give me the opportunity to work with a larger than average Native American population,” Martin Arndt said.
Devils Lake is located just north of the Spirit Lake Reservation and many patients from the reservation receive care in Devils Lake. This fit what Martin Arndt was looking for. During her ROME experience at UND, the physicians in Devils Lake helped her understand the full spectrum of what family medicine physicians can do in a rural setting. “I had more hands-on experience from ROME than my main campus classmates. I was better prepared for residency and had more confidence to perform procedures,” she said.
Another program available through UND designed to encourage and entice a rural North Dakota practice location is the RuralMed program, a state-funded tuition forgiveness program offered to SMHS grads in return for five years of practice in a rural North Dakota community.
In addition to participating in ROME, Dr. Stephanie Foughty was the first-ever participant in the RuralMed program. She committed to the program in her second year of medical school, even before her ROME experience, because she knew a rural medicine practice was in her future.
The decision to select Devils Lake as her rural practice location was an easy one, said Foughty.
“Rural medicine can be really challenging, and I had the opportunity to see how the group in Devils Lake handled these complex situations during ROME,” she said. “The physician group works so well together and really has each other’s backs. That has remained true during my time practicing in Devils Lake.”
Like Foughty, Elise Dick is also a RuralMed participant.
“I had a brief identity crisis in my first year,” Dick said. “I signed up for RuralMed but withdrew that same year because I thought it might limit my practice choices.”
But Dick re-applied for the program in her fourth-year because she learned (through her ROME participation in Devils Lake) that by choosing family medicine, her practice choices wouldn’t be limited at all. Before ROME and Rural Med, however, Dick’s first encounter with Devils Lake was during her four-week externship through a now-discontinued program called the Don Breen Program, which she completed after her first year of medical school.
“I came to Devils Lake multiple times as a medical student and as a resident. The joke was that each time I stayed a little longer,” smiled Dick.
Joining the team soon is Ashlyn Kamrath, who is currently finishing her surgical obstetrics fellowship in Grand Forks and will start practice in Devils Lake this summer. Kamrath is a 2020 SMHS graduate who completed ROME in Devils Lake during her third year of medical school. Hailing from nearby Lakota, N.D., Kamrath was drawn to Devils Lake for proximity to family, as well as the impressive training she received.
“Honestly, Devils Lake chose me as much as I chose it,” she said. “I felt like I was accepted as a member of its medical team and was able to make a difference as a student.”
In addition to ROME, Kamrath made rural health a focus during her medical school career by leading the Rural Health Interest Group (RHIG). RHIG is a student-led constituency group of the National Rural Health Association. RHIG worked to bring rural-related content to health profession students on campus.
Not looking back
Going forward, these five providers are all doing their part to offer the same great training opportunities that they received, including teaching ROME students. And all five agreed that they would advise any medical student considering ROME to go for it.
“The chance to experience being part of a care team in a small community is something you may never get to experience in any other aspect of your medical training,” Foughty said.
“After completion of ROME, you realize that your confidence in identifying diseases, treatment, and even how to do procedures has grown significantly,” Dick added.
Kamrath, who is looking forward to donning her white coat in the clinic room, looks back on ROME as one of the best things UND has to offer.
“I feel that the ROME experience is one of the best opportunities for clinical medicine training available to students,” she said.
While it may seem like Devils Lake is flush with physicians, they are continuing to keep their foot on the gas when it comes to accepting opportunities to showcase their location through training options.
“Recruiting physicians anywhere, but especially in rural areas, will continue to be a challenge,” Foughty concluded, “which is why programs like ROME are so important.”