TRUSTing Students:
Building Connections Through the New Curriculum

TRUST student Justinn Marshall tries out an otoscope on preceptor Anne Millard, M.D., at Francis Mahon Deaconess Hospital in Glasgow, Mont.

Targeted. Rural. Underserved. These words pinpoint the UW School of Medicine’s dedication to encouraging medical students to stay in the WWAMI region to practice medicine. The words are also the core of the School’s TRUST program — the Targeted Rural and Underserved Track.

This year, TRUST is providing a special curriculum for approximately 92 students, a number expected to increase next year. Chosen for their commitment to medicine in rural or underserved areas, TRUST students spend time in one of several WWAMI communities the summer before their first year. Then they commit to participating in multiple training opportunities — in that same area — throughout their four years of school.

Starting in Montana
Jay Erickson, M.D., Res. ’90, UW assistant clinical dean for Montana WWAMI, created the TRUST program for Montana in 2008. Since that time, TRUST has spread to the other states in the WWAMI region. It has also grown in popularity in its state of origin. “In 2008, we had three TRUST students in our medical-school class of 20 students. For the last three years, we’ve had 10 students out of a class of 30,” he says.

This year, the TRUST program has become even stronger with the new curriculum. Students are expected to visit their TRUST site for three out of five intersessions, brief periods set between the academic blocks for rest, remediation and enrichment. Students also return to their TRUST site to participate in other School programs that immerse them in the practice of rural medicine.

What does this mean? Greater continuity. More connections.

“Students go back to that same community and to the same mentor and patients,” says Erickson. “In the past, there wasn’t really the chance to develop a connection longitudinally over all four years.”

Continuity and community
These changes are already making an impression on first-year medical students and TRUST scholars.

“So many of the patients I’d seen over the summer remembered me and were excited that I was back,” recalls Justinn Marshall after her first intersession in Glasgow, Mont. “There was this really cool continuity and sense of community.” Justin Brewer appreciated the familiarity he felt returning to Lewistown, Mont., for his first intersession. “I felt very comfortable being in the hospital. I knew where I needed to be. And I knew a lot of the staff there,” he says.

Intersessions provide students with the perfect opportunity to practice newly learned clinical skills. “It was a lot of fun to take everything we learned from the first semester and apply it in the clinic,” says Marshall. “I felt really comfortable going into a patient’s room and talking to them, and I think that’s pretty cool after only a semester of medical school.”

Students are discovering that increased trust frequently leads to increased responsibility. “The physician in the ER had me do the interview and the physical exam,” says Brewer. “Then they asked me what I thought the diagnosis was and how I would treat it. This was a completely new experience for me and not one that many first-year students get to have.”

This phenomenon doesn’t surprise Erickson. “When you go back to your rural community, you’re often thrust into leadership positions,” he says. “We want these students to have a skill set that they can use throughout medical school, in residency and eventually in their practice as leaders in their community.”

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