Virginia Commonwealth University

12/09/2019 | News release | Distributed by Public on 12/09/2019 09:29

These VCU medical students are working to address the nation’s shortage of family physicians

Monday, Dec. 9, 2019

On a recent Friday, over 50 medical students crowded into a fifth-floor classroom in the McGlothlin Medical Education Center at Virginia Commonwealth University to hear Sandra Balmoria, M.D., a family physician who works more than two hours away at Eastern Shore Rural Health System, discuss rural medicine.

Balmoria, a former VCU medical student and resident, videocalled into the tele-lecture from her office. She elaborated on the details of her rural location, schedule, duties and practice. The community-oriented lifestyle was a draw, she said, although there are sometimes personal challenges in rural areas such as finding child care, educational opportunities for children and jobs for spouses. She admits distances are sometimes a barrier. Once, she said, a patient paid for their visit with a bushel of crabs.

'People often ask about primary care in a rural setting: 'Do you have to do everything?'' she said. 'Well, it helps. Twenty percent of my work addresses mental health.'

Balmoria was speaking to the students as part of a series of lunchtime lectures hosted by the VCU Student Family Medicine Association, which provides medical students with opportunities to interact with family physicians. Practicing in a rural setting has its challenges, Balmoria said, but a benefit is the variety of duties. To demonstrate, she showed a slide logging a day in her clinic life. It included inserting an IUD, a diabetes follow-up, meeting with depressed patients, a pediatric upper respiratory checkup, treating an athletic injury and networking with a transgender support group.

She emphasized the opportunities for family medicine practitioners in rural areas.

'You can build a practice however you want it to be,' Balmoria said. 'I love my job because we don't turn anyone away.'

Her advice to the students curious about family medicine in a rural setting: 'Go somewhere where there is no Starbucks and where it is a bit more complicated to get stuff.'

Nicholas Nowell, a third-year medical student, found Balmoria's talk convincing.

'I just came off a rural family medicine rotation in Front Royal, and I fell in love with rural family medicine,' Nowell said. 'The scope is unbeatable. It's super appealing. I got to see a day in the life of a doctor. I got to repair a wound and then guide someone through hospice.'

A lively lineup of events

Iris Wu, former co-president of the Student Family Medicine Association, said events like Balmoria's lecture provide students with exposure to a crucial field that is underrepresented among the faculty, which is made up mostly of specialists.

This year the student-led organization has been recognized with an American Academy of Family Physicians Program of Excellence Award because of its adherence to its mission to provide students a positive exposure to family medicine, its value in the health care system and the roles and functions family physicians provide for patients, families and communities.

The organization achieved that distinction through a lively lineup of lectures, workshops and social events throughout the year, producing a student-driven e-magazine, facilitating a pre-med mentorship program, organizing community service opportunities and attending conferences.

'We put on a lot of really cool events, and I think that comes out of everyone having really diverse interests, being comfortable and then having the group support their drive and realizing events that grow out of their interests,' Wu said. 'So it's been really rewarding.'

Wu said the organization helps address misconceptions about family medicine that students may hold when they first get to medical school.

'So that's been fun too, to help the field get that exposure,' Wu said. 'I think a lot of people have realized, 'Oh, like there is a much broader scope. There's a lot more diversity within family medicine and versatility of what you can do with family medicine.' It's rewarding to think that we could be helping to kind of recruit more primary care folks.

I just came off a rural family medicine rotation in Front Royal, and I fell in love with rural family medicine. The scope is unbeatable. It's super appealing. I got to see a day in the life of a doctor.

Opportunities outside the classroom

The Student Family Medicine Association is one of nearly 100 student organizations in the VCU School of Medicine. But it is unique because, with over 300 registered members and nine student leaders, it focuses on providing opportunities to learn about and experience family medicine outside the classroom.

The organization's efforts fill a crucial need. According to a 2019 report from the Association of American Medical Colleges, the U.S. is expected to see a shortage of up to nearly 122,000 physicians by 2032.

'The family physician is uniquely positioned, to not only speak to, or integrate themselves in the individual aspects of medicine, but also the larger picture as well,' said Rachel Smith, former co-president of the Student Family Medicine Association. 'I think as our political climate is changing and as our policies and needs change, the family physician is going to be integral in advocating for their patients and working on those bigger systemic levels as well.'

Judy Gary, the organization's adviser and assistant director of medical education programs in the Department of Family Medicine and Population Health in the VCU School of Medicine, said the Student Family Medicine Association is a key piece of the department. The organization is student driven but support from the American Academy of Family Physicians, the Virginia Academy of Family Physicians, the School of Medicine and the department help provide resources like food for lunchtime lectures.

Gary said the organization, as a longstanding and vibrant presence on the medical campus, contributes to students' understanding of family medicine and is a key component that has attracted more students to match in family medicine.

Osteopathic techniques workshop

On a recent Wednesday night about 20 medical students crowded around portable, padded massage tables in a third-floor classroom of the McGlothlin Medical Education Center.

The room's other tables and chairs were shoved to the sides while Joy Elliott, D.O., assistant program director of the VCU Riverside Family Medicine Residency Program in Newport News, and Jef Groesbeck, D.O., assistant program director of the VCU Shenandoah Valley Family Medicine Residency Program in Front Royal, conducted an interactive osteopathic manipulation treatment workshop for the Student Family Medicine Association.

Elliott and Groesbeck showed the students the osteopathic techniques they use, focusing on drug-free, noninvasive manual therapy that aims to improve health across all body systems by manipulating and strengthening the musculoskeletal framework. They focused on joints, muscles and the spine. Students volunteered to lie on the tables acting as patients. They then broke into groups and tried the techniques on each other.

Groesbeck emphasized the need to listen and pay attention to a patient's breath to help them loosen their back muscles.

'Some people are super tight, so we use respiration,' Groesbeck said. 'When they breathe in, we raise our hands; when they breathe out, we let go.'

When a student asked how these short sessions could have a lasting effect, Groesbeck answered: 'I give patients homework.'

'Or I teach patients how to do this to themselves,' Elliott added. 'I teach parents how to do these techniques to their children.'

Medical student Alex Saffran said the workshop helped him see the potential of the field.

'It's super valuable,' Saffran said. 'Hopefully it will provide us with tools to get better.'

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