The chance to conduct clinical research adds to popular family medicine residency’s appeal
At Smiley’s Clinic in south Minneapolis, first-grader Hamsa Abdala, 7, waits with his mother, brother, and a Somali language interpreter to see a doctor. He hops up on the exam table, flashes a bashful smile and says that he’s glad to miss a school fieldtrip that day because of his checkup. His class was going ice skating, he explains—he prefers golf.
Hamsa is one of six pediatric patients that Sankari Kasi, M.D., a second-year family medicine resident at the University of Minnesota, will see that week for a clinical research study she’s working on as part of her residency.
The study, begun in 2009, involves performing developmental screening of Somali children to assess their growth in motor skills and verbal abilities. The research team, which includes fellow resident Nadia Malik, M.D., and Diane Madlon-Kay, M.D., Smiley’s research coordinator, is evaluating how doctors can encourage Somali parents to report health or developmental concerns about their children to help doctors catch potential problems and intervene sooner.
“If you miss a diagnosis, it makes a difference for the whole family and their future,” says Kasi. “I think about how that could change the kids’ lives.”
Doctors at Smiley’s had noticed that when Somali parents bring their children to the clinic for well-check visits, they seldom describe any problems or ask questions.
“Even though we have interpreters, parents rarely have concerns. This is uncommon,” says Madlon-Kay, an associate professor in family medicine.
To make it easier for these parents to share information and raise questions about their children’s health, the research team is using a number of new approaches, including a revised evaluation form that’s written in Somali. “We’re hoping it will make a difference,” says Madlon-Kay.
Kasi, who joined the study in 2009, says that the opportunity to participate in clinical research helped attract her to the University’s family medicine residency program.
After attending Tirunelveli Medical College in southern India, she moved to the United States to complete her residency. When a friend was doing a rotation at Hennepin County Medical Center, Kasi visited her and came to learn about the University of Minnesota.
“I had a gut feeling that this was the place I had to be,” she says.
Drawn to family medicine
Kasi has plenty of company. The University of Minnesota’s Department of Family Medicine and Community Health has graduated more than 1,550 residents from seven of its residency programs since their inception.
And the percentage of the University’s medical graduates who choose family medicine is far higher than the national average, says department head Macaran Baird, M.D., M.S.
“The national average is 7 percent. Some medical schools [graduate] 0 to 3 percent in family medicine. We’re at 16 to 20 percent,” says Baird. He believes that several factors boost this statistic, including the University of Minnesota Medical School-Duluth Campus, which also has a strong family medicine residency program, and the Rural Physician Associate Program (RPAP).
About half of the Duluth campus medical students go on to specialize in family medicine, thanks, in part, says Baird, to their early contact with primary-care physicians, a key component of the Duluth program. That number shoots to 70 percent for students participating in RPAP, which is offered on both campuses.
Kasi offers a number of reasons for choosing family medicine, including the variety and the chance to develop long-term relationships with families. “You follow the patient and the whole family. The continuity is the best thing,” she says.
Another draw was the job market. “There is a lot of respect for family physicians in the Midwest,” says Kasi. “There are a lot of job opportunities.”
Baird concurs. “Residents can get jobs in many places,” he says, referring to both urban and rural opportunities. “Salaries are going up so fast. Our residents are signing contracts in their second year.”
For Kasi and others, the rare opportunity to conduct clinical research as a resident adds to the program’s appeal.
“The University provides an experience in research that you don’t find in many places,” says Kevin A. Peterson, M.D., M.P.H., research director for the Department of Family Medicine and Community Health. “We have the third-largest research group in family medicine in the country.”
Baird believes such research experience is extremely helpful to resident development. “A resident in the real world faces patients with complex, multiple illnesses with psychosocial dimensions,” he says. “Research is very specific. Physicians have to know how to interpret research and be able to apply that knowledge appropriately when treating patients.”
Kasi hopes her research will help her catch and address patients’ developmental problems at an early age. “It’s going to bring change,” she says of the study. “I’m going to change someone’s life.”
By Robyn White