A Residency Program Where International Applicants Focus on Rural Care
Dr. Denny Peterson (’89) practiced Family Medicine in Willmar (1992-2013) and is now in St. Cloud, Minnesota, as faculty for UMN/Centracare St Cloud (2013-present). While doing so, he has supported and mentored numerous physicians through medical school and the residency program. Many past and current residents have ethnic connections to Somalia, Ethiopia, Nigeria, Central America, Russia, and the Philippines. “The diversity of Minnesota has changed quite a bit during the last 30 years,” he said. “When I went to medical school, our class and most Minnesota communities were pretty homogenous. Now we see fifty to sixty percent of our communities who claim a variety of ethnic backgrounds. Minnesota medical training is beginning to recognize those demographic changes, and our physician training has also needed to reflect that. Now we’re seeing applicants with incredible knowledge and skills requesting residencies in our areas from similar countries and backgrounds as our patients.”
According to Dr. Peterson, the residency selection process includes an application pool that amasses between 700 – 1,000 submissions for six positions. “The quality of individuals and breadth of our applicants is overwhelming and humbling. Not only are they bright and skilled, but they are also hardworking and dedicated to helping patients. They speak the languages of our patients. There have been times when we’ve had over forty percent of visits that were interpreted. This reflects the diversity in our communities and how important it is to communicate effectively. We need to have physicians who are familiar with the language, who understand the culture, and the nuances of their medical care that I might not understand.”
Among the residents who worked with Dr. Peterson is Dr. Sadio Mohamed, who reflects on the location of St. Cloud geographically and what this means to patients from a variety of life paths. “There are many issues that face the patients we serve,” she said. “Language barriers, food insecurity, and substance abuse which are just a few that come to mind. Although we have a very diverse patient population, there is a large Somali immigration and refugee community that make up a substantial number of patients that I see.”
As a third-year resident, Dr. Mohamed has yet to select where her future practice will take place, even though the St. Cloud area is at the top of her list. “We are fortunate in our program to have so many resources available to patients,” she said. “These include an in-house lawyer, two social workers, integrative behavioral health as well as a patient advocate, all of which work together to address the specific needs of our patients. But, equally importantly, our program has emphasized diverse residents from different backgrounds. This is essential because we all know that research has demonstrated that patients fare better when they are cared for by physicians of similar backgrounds who understand the nuances of their culture.”
At the same time, Dr. Bashir Moallin is the chief resident of the St. Cloud Medical residency program, where he has worked with Dr. Peterson and within the local community. He agrees that the St. Cloud area's East African and Hispanic communities are growing mainly from internal migrations. “These communities are underserved,” he said. “There is a large disparity in all health care metrics. For example, in Minnesota, the colorectal cancer screening rate is upwards of 73% in the general population, whereas non-English-speaking patients have significantly lower rates of colorectal cancer screening. Also, there is a large gap in the screening rates of Cervical cancer and breast cancer screening for communities of color and immigrants. Immigrant communities trust providers with a common cultural background and native language. Culturally appropriate, sensitive, and linguistically appropriate care may reduce the burden of health disparities in our immigrant populations.”
For Dr. Peterson, the residents like Drs. Mohamed and Moallin inspire him in everything that needs to happen for them to practice medicine. “It’s humbling when you see the efforts put forth by so many individuals to get where they are, including visa requirements and all the work behind their education. Then you see the incredible blessing that they bring into the communities where patients might not have felt heard or seen or cared for in a way that felt familiar. Our goal is to give each resident a rural practice experience. In many ways, we have duplicated what the Duluth Campus has accomplished, where medical students experience a rural community and experience what their preceptors and peers will face as small-town doctors. Rural Minnesota is changing, and medical education must adjust and anticipate our future.”