Hometown health care Hometown health care Hometown health care

There’s something special about rural medicine. That’s how fourth-year UW School of Medicine student Wyatt Bowles has always felt.

“What I really like about it is the relationships with the people. You take care of the whole family,” says Bowles, who grew up on a dairy farm in Dayton, Idaho, population 526.

But future doctors like Bowles are becoming less common. Between 2002 and 2017, the number of medical students from rural areas declined by 28%. Of those who graduate, many are saddled with debt and opt for higher-paying jobs in large hospital systems—while doctors currently working in rural communities get closer to retirement, diminishing an already thin workforce.

Small towns and sparsely populated areas need more physicians like Bowles, who hopes to eventually return home to practice. The University of Washington School of Medicine, with its robust training in rural and under-served communities, aims to meet that need. It was a great fit for Bowles. And thanks to scholarship support, he’s able to focus on preparing to serve communities like Dayton.

The youngest of four boys, Bowles spent his childhood exploring his family farm’s acres of sagebrush and pine, riding four-wheelers with his brothers and tending to the land and livestock.

“We spent a lot of time building fence, working with cattle, moving irrigation pipe for the farm. And I’d feed the cows before I went to school,” says Bowles.

He began thinking about a future in medicine as a preteen, when his eldest brother applied for medical school. In high school, Bowles took a Certified Nursing Assistant class and worked in a nursing home to get practical experience.

Though Bowles had his sights on medical school, he says many kids in Dayton didn’t even consider it a possibility: “There’s a lack of mentors in rural areas for going to medical school and coming back home to practice. And it is expensive. People think you have to pay for it completely out of pocket.”

Even with his brother’s example, and after applying to medical school and interviewing at the UW, Bowles wasn’t sure he belonged.

“I was planning to reschedule my MCATs and second- guessing if I was a good fit for medical school at all,” he recalls. “It was one of the lowest moments of my life—and then I got the call from the UW that I was accepted.”

Even after that happy news, Bowles knew there would be challenges ahead. Practicing rural medicine requires grappling with a lot of complexity, including potentially being the sole doctor in a region without ready access to specialists. Luckily, the UW School of Medicine offered unique, immersive programs to prepare him for what’s ahead.

In 2020, Bowles began his UW training—in Moscow, Idaho. The University of Idaho is one of the UW’s partners in the innovative WWAMI program, which allows UW students to train at participating campuses in Washington, Wyoming, Alaska, Montana and Idaho. Through WWAMI, students can stay close to home for their schooling, or get hands-on experience in similar communities.

WWAMI students spend their first 18 months taking essential science courses, then train in hospitals, clinics or practices within the five-state region. They have access to programs that bolster their understanding of medical practice in underserved areas.

Bowles has broadened his experience with rotations at Seattle Children’s and other local hospitals.

In his first summer of medical school, Bowles took part in the School of Medicine’s Rural Underserved Opportunities Program (RUOP). During this four-week experience in community medicine, Bowles worked side by side with Lance Hansen, a family doctor at a busy rural clinic in Montpelier, Idaho.

Under Hansen’s oversight, Bowles stepped into the role of the provider, assessing patients, many of whom knew Hansen from the community.

“He had this special connection with people because he’d been there in that small town for 10 years,” Bowles notes. “Patients would come in and say, ‘Oh, our kids are on the same basketball team.’” Bowles was inspired by these authentic relationships and impressed by how Hansen balanced patient privacy with personal connection.

Bowles also got experience creating and communicating care plans and performing procedures: “I practiced, I sutured, I gave injections. I had my hands in a C-section. I was doing what we’d only watched or talked about in medical school.”

This vital experience helped him better understand the versatility and bedside manner necessary for rural medicine. “Dr. Hansen did colonoscopies and endoscopies because there’s no gastroenterologist there. Rural doctors have to do a little bit more because they’re more secluded and have fewer resources,” says Bowles.

The WWAMI program also gives students the chance to travel. While students at other medical schools may do their third- and fourth-year clinical rotations at a single teaching hospital, WWAMI students can regularly relocate to try different regions and clinical environments.

Bowles opted for the WWAMI program’s Idaho track so he could stay in that area as much as possible. He’s completed several rotations in southern Idaho—but he’s also broadened his experience with rotations at Harborview Medical Center, Madigan Army Medical Center, Seattle Children’s and UW Medical Center.

Though he’s weary of moving around, he says the ability to personalize his learning environments and the experience he gained through RUOP and WWAMI have been invaluable. It’s further solidified his interest in rural medicine and enhanced his skills.

“I learned that every doctor is different,” says Bowles. “There are different ways to practice medicine. And it depends on your population and who you’re serving.”

In addition to providing academic support, the UW School of Medicine strives to give students from rural and underserved communities the financial assistance they need to succeed. Bowles received the Laura Moore Cunningham Endowed Scholarship, awarded to lifetime residents of rural Idaho who intend to return and practice there. He also earned the Everett Orville Jones, M.D. Endowed Scholarship.

“It’s a certain amount of money that I don’t have to pay interest on and don’t have to worry about paying off,” says Bowles. “The scholarships helped reassure me that I am qualified for the program.”

Bowles is set to graduate in May 2024 and plans to go into pediatrics. He still hopes to practice close to home.

“Wherever I end up, I want to be active in the community—not just be the doctor,” he says. He also wants to serve as an example. “I want to help kids realize there are schools that believe in them and scholarships for them,” says Bowles. “That they can be doctors just like me.”