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School of Medicine discoveries

July 10, 2018

Student researches fallout in small towns after a family doctor leaves

Through his research, the Class of 2021's Paulius Mui hopes to capture what happens to patients when a rural physician leaves the community and use their perspective to inform policy and recruit physicians to low-population areas.

Through his research, the Class of 2021’s Paulius Mui hopes to capture what happens to patients when a rural physician leaves the community and use their perspective to inform policy and recruit physicians to low-population areas.

If you’re from a small town, you may have a family doctor who has been present at the most important moments of your life: birth, serious illness, a child’s broken arm, a parent’s death. So, what happens to patients when that doctor retires or moves?

That’s what the Class of 2021’s Paulius Mui is trying to uncover. Entering his second year as an fmSTAT student at the VCU School of Medicine this fall, Mui has spent considerable time driving to small localities in southwestern and eastern Virginia that have lost their primary care physicians, interviewing residents about the personal impact of these losses. Earlier studies have examined the doctors’ side of the issue, but Mui says there has been very little research into patients’ viewpoints.

“Some people are losing their best friend in that regard,” Mui says. “A rural physician really ties a community together.” His idea is to capture people’s perspectives and use them to inform policy decisions to attract and retain primary care physicians to low-population, sometimes isolated, places.

Mui’s project is funded by a microresearch grant from the Collaborative for Rural Primary care, Research, Education and Practice (Rural PREP), and he hopes to expand the interviews beyond Virginia with the help of other medical students he’s working to recruit across the country.

Born in Russia and raised in Vilnius, Lithuania, Mui moved to the Chicago suburbs with his mother when he was 14, and attended college at Boston University — so he’s never lived in a small town himself. Mui calls family medicine “the coolest specialty there is. You get to know a little bit about everything. It allows you to take care of anyone who walks in your door.”

After graduating with a bachelor’s degree in economics in 2013, Mui worked in administrative positions at the National Brain Tumor Society and the Harvard Medical School Center for Primary Care. The fmSTAT program is the main reason he decided to apply to VCU for medical school, Mui says.

In 2012, the School of Medicine started the Family Medicine Scholars Training and Admission Tract — or fmSTAT — as a dual-admission program for students certain of their goal to become family physicians. In an effort to attract and retain students, the fmSTAT Scholarship Fund aims to build an endowment to provide future fmScholars the equivalent of one year’s tuition.

Mui is already a standout fmScholar, regularly making suggestions to improve the medical school’s programs for students, says Judy Gary, M.Ed., assistant director of the Department of Family Medicine and Population Health’s medical education programs.

Mui’s line of study could have national implications, says Department Chair Anton Kuzel, M.D., M.H.P.E. Family medicine was VCU’s most popular specialty among 2018 medical school graduates, but that isn’t necessarily the case across the country.

Virginia prioritizes VCU’s, University of Virginia’s and Eastern Virginia Medical School’s family medicine programs in its state budget. Some other states do likewise, but there is concern that without more widespread attention to medical school admissions policies and addressing student debt for those who want to do primary care, there will not be enough family physicians and other primary care clinicians to care for an aging U.S. population. This will be particularly true in rural areas like the ones where Mui is conducting interviews.

VCU’s fmSTAT program and International/Inner City/Rural Preceptorship, which trains doctors for underserved areas in urban, rural and international locations, are somewhat unusual in the field, Kuzel says, and draw students like Mui who “by and large see medicine as a calling.”

Kuzel calls Mui’s project “by far the most ambitious” student study in his experience. Making connections with community leaders first is important in gaining other residents’ trust, which can be a lengthy process, Kuzel adds.

In June, Mui presented his early findings to a group of leaders from the National Organization of State Offices of Rural Health and Rural PREP, who were very encouraging and offered to advise him in the future.

“It was really an incredible opportunity for me to get guidance in very targeted ways to make this project more successful,” Mui says, and he feels he’s already succeeded in his personal objective to “put myself out there and leave my comfort zone.”

Despite Mui’s strong interest in local care, Kuzel predicts his student will one day go on to make a national impact: “His gaze is much bigger than that.”

By Kate Andrews

Virginia Commonwealth University
VCU Medical Center
School of Medicine
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Updated: 04/29/2016