Not everyone can claim to be the first in the nation, but since Laura McDowell, MD, joined the University of Wisconsin Department of Obstetrics and Gynecology in June, she can. McDowell is the first-ever rural resident in the first-ever dedicated, sanctioned rural obstetrics and gynecology residency program in the country.
Rural medicine tracks are not uncommon in medical schools and residency training programs, according to UW Ob-Gyn Residency Program Director Ellen Hartenbach, MD. With the rural ob-gyn training track, UW Ob-Gyn hopes to combat unique health issues for rural women.
“There is an actual crisis in rural medicine. One in three counties in Wisconsin and one in two in the country don’t have an ob-gyn,” says Hartenbach. “Hospitals in rural communities are actually closing down their maternity centers, and there are parts of Wisconsin where people are 60 minutes away from hospitals where they can give birth.”
Rural ob-gyns also provide important prenatal care, gynecological cancer screenings and management of complicated gynecological problems. Losing easy access to local ob-gyns can widen the disparities between rural and urban women’s health.
It’s exactly those inequalities that drew McDowell to rural medicine. “There are many differences in health outcomes between rural and urban patients, specifically maternal outcomes,” she says. “I am interested in learning more about these disparities and working towards reducing the gap between rural and urban maternal outcomes.”
McDowell got to know both the joys and challenges of rural life growing up in Minnesota and Iowa. She attended the University of Minnesota for undergrad and medical school. “Ever since starting medical school I have been committed to practicing rural medicine,” she says. (McDowell pursued a rural training track in medical school.) “I am excited that there is now an opportunity to do so in ob-gyn training.”
Over the next four years, McDowell will spend about 80 percent of her training time in Madison, experiencing high-volume and specialty training alongside the six other UW Ob-Gyn residents. The rest of the time, McDowell will rotate through collaborating rural hospitals in Portage, Monroe, Watertown, Ripon and Waupun. Hartenbach describes the rural training program as “residency-plus.”
“The rural rotation is a little bit more about giving our residents the smaller community experience so they’ll have the confidence to take those jobs when they graduate,” Hartenbach says. “There’s a fear of not being around specialists all the time. We hope to teach doctors when to refer, when to know that your hospital or your community doesn’t have the resources to take care of, say, a premature delivery.”
So how does McDowell feel about making history as the first rural ob-gyn resident in the country? “I am very grateful for the honor of being the first rural ob-gyn resident and I know it comes with a lot of anticipation,” she says. “I intend to make the most of learning from my patients and mentors on how to be a better physician and better serve rural communities.”
Welcome to Wisconsin, Dr. McDowell!