Making country doctors | Local News

On Tuesday, Makylah Apostol, Katelyn Estrada and Faith Vicente, three students in the University of New Mexico’s combined Bachelor of Arts/Medical Degree (BA/MD) program, were acknowledged with a reception at Eastern New Mexico Medical Center as they finish their rural summer practicum in Roswell. The BA/MD program helps students appreciate how the personal stories of patients and their distinctive rural experiences intersect with the practice of medicine.

In the essay “On working with cadavers,” Marion Bishop describes being in medical school, learning about bodies while simultaneously reflecting on the human condition from the vantage point of someone who loves literature and the humanities. Bishop, like the UNM BA/MD professors, understands medical school is more than chemistry and microbiology, more than anatomy and complex math.

Being in medical school requires learning to sit with patients in their darkest moments: when a CT scan shows a new tumor, when a patient must decide whether to accept a complex surgery or spend their last days with family at home.

“It does not seem fair to know a body so well without knowing the life that shaped it,” Bishop writes, particularly true, as UNM knows, in a rural community. From a cancer diagnosis to a life with chronic pain, doctors detect, treat — and importantly — describe. They help us understand the new plotline to our story when illness interrupts.

The practicum in Roswell is in its fourth year. “Every year, we have two to three students that come into our community in June and they spend time shadowing our doctors and volunteering with our organizations,” said Cristina Arnold, community preceptor, city councilor and mayor pro tem. The students enter the practicum at the end of their sophomore year at UNM.

This June, the three students worked with Harvest Ministries, the Historical Society, Mainstreet Roswell, Boys and Girls Club of Chaves and Lincoln Counties, the Chaves County Health Council and others. “They also engage in community exploration, so they get to spend time at Bottomless Lakes, the UFO museums and the downtown market. We have the planetarium coming up.”

Apostol is from Roswell, and when she originally was assigned to a different practicum site in New Mexico, a process conducted randomly, she petitioned to return to Roswell to learn about her community.

“I think that says a lot for your town and your community that she would want to come back and see her hometown in a different way,” said Dr. Sushilla Knottenbelt, director of the combined BA/MD program. The national undergraduate program empowers students with all prerequisite courses needed to enter medical school.

The program’s mission is to “help address the critical physician shortage in New Mexico by providing educational opportunities to a diverse group of students committed to serving New Mexico communities.” In addition to community service and engagement in June, students shadow doctors and interact with the kinds of patients they will encounter in their careers.

“The BA/MD program emphasizes the human aspect of medicine,” Arnold says. Students apply to the program while still in high school, and once admitted, their undergraduate degree is fully paid for.

Estrada encourages interested high school students to plan ahead. “My brother was the one that told me to try hard in high school and make sure to get all the prerequisites for the program out of the way so I can have a full shot at this amazing opportunity.” Estrada is interested in surgery and plans to work in a rural community, possibly in trauma or pediatrics.

After completing four years of medical school at UNM, students will spend five years in an under-resourced community in New Mexico. “We are expecting a doubling of the number of practicing physicians over the next five years,” Knottenbelt explained.

Currently, 67% of practicing alumni from the BA/MD program work in New Mexico. 65% of practicing alumni work in primary care; 61% are from minority groups who are underrepresented in medicine; and 17 doctors are working in their hometowns.

“I can’t tell you how valuable you are to make our community work. Because we don’t have near enough doctors,” Mayor Tim Jennings said at Tuesday’s reception. Accentuating the human aspect of their future work, the mayor said of Roswell, “you will have a network where you can change this world.”

The hope is students like Apostol will spend their professional lives as doctors working where they grew up. The practicum is an important part of urging students to return. “They’re really reinvigorated. They remember why it is they’re committed to this path to wanting to train as doctors and to come back and serve the underserved in New Mexico,” Knottenbelt says.

Apostol is interested in dermatology. She has advice for people like herself who are from minority groups and underrepresented in medicine: “I come from a Filipino American background. My parents immigrated here. So definitely just reach out and have the confidence to make those connections and experience those things you will be doing as a doctor.” Apostol’s brother is enrolled at UNM School of Medicine.

The students at UNM all minor in health medicine and human values. “A lot of the curriculum is focused around the social determinants of health. So things outside specifically science that affect our health, things like our living situation, our income, our education level and our sex,” Vicente says. Raised on the Isleta Pueblo reservation, Vicente is interested in forensic pathology and supporting the Native American population’s health care.

“The program makes sure we understand patients aren’t just like robots or people that we’ll see. We try to dive deeper into the person and their life because that could also be impacting their health too,” Vicente says.

To know both a body and the life that shaped it: that is one goal of the BA/MD program. Doctors in rural communities do more than diagnose and treat. They help their patients discern how their conditions fit within the broader framework of their everyday lives.

Working in a rural community gives both patients and doctors opportunities they might not have in a big city: the chance to build lifelong relationships — to know the stories behind the bodies they treat.

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