Tufts medical students say goodbye to SMH

Photo: Peter L. McGuire

BITTERSWEET GOODBYE —  After nine months, four medical students from Tufts University hosted at Stephens Memorial Hospital are moving on. Here, Rebbeca Wood, Thatcher Newkirk, Gwen Downs and Jennifer Zuar, front row from left, pose with pysicians they've worked closely with during their time at SMH. Back row, from left, Dr. William Medd, Dr. David Kumaki, Dr. James Eshelman, Dr. Brian Nolan, Dr. Michael Mosheni and Dr. Greg Hardy.

NORWAY — For the past nine months, four medical students from Tufts University have been learning, first-hand, the ins and outs of a busy rural hospital at Stephens Memorial Hospital.

Rebecca Wood, Thatcher Newkirk, Gwen Downs and Jennifer Zuar are part of Tufts' Maine Track program, which trains medical students interested in practicing in rural Maine. 

Now, the four are moving on to Maine Medical Center in Portland where they will focus on specific areas of care.

That will be a significant departure from their time at SMH –  the programs' Longitudinal Integrated Clerkship model exposed them to daily, varied work at the hospital.

During a recent farewell breakfast at SMH, the students and physicians looked back at the last nine months.

The students have mixed feelings about leaving –  they will be able to focus on one area of care at MMC, but will miss the close relationships they have built with physicians and patients.

In true small community fashion, those relationships often went beyond hospital corridors.

"I think for the past three months I haven't gone anywhere in the area where I haven't recognized at least one person and said 'hi,'" Zuar explains. 

That small-town feel could get a little uncomfortable at times, Wood admits.

"Patients are sometimes very willing to bring up their medical problems at Hannaford," she says.

Working directly with physicians has also been rewarding –  Zuar says she will miss that interaction at the bigger MMC facility, where the students will be smaller fish in a much bigger pond.

Dr. Greg Hardy, director of the medical school program at SMH, says they shouldn't worry about fitting into the mix at MMC.

The fast-paced, in-person experiences the students have had a SMH means  they'll know what to expect from an active hospital environment, he says.

"They're so much more used to having that interaction that, 'I'm taking care of that patient,' as opposed to 'I'm following someone taking care of that patient,'" Hardy says.

In addition, they've had daily exposure to working in a rural environment, an opportunity most medical students don't have.

"With a single exception, all the doctors on our medical staff are from away," Hardy says.

"We're here because we love it here. The problem is students never get that experience –  they never see what it's like to practice in a small town ... this is a great opportunity for them to see that."

Physicians in small town hospitals often need to be the experts in their field, Hardy explains.

"You have to know that, at 2:30 in the morning, you can't go across the hall and ask somebody else –  you have to be on your game as a rural doc, because you're the end of the line."

That challenging environment hasn't driven the students away. All four say they're interested in pursuing careers in rural medicine.

Hosting the students has also proved to be a resource for the hospital –  After a few months learning the ropes, physicians relied on them to work with some patients on their own.

"I think at the beginning it requires a lot more supervision, but by the end we're able to see patients and present them and the physician just has to go in for a couple minutes to verify things," says Downs.

The personal care the students can offer patients is particularly valuable, Hardy says –  they can spend time listening to a patient's concerns before or after a procedure – time a physician might not have.

Plus, having students around keeps the doctors on their toes, says Dr. William Medd. Rather than go through the motions on their own, the doctors have to be ready to answer questions and offer guidance.

"It makes us think more, it challenges us more," Medd says.

Even though this class of students are moving on, the program is actually getting bigger, says James Eshelman, medical staff president at SMH. 

Although the program is only in its second year, it has already gained a reputation for success at MMC and Tufts, Eshelman says. 

This year the program is being expanded to include fourth-year medical students taking electives at SMH for a month at a time and another group of third-year students is due to arrive in June.

"We have improved this program and made it better than it was last year," Eshelman says.

"Our goal is to continue to do that. We want this to be very successful –  we think it's important for Maine, and we think we have something to offer the students."