Nourishing the roots of rural health

This piece originally appeared on the Good Notes blog.

You wouldn’t think dissecting a cow heart would inspire a person to go into medicine, but then again, Merrick Reynolds isn’t just anyone.

“Growing up in Hurricane, Utah—population 18,000—we just didn’t know about jobs in health care,” Reynolds said. “When students from the University of Utah came to talk to our high school science class, it really woke me up to the fact that little towns like Hurricane need more health care providers and health care education, and I wanted to be part of that.”

Reynolds exemplifies the Rural & Underserved Utah Training Experience (RUUTE). Founded in 2018, RUUTE increases medical education opportunities for people in rural and underserved areas of Utah.

Raised in rural southwestern Utah, Reynolds knew how few and far between medical providers were. So, after moving to St. George, he began shadowing his own primary care physician, Larry Cain, MD. Cain was instrumental in encouraging Reynolds to pursue a college degree.

Rural clerkship rotations, 2020-21

After high school, Reynolds studied biology at the University of Utah, wondering where it would take him. He only knew he wanted to practice medicine in a small community.

“I did well in my major and was encouraged to apply to medical school,” Reynolds recounted. “I put all my eggs in one basket, applying only to the University of Utah. I still thank Dr. Chan every day for accepting me into the program.”

Now in his third year, Reynolds is doing clerkship rotations in smaller communities, including Tooele and St. George. Students in RUUTE must complete seven clerkships in their third year, ranging from family medicine and obstetrics/gynecology to neurology and psychiatry.

Broader student experience

The RUUTE program offers hands-on experiences for medical students interested in rural and underserved areas of Utah. It also provides a plethora of interesting opportunities for undergraduates from other Utah colleges and universities who are interested in the health sciences.

Reynolds said medical school would not be the same without the RUUTE program. Classes on topics like sustainable health care and telehealth have opened his eyes to the unique needs of rural communities.

“I just learned so much more through RUUTE than I think I would have by taking a more traditional path in my education,” Reynolds said. “In fact, I think all medical students should do a stint in rural health. They will find they gain much more overall, real-life experience.”

Rural communities benefit 

Of Utah’s population, 85% lives along the Wasatch Front and has access to large medical institutions. The other 15% live in small, even isolated, communities with little access to health care or health education.

These are the areas where programs like RUUTE can especially make a difference. RUUTE places third-year medical students in rural clinics to train under and assist doctors who may be trying to treat hundreds of patients by themselves.

“During my clerkship in Tooele, I had all kinds of roles,” Reynolds explained. “One minute, I’d be patching up a laceration and the next minute, I’d be delivering a baby! You just don’t get these kinds of experiences in conventional medicine. Rural health care is extremely personal in that you get to really know your patients and their needs. You become part of the family, part of the community.”

Emphasis on educational outreach

Although similar programs exist throughout the country, RUUTE is especially progressive in its educational outreach efforts. For example, the Little RUUTEs program sends medical students into rural elementary schools to begin engaging younger children in the health sciences. Later, as part of the ambassadors’ program, undergraduate students, with the assistance of medical students, actually create health sciences curricula for rural and underserved schools.

During spring and fall breaks, medical students often go back to their own small towns to work in schools, speak to area organizations and provide other community services. Rural doctors become “hub leaders” who serve as mentors and role models for medical students.

More recently, the RUUTE Scholars program was created to offer an avenue for rural or underserved students who want to attend medical school at the U and later return to their hometowns to establish a practice.

During the 2021 academic year, 28 of our medical students participated in educational outreach. Together they reached 2,330 students at 52 rural and underserved schools in Utah.

Going full circle

Educational outreach is paramount in raising awareness and interest in rural medicine. But the RUUTE program ultimately benefits medical students and the rural, underserved communities they choose to practice in.

Reynolds is currently doing a family medicine clerkship in St. George under the keen eye of his old mentor.

“The RUUTE program has taken me full circle already,” Reynolds concluded. “I started my journey by shadowing Dr. Cain to see if I wanted to pursue a career in medicine. Now, here I am three years into medical school and I’m actually assisting him in his clinical practice. I’m right where I’ve always wanted to be—and I credit the RUUTE program for that!”