MSU’s mission to train rural doctors

For more than 40 years, would-be physicians have learned first-hand what it means to practice medicine in the sparsely populated Upper Peninsula.

The 12 students admitted each year to Michigan State University's College of Human Medicine Rural Physician Program get a stiff dose of the challenges, spending all of their third and fourth year of medical school in the U.P.

At the end of their third year, they are assigned eight weeks in a rural community, often splitting time between two family practice physicians. Students shadow the doctors in their office, hospital, at nursing homes or on home visits.

Spring Madosh has vivid memories of the eight weeks she spent 2008 in Calumet, a community of about 700 residents in the UP's Keweenaw Peninsula.

“It was eye-opening,” said Madosh, 31, a native of rural Wisconsin who enrolled at MSU in large part because of its rural practice program. She graduated from MSU's College of Human Medicine in 2010.

RELATED:In rural Michigan, a doctor shortage promises to get worse

During that rural assignment, Madosh split her time between two family practice physicians, tagging along on about 10 home visits, as well as trips to nursing homes.

“On the home visits, you see so many of the factors that affect their health; what's in the cupboard, how they eat. They were invaluable.”

After completing her family practice residency in 2013, Madosh set up shop in the same U.P. community where she performed her rural apprenticeship.

“It was the right choice for me,” said Madosh, who said she found no other medical school with a comparable rural program at the time she applied.

It's worked well enough that MSU officials set up a similar program three years ago in the Lower Peninsula. The idea: Equip medical residents with the unique skills they'll need when they might be only doc in town. For a rural family practice physician, that means the ability to diagnose and treat a wide range of ailments, often without the backup of a specialist. Often, it also means the flexibility to conduct home visits when needed.

“Practice in a rural community is different,” said Aron Sousa, senior associate dean for MSU's College of Human Medicine.

“Physicians have to be able to work with the general community on a whole range of health issues, from working with the schools to geriatrics. You have fewer colleagues to work with.

“You need to be a physician who is willing to take on those challenges.”

Since its founding in 1974, according to MSU data, more than 230 physicians have completed the U.P. rural practice program, more than half in primary care, with 88 graduates now in rural practice and 67 in practice in the U.P.

In 2012, MSU established the Rural Community Health Program in the Lower Peninsula, admitting six students each to medical campuses in Traverse City and Midland. It graduated its first class this year.

“Our goal by the time they graduate is that they have a really good understanding of what it would be like to practice in a rural community in Michigan,” said Andrea Wendling, 46, the program's director. She is a rural family practice physician herself, an MSU associate professor and director of the medical school's rural health curriculum.

Wendling, who graduated from MSU's College of Human Medicine in 1994 and completed her residency in 1997, has practiced in tiny Boyne City in the Lower Peninsula's Charlevoix County since 2003. That's when she and her husband, Mike Harmeling, also a family practice physician, decided to move their practice. It made sense, since they both grew up in rural areas.

“We felt like we were living this suburban life that we never set out to live,” Wendling said.

Though Wendling now splits her time between family practice medicine and faculty duties, she hasn't lost her zeal for rural medicine. It sounds as much like a calling as a profession to hear her describe it.

“To be successful in a small town, you really need to be somebody people can trust. You are going to build a reputation one way or another in a small town. You want to be somebody who builds that reputation in a positive way.”

To Wendling, the rewards transcend money.

She recalled a family camping trip three years ago to a state park in Charlevoix County, when a nearby camper suffered a heart attack. He was the grandfather of friends of hers – and naturally, neighboring campers knew where to find the town doc.

In her pajamas, she performed CPR and then helped defibrillate him when EMS help arrived. He survived.

“Two weeks later,” she said, “he came to the office with flowers.”

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Tue, 07/21/2015 - 10:45am
Great story on an important topic. I just want to mention that Michigan Technological University, a state university in Houghton, on Michigan's Upper Peninsula, partners with MSU's College of Human Medicine through an early acceptance program for Michigan Tech pre-med students who plan to work as physicians in the UP. The program provides an enhanced opportunity for admission to medical school to qualified premedical students who wish to practice in underserved areas. Three or four Michgian Tech students have entered medical school through this program each year since 2009. See
Tue, 07/21/2015 - 11:48am
Excellent reporting! There is a shortage of physicians, so Eastern Michigan University now offers a 24-month, full-time, year-round graduate professional program leading to a master of science in physician assistant studies. The physician assistant program provides a strong foundation in primary care medicine and interdisciplinary practice. The program’s faculty include experienced physician assistants and physicians. St. Joseph Mercy Hospital in Ann Arbor is also a great partner in helping Eastern Michigan develop strong healthcare providers. See more at Eastern also offers advanced nursing programs such as the adult gerontology primary care nurse practitioner program. The master’s program in nursing prepares nurses to meet the need of the community. Nurse practitioners and clinical nurse specialists are working in hospitals, primary care, community agencies, clinics and home health care agencies. See more at Keep up the good work in reporting!
Tue, 07/21/2015 - 4:05pm
Are there opportunities for junior and senior high school students to be exposed to the field of medicine? We need to plant the seed early.
Fri, 07/31/2015 - 7:28pm
Hi Cathie, Yes, there are opportunities for high school students to be exposed to the field of medicine! There is a program called HOSA which supports aspiring doctors, nurses, dentists and the allied health fields. You can find more about it here: Good luck! Wendy
Mon, 07/27/2015 - 9:20am
Great article. I was just really surprised you left the other MSU Medical School out of the article as MSUCOM's focus has been primary care for such a long time, and we here in Northwest MI have been fortunate to have many MSUCOM graduates providing our primary care for our entire lives. It is nice that MSUCHM is now providing this track.
Fri, 07/31/2015 - 7:34pm
Dana, In the Upper Peninsula of Michigan we have several MSUCOM and MSUCHM graduates providing excellent care in our rural locale. Both schools are important and graduates of both programs bring different skill sets to the table. We are fortunate to have both options! Thanks, MSU! Go Green! Wendy =)