In the early morning of August 23, 2016, I eagerly packed my belongings in my car and headed 225 miles west: it was time to begin my journey to Silver City, New Mexico for my rural family medicine clerkship. Originally founded as a mining town, Silver City is located in southwestern New Mexico with a population of roughly 10,000 people. During six weeks in Silver City, I rotated at various Hidalgo Medical Services clinics. For the majority of my time, I rotated at a small clinic in a neighboring town named Bayard. The Bayard clinic has only four standard exam rooms, one procedure room, a small lab, and offices for the medical staff, and while small, the staff there sees up to 35 patients daily. During my time at Bayard clinic, I had the privilege of working with Dr. Irma Santiago. Through working with her one-on-one, I not only learned more about medicine, but also about the unique role that family medicine physicians have in this rural community.
Fionna Feller and Dr. Irma Mariana Santiago at HMS Bayard Clinic
Through my rotation, I developed a better understanding of the challenges that healthcare professionals face in serving a rural community. I reflected on this with Dr. Santiago, who completed her medical school and residency at the University of New Mexico before moving to Silver City. Transitioning from an academic setting in Albuquerque to rural Silver City was a significant change for her. For example, this small community faces the challenge of a scarcity of specialists. Patients from remote surrounding areas often have to drive hours to access family physicians. Many patients need to travel several hours to see specialists in either larger New Mexico cities or even in the surrounding states of Texas and Arizona. Therefore, rural physicians have to be judicious when referring patients to specialists. In addition, family medicine physicians spend mornings leading maternal-infant rounds at the only hospital in the area, Gila Regional Medical Center, before coming into the clinic. This creates a unique and central role of family medicine physicians in this community; they are trained to become the most independent, self-reliant, and efficient doctors for their patients.
Serving as a physician in a small community comes with the invaluable benefit of forming strong bonds with patients. It is not uncommon for family medicine physicians to care for generations of large families due to the trust they have established over the years. Though I only spent six weeks in Silver City, I quickly recognized the breadth of their impact on the community. I saw many patients willingly open up to their physicians about personal struggles at home and how that communication significantly impacted their health. The connections that I established with my patients remain to be one of the most memorable and meaningful parts of my rotation. As Dr. Santiago explained to me, the bonds that she establishes with her patients are the most rewarding aspect of her job and that she feels “honored and has a big responsibility” to care for her community.
I am grateful for the opportunity to complete a rural rotation during medical school. My rotation forced me to step out of my comfort zone to apply what I have learned, and, in return, I was given a unique insight of the life of a rural physician. The family medicine physicians at HMS continually encouraged me to become a better student and clinician, and to always think about how we can deliver healthcare most effectively to our patients. I look forward to carry my experiences there forward with me as I continue my journey in medicine!
Fionna Feller is a medical student at The University of Arizona College of Medicine – Phoenix and a member of the 2018 graduating class. She earned her degree in biology from The University of Arizona in 2013 and has been a proud Wildcat ever since! Her interests include traveling, drawing, teaching, and learning new languages.