Illinois Medicine

O rural environment require extra training and extra expectations. "Students who become doctors in rural communities are not afforded the luxury of being anonymous in the community," Hunsaker notes. "They are recognized after hours, at the grocery store, at church and at community events. Very often, they will be asked to join the school board, the Rotary Club or Kiwanis. We want to make sure our graduates are equipped to deal with those kinds of leadership expectations." He adds that nearly every student in the program has ties to a rural area, "giving them a sense of place and family. Those are the types of students who are the best people for success in their practice, professional fulfillment and long-term rural retention." Among graduates who are happy with their choices are Matt and Beth Gullone, both MD '06, who met while enrolled in RMED, married after graduation and later joined the staff at Midwest Health Clinic in Galena. They are the images of the young physicians who trained in the College of Medicine's Rural Medical Education program and have now fanned out across the state to provide superior care for the patients they serve far from the big cities. "If you look at land mass, most of Illinois is rural," says Matthew Hunsaker, MD '95, a physician with KSB Hospital in Dixon, who has been director of the RMED program since 2004. "For us, teaching in context is everything." RMED marked its 20th anniversary this year with a June 22 reunion at the Allerton House in Monticello, Ill. Both RMED and its companion pharmacy program, RPHARM, are based at the National Center for Rural Health Professions on the college's Rockford campus. Since its inception, RMED has been a great boon in funneling physicians to rural communities. Some 226 students—160 in practice and 66 in residency training—have graduated from the program. Of those in practice, 118 work in 78 different communities in Illinois, and 75 percent are in towns of less than 20,000 people. The need is great. Hunsaker says the program conducted a study that showed between 400 and 500 rural physicians will reach retirement age in the next few years. "We're looking at expanding the number of students we take to address that even more," Hunsaker says. "We're making a dent, but there's still an unmet need." There are six universities with full rural medical education programs in the U.S. The University of Illinois was the third university in the country to create such a program after the University of MinnesotaDuluth and the Jefferson Medical College at Thomas Jefferson University. Since that time, RMED has mentored new rural programs at Indiana University-Terre Haute, the University of California-Davis and Florida State University. RMED also has achieved international influence: Hunsaker and his team have made numerous trips to Thailand to help that nation establish rural health care training. RMED students take all the standard clinical courses as their counterparts in Rockford and other campuses, but the demands of a Photo: Lloyd DeGrane n billboards for hospitals and medical groups in Illinois towns from Galena to Gibson City, the smiles of success beam down on small, rural communities. Matthew Hunsaker, director of the RMED Program, hopes to expand the number of students in the coming years to ensure that rural areas throughout Illinois have adequate medical infrastructure. "When you are a family doctor in a rural area, you are able to practice the full scope of family medicine and use all of the tools and procedures that you learned in residency," Beth Gullone says. In terms of community visibility, Matt Gullone volunteers at the local high school. "I am on the sidelines at football games to evaluate injuries—especially the concussions," he says. In rural areas, the need for medical care extends far beyond the football fields and the cornfields. According to the Illinois Department of Public Health, 68 of 83 rural counties in the state do not have enough primary-care doctors, including general internal medicine, family medicine and general pediatrics. All three specialties are RMED program target outcomes. To create a pipeline of physicians to fill those positions, RMED recruits between 15 and 20 students annually who grew up in rural Illinois and plan to pursue a career in primary-care medicine. Karissa Monney, who grew up in Oreana, Ill., plans to practice family medicine in a rural Illinois community after her 2015 graduation. "I would have a very hard time moving out of Illinois. My entire family is here," she says. Philanthropic support is chipping away at rural health disparities. RMED recently received enough funding for an endowed professorship in rural health, the first professorship on the Rockford campus. Technology also is giving a boost to rural care. Physicians not Photo: Anne Boyle illinois medicine | 21

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