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Surgery Residents Exposed to Rural Settings Inclined to Stay

John Commins, for HealthLeaders Media, July 10, 2013

The study's lead author, Karen Deveney, MD, program director for OHSU's Department of Surgery, says a rural rotation exposes medical residents to a "sense of community" that often isn't as well defined in urban areas.  

"You have a more long-term relationship with a lot of your patients than is often the case in the higher-urban areas, particularly in a specialty where you have brief encounter to take out the gallbladder and you see them a couple of times and they are gone," Deveney says.

"In a small community you take care of them. You take care of their mother and father. You take care of their kids. You see them in the grocery store. You see them when you're getting your car fixed. You end up having this sense of community and people kind of seek that. A lot of our whole hectic life, particularly in urban centers has become fairly isolated and so, this combats that."

"The other thing is that you feel comfortable with a greater variety of procedures and diseases and things and that gives a sense of accomplishment. Sometimes in the urban academic medical centers we are sort of—brainwashed is too harsh a word—but influenced that you can't know it all and so you should focus more and more on a smaller and smaller area."

"Then you get such fragmentation of care that you become an expert in a small thing but that over the long term is less satisfying because it also gets confining. If someone goes into a rural area to do training and practice they see you really can perform at a high level and have a good capability of taking care of a broad range of problems capably."

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