Program turning out more country doctors for state

DAVE PARKS
News staff writer
http://www.al.com

Dr. Drake Lavender wears many stethoscopes as a family physician practicing medicine in rural Alabama.

He sees 15 to 20 patients a day at the Pickens County Family Practice Center in Gordo, then heads over to the Pickens County Medical Center in Carrollton, where he makes rounds, helps staff the emergency room and serves as co-medical director for the geriatric psych unit. It’s challenging, but at age 32, there’s nothing else he’d rather do.

“It’s very rewarding,” he said. “The people here very much appreciate what you do for them, and they let you know. It’s kind of neat.

“If I were practicing in Tuscaloosa, Birmingham, Mobile, Montgomery, whatever, I wouldn’t necessarily run into my patients all the time when I go to the grocery store, pick the kids up from school, go to the ball field. Here, everywhere you go it’s people who are your patients. You really are part of the community.”

Lavender is exactly what Dr. John Wheat had in mind 10 years ago when he worked to establish the Rural Medical Scholars Program, a collaboration between the University of Alabama College of Community Health Sciences and the Medical School at UAB.

“You got to do it all,” Wheat said. “You got to be a jack of all trades.”

About 50 doctors have graduated from the program over the past decade, and about half of them have gone into rural medicine as family practitioners, internists or pediatricians, an impressive feat since normally only about 3 percent of medical school graduates choose practice in rural areas. Rural areas are chronically short of doctors, with far more retiring than being replaced.

The Rural Medical Scholars Program has been so successful that the medical school recently decided to clone it. The concept has been expanded to UAB’s Huntsville campus with a program that is being conducted in collaboration with Auburn University. The program’s first 10 students entered medical school this year.

A break on admission:

Students in the programs complete a year of pre-med study, with courses specializing in rural sociology, agriculture and health policy. They will spend their first two years of medical school on the Birmingham campus and complete their third and fourth years in Huntsville or Tuscaloosa. Then they usually go into a three-year residency program.

Both programs require that students are Alabama residents who have lived in a rural area for at least eight years and want to practice medicine in a rural area.

The big attraction for students is that the programs help them get into medical school with lower scores on the Medical College Admission Test, the MCAT.

Wheat said studies have shown that a 24 is a high enough MCAT score to predict that a person will complete medical school and make a good doctor. But getting into medical school is so competitive that many students score into the 30s. Generally, most of these high-scoring students aren’t interested in practicing rural medicine, but they’re more likely to get into medical school.

“We want a rural kid. Kids with rural personalities. Good ethics, good students,” Wheat said.

So they lowered the MCAT score to 24 for them, and it didn’t make much difference in student performance, he said. “They do fine.”

A study of the first five classes found that the rural medical scholars graduated on time. They don’t score quite as high in the first two years of basic sciences on standardized tests, but the difference is minuscule, he said. Many of the rural medical scholars have ended up becoming chief residents, which speaks highly of their commitment to medicine and their leadership abilities, Wheat said.

He sees it all:

Lavender, a native of Eutaw in Greene County, started out at the University of Alabama studying computer science. He was looking for a health-related computer project to do for a class and went to see Wheat.

“He said, `I really don’t have any computer projects for you to do, but I’ve got this other program you might be interested in,'” Lavender recalled. “He handed me a pamphlet for the program and I said, `Gosh, this sounds great. This is exactly what I want to do.'”

So these days Lavender sees about every type of health problem imaginable.

“In my two years here I’m convinced that if it can happen in medicine, it will happen in Pickens County,” he said. “I’ve had things that I’ve never seen in textbooks before.”

He’s seen strange cancers, terrible traumas and once a ruptured heart valve, an exceptionally rare health crisis that the patient survived.

Lavender is proud of what he does and proud of the program that produced him.

His class of eight provided family practice doctors for Jasper, Boaz and Centre and an internal medicine doctor for Talladega.

“Of the eight students who may not have gotten into medical school otherwise, five of them now are serving Alabama in rural areas,” he said. “That’s pretty strong.”
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