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Canadian Journal of Rural Medicine
../../../ 1998

Going back to high school

Jason A. Shack, BSc

CJRM 1999;4(3):165-6


About 2 years ago I returned to my long lost alma mater. Returning reminded me of growing up in a small town in northwestern Ontario, which offered a lifestyle to which some day I would like to return as a rural doctor. This day, however, was not just a day of reliving old memories. I had returned to talk with my successors in high school about the opportunities, rewards and challenges that a career in medicine, especially rural medicine, has to offer.

It had all started about 1 year before when a group of medical students at the University of Toronto who were interested in rural medicine joined together to form the Rural Health Interest Group. We started the group because we felt that there was a lack of focus on rural education at the university, and we wanted to educate medical students and faculty about the realities, challenges and rewards of rural medicine. We hoped to become advocates for change in the medical curriculum, to facilitate access to rural experiences throughout the medical curriculum and to reach out to rural high school students in the hope of fostering an interest in medicine so that one day they might return to practise in a rural area.

The rural outreach program is designed to be informal, interactive and portable. The presentation is centred around a simple question-and-answer book that medical students can quickly read to give them ideas about what they may want to talk about. It also suggests answers to the most commonly asked questions. The presentation begins with a brief personal recollection about university life and then moves into a discussion about medical school and what it means to be a rural doctor.

It was an interesting experience to return to my former high school and to find myself looking at others sitting in the same seats in which I once sat and where I once contemplated my own future. Each talk began much the same way. A group of glassy-eyed individuals looked on, probably thankful that their class time was being occupied by something that was not going to give them any homework. As I began to reminisce about my experience of going off to school in the "big city" the look in their eyes began to change. If I had never seen it before, I will now never miss that glimmer of interest and excitement reflected in their eyes.

Given that I was a university student, albeit in my sixth year, and a relatively recent high school graduate, they saw in me somebody with whom they could identify. They could ask me questions and trust that the answers would be a reasonable assessment of reality. Once those questions began, each talk quickly continued with unfaltering interest for 50 minutes and could have gone on much longer had it not been for that usually longed-for bell.

Initially, there were many questions about applying to university and what could be expected from university life. Then came the wave of questions about medicine. What marks do I need? What volunteer work should I do? What undergraduate courses do I need to take? Although it may sound trite what we were all told about becoming a well-rounded individual is really the best answer to many of their questions.

Since the initial trials of our rural outreach program, it continues to expand and receive many accolades, not only from the students and staff of the high schools but from the medical student presenters themselves.The positive response indicates that the program is on its way toward fulfilling its 3 goals. The first goal is to instill an interest in postsecondary education and the second goal is to instill an interest in rural medicine and make high school students realize that it is possible for someone from a rural area to make it into and through medical school.

The ultimate long-term objective of this program is to have a positive impact on the recruitment and retention of rural physicians. This is a lofty goal by any standards. Given the fact that the program has only been in operation for 2 years, it has not had time to have an effect on the number of rural physicians. However, if we apply what is now known about the recruitment and retention issue then we can, through implication, comment on the effectiveness of this type of program. A slightly more advanced program directed at high school students has shown that it is possible to intervene at the high school level and increase the number of students from rural areas in an urban medical school.1 We also know that those who come from a rural area, and especially those who also do some training in a rural area, are more likely to return to a rural area to practise.2 I grew up in rural Canada and plan on returning. I cannot emphasize how much an appreciation of the rural lifestyle prepares you for doing so.

Ultimately I believe that the solution to the recruitment and retention problem is not simple and requires an integrated approach with many systemic changes. This approach has been echoed by many professional bodies, most recently by a collaboration between the Ontario Regional Committee of the Society of Rural Physicians of Canada and the Professional Association of Internes and Residents of Ontario.3 As part of the integrated solution, approaching rural high school students is one of the first key interventions. I hope that the small student initiative here at the University of Toronto can have a positive impact.


Jason A. Shack, BSc, Medical Student, University of Toronto, Toronto, Ont.

Correspondence to: Jason A. Shack, 1219­620 Jarvis St., Toronto ON M4Y 2R8; jason.shack@utoronto.ca or jshack@schreiber.lakeheadu.ca


References
  1. Calke J, Johnson A, Mares KR. Identification of rural-background applicants by talent identification program of WMAHEC. J Med Educ 1978;53:764-5.
  2. Magnus JH, Tollan A. Rural doctor recruitment: Does medical education in rural districts recruit doctors to rural areas? Med Educ 1993;27:250-3.
  3. From education to sustainability: a blueprint for addressing physician recruitment and retention in rural and remote Ontario. A joint project convened by the Ontario Regional Committee of the Society of Rural Physicians of Canada and the Professional Association of Internes and Residents of Ontario. 1998.

© 1999 Society of Rural Physicians of Canada