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.
The student-led organization has earned the American Academy of Family Physicians Program of Excellence Award seven times since 2012, including this year. The award recognizes the student group’s 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.
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.
The event is just one of a lively lineup of lectures, workshops and social events throughout the year that earned the association its national recognition from the American Academy of Family Physicians. The group’s members also produce a student-driven e-magazine, facilitate a pre-med mentorship program, organize community service opportunities and attend conferences.
This semester, the group invited family medicine residency program leaders from around Virginia to showcase osteopathic techniques focused on noninvasive manual musculoskeletal therapy. The event gave students an opportunity to learn about different approaches to treatment that they might encounter in residency and, later, in practice.
“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.”
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 — students like alumna Sandra Balmoria, the rural Eastern Shore physician.
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.”
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