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Going Rural

By Liz Russell, NEOAHEC Rural Rotation Coordinator, & Meredith Lair, NEOAHEC Executive Director

An unknown author once wrote, "Sometimes you find yourself in the middle of nowhere, and sometimes in the middle of nowhere, you find yourself." Veronica Crowder of Portland is one student who found her life calling in the quiet countryside of rural Northeast Oregon.

Veronica is a second year Physician Assistant (PA) student at the OHSU PA program currently finishing her rotation under the Campus for Rural Health at the Winding Waters Clinic in Enterprise, Oregon She will be graduating in August 2017 and shortly after, she will begin her new role as a practicing PA in the Eastern Oregon Center of Orthopedics in Baker City.

Having lived in the city, Veronica shared that when she entered the PA program, she knew that she wanted to practice in Eastern Oregon, as far away from the hustle and bustle of the Portland/Metro area as possible. Bringing her dream to fruition, she embarked on her first rural rotation in Baker City at the Eastern Oregon Center for Orthopedics during the summer of 2016. She had no prior experience in orthopedics but was more than eager for the challenge. Veronica said she learned a great deal from her preceptor, Dr. Eric Sandefur, including how to shear an alpaca on his ranch! She immediately realized her love for the small clinic and hospital and desired to call it her professional home one day.

While in Baker City, Veronica spent many days exploring the area and immersing herself in the local community. From hiking to participating in a local peppermint harvest with one of the clinic employees, she became one with her rural setting. She fell in love with the little cabin provided by Northeast Oregon AHEC and hopes that one day she and her husband will be able to build a similar one on a piece of property there.

Veronica also had the opportunity to complete several other rural rotations during the two-year PA program. So far she has rotated in Heppner, Lebanon, Prineville, and is currently completing her rotation in Enterprise. She expects this will not be her last rural rotation before graduation.

Veronica shared that her current clinic, Winding Waters, is the busiest clinic that she has ever worked in! She noted that this rotation has given her an incredible amount of hands on experience and prepared her for practicing in a rural community. She praised Winding Waters staff for going above and beyond the call of duty to help her meet her rotation goals. She said this of her time in Enterprise:

“The most memorable thing about my rotation was the personal connection with patients. I liked how I could see a patient in the clinic but also walking around town or at the grocery store. My rotation at Winding Waters exceeded my expectations and reinforced my dream of practicing rural medicine.”

When asked about OHSU’s PA program that Crowder has so vibrantly excelled in, Curt Stilp, the Director of Oregon AHEC and an Assistant Professor of the Division of Physician Assistant Education, said, “When I looked at the PA program rotations a few years back, about 75% were done at community sites (non-OHSU). Not all of those were rural, but the OHSU PA program was set up from the beginning to place emphasis on community training.”

Stilp added that the mission of the OHSU PA Program is as follows:

•Prepare physician assistants for the practice of medicine and the delivery of team-based primary care services to diverse populations, including medically underserved;

•Contribute to meeting the health workforce needs of Oregon;

•Provide a model of excellence in physician assistant education and;

•Advance the physician assistant profession in the state.

Veronica is just one example of the many talented learners who rotate through NEOAHEC’s eleven-county region each year. Hearing the call from medical communities in our service area, NEOAHEC responded by coordinating housing and providing regional support for 26 residents and 34 student learners in 2016. Communities that currently support rural clinical rotations included Baker City, Enterprise, Heppner, Hermiston, La Grande, Ontario, and Pendleton. This past year, trainees came from various schools and programs within OHSU, Pacific Northwest University of Health Sciences, Idaho State University, Cascades East Family Medicine Residency, and Pacific University. NEOAHEC’s region is bordered by two states—Washington and Idaho—giving it the unique opportunity to work with other northeast medical communities to provide community-supported student and resident housing. NEOAHEC has also reached agreements with out-of-state schools who support housing for their students to rotate in the region’s clinics.

Veronica’s story provides NEOAHEC with the reassurance that interacting in rural and frontier Eastern Oregon in a meaningful way provides a key opportunity to recruit and retain providers who have a genuine interest in practicing in our area. Without these experiences, it would be difficult to redistribute an urban trained healthcare workforce to the most needed areas in the state. NEOAHEC looks forward to sharing more stories like Veronica’s in the future.