Tales from Tioga and Fort Totten about how rural experiences changed the minds of some UND medical students.<\/p>\n
Medical students are assigned many rotations, or other clinical experiences, throughout their four years of medical school. For those in their first two years, opportunities for short shadowing experiences are available for a glimpse at a community or facility. And in the later years of medical school, longer and more formalized rotations fill their schedules.<\/p>\n
Some of these later rotations include those in rural areas of North Dakota. Cody Riggle (MS4), Mercedes Hoffner (MS1), and Eric Leveille (PGY1) are only a few of the current or former UND School of Medicine & Health Sciences<\/a> students who took on a rural rotation.<\/p>\n To get a direct take on the value of rural training, North Dakota Medicine<\/em> magazine<\/a> assembled the trio and asked them to share how their rural experiences during medical school shaped their view of what rural practice means and what they hope to carry forward in their medical school and professional practice journey.<\/p>\n A deeper understanding<\/strong><\/p>\n Mercedes Hoffner is nearing the end of her first year of medical school. While official rotations don\u2019t start until later in the second year of medical school, Hoffner heard about RISE \u2013 the Rural Interprofessional Shadowing Experience available to health profession students at the University of North Dakota \u2013 through the UND Center for Rural Health<\/a> and wanted to get out and experience rural healthcare settings as soon as possible.<\/p>\n Hoffner chose to shadow at Spirit Lake Health Center<\/a> (SLHC) in Fort Totten, N.D., this past fall. There, she was paired with Dr. Jeffrey Vaagen, both a family medicine and internal medicine physician, who has been with the organization since 2016. A UND grad himself (M.D. \u201994), Vaagen showed Hoffner that addressing family and community health, in addition to physical health, is vital to patient care.<\/p>\n Given Hoffner\u2019s passion for public and community health, and, since COVID, population health, Vaagen\u2019s background struck a chord with the medical student.<\/p>\n \u201cI was blown away by Dr. Vaagen\u2019s close relationships with his patients and how patients opened up to him about sensitive topics,\u201d Hoffner said, noting that Vaagen would spend nearly an hour with some patients to understand them better. \u201cI hope, in the future, I can take time to listen to patients like he does and learn about their entire wellbeing so I can provide better care for them.\u201d<\/p>\n Dr. Vaagen defers the praise of being a great teacher to the community members. \u201cThe Spirit Lake Oyate \u2013 or, community \u2013 are the real teachers,\u201d Vaagen said. \u201cOur students get to experience some of the rich culture that we serve and see our relationships with our patients.\u201d<\/p>\n Additionally, Hoffner was amazed by the resources available in a small clinic, something that Vaagen says is a common surprise.<\/p>\n \u201cMy preconception was that a lot of referrals took patients to larger cities,\u201d Hoffner said. After being on-site and experiencing how patient care was delivered at SLHC, though, Hoffner saw the importance of having many services already on-site that they could literally walk their patients to. \u201cIt made me more excited about rural health and the potential of serving a rural community. I realized I wouldn\u2019t have to sacrifice quality of care or diagnostics because of being located rurally.\u201d<\/p>\n While Hoffner\u2019s experience was short, it made a lasting impression.<\/p>\n \u201cI had so much fun,\u201d she said. \u201cThe experience helped give me a more realistic view of practicing in a rural area.\u201d<\/p>\n \u2018I want to be like Dr. Bob\u2019<\/strong><\/p>\n Eric Leveille (M.D. \u201922) and Cody Riggle both spent time in Tioga for clinical rotations. Riggle was there during his fourth year and Leveille did two separate rotations; one in his third year and again in his fourth.<\/p>\n \u201cIt was such a good experience that I wanted to go back,\u201d Leveille said. Coming from the state of Michigan, Leveille had never been to rural North Dakota before his first Tioga experience. He was surprised by quite a few things. \u201cThe landscape was one thing, but I was more surprised that someone like Dr. Bob was out there to begin with.\u201d<\/p>\n \u201cDr. Bob\u201d is Dr. Robert Rotering. Affectionately known to his students and patients as Dr. Bob, Rotering joined Tioga Medical Center<\/a> (TMC) in 2016 after a colorful career in global medicine under \u201cProject Hope\u201d (see the Spring 2019 issue of North Dakota Medicine<\/em>). He came back to his home state of North Dakota in the name of service after traveling the world to provide medical care to the underserved. Now, Rotering is taking on medical education by storm. In his seven years at TMC, he has bolstered the site\u2019s medical education program, instructing about 15 health professions students every year.<\/p>\n \u201cTioga is the best site to do a rural rotation,\u201d said Riggle. \u201cI felt like a full-fledged physician there. If I made mistakes, Dr. Bob would be patient with me and help guide me. Even as a super busy physician, he still made us a priority without feeling rushed.\u201d<\/p>\n Leveille agreed. \u201cDr. Bob really makes sure his students get the full experience of being the doctor,\u201d he added. \u201cHe really lets you take the lead and have ownership \u2013 with supervision and feedback \u2013 of the patient and their care, which prepared me going into residency.\u201d<\/p>\n Riggle also noted that he was shocked by the number of specialists available to patients in the small rural community of Tioga. Rotering and the TMC team have worked hard to develop specialty care services there, and now have monthly visits from specialists in cardiology, endoscopy, general surgery, orthopedic surgery, foot and ankle services, sports medicine, pediatric oral surgery, and mental health. And Rotering makes sure the students spend time with as many of the specialists as possible for expanded learning opportunities.<\/p>\n \u201cIn Tioga, I never would have guessed you could get exposure to all those specialties,\u201d Riggle said.<\/p>\n Beyond the experience of patient care in the clinic and hospital setting, both Leveille and Riggle took other lessons away. Leveille learned from Rotering that a rural lifestyle provides physicians with the opportunity to combine passion and practice. Leveille is a former participant in the UND Indians Into Medicine<\/a> (INMED) program and wanted to incorporate Indigenous health into his profession. Rotering took note of this interest and invited Leveille to go along with him to a Pow Wow at a nearby reservation.<\/p>\n \u201cHe has so many connections, and he knew everyone there,\u201d Leveille said. \u201cHe showed me that, yes, I can incorporate my passion into a rural health career.\u201d<\/p>\n Riggle, too, left with a renewed sense of excitement about his future career path: \u201cOne of my goals is to provide psychiatric care to a rural area, and my time in Tioga showed me how important it is to have services in these locations,\u201d he said.<\/p>\n