1. To acquaint the first year student with the various determinants of the health of a rural community.
   • To observe and reflect upon the interaction among health institutions, health programs and community activities to promote health, prevent disease and injury, treat illness and offer rehabilitative and/or palliative care in a rural setting.
   • To understand the importance of behavioural, socioeconomic and cultural factors in determining the health of the community.
   • To develop an awareness and understanding of the role, activities and interaction of the various health professionals in the community.
2. To acquaint the first year student with the role of the physician in a rural setting.
   • To observe the responsibilities and activities of a family physician in a rural primary care practice. This does NOT include the use of clinical skills by the student beyond those taught in the Introduction to Medicine Course prior to the placement.
   • To identify the responsibilities and activities of the Regional Medical Health Officer and the interaction between the Rural Family Physician and the Regional Medical Health Officer.
3. To examine ethics and humanities issues in the rural placement context.
   • To heighten the student's awareness of ethical issues that arise in the everyday experience of the health team (nurses, physicians, nutritionists, physiotherapists, etc.).
   • To develop the student's sensitivity to the broader more positive humanistic aspects of medicine that occur in the everyday experience of health professionals.
   • To develop the student's skill and ability to summarize and report observations in a clear and consise manner.

   Rural teaching sites are available in most areas of Newfoundland and Labrador, New Brunswick and Prince Edward Island. Students will select sites as a group through a process of drawing names at random. Students from New Brunswick will be given priority for the New Brunswick sites. Following the assignment of sites there will be a short period of time allowing students to exchange sites if mutually agreeable.

   Prior to the visit, a one hour session will be scheduled to review the objectives and expectations for the placement and answer any other questions.

   The placement is for a full 10 days. After your visit, you will meet in small groups to discuss the experience. This will allow the group to:

1. Identify the determinants of health in the communities visited.
2. Identify strengths and weaknesses of the health team in meeting the needs of the communities visited.
3. Describe the role and life of the Family Physician and Regional Medical Health Officer in a rural setting.
4. Describe and discuss issues identified related to ethics and humanities.

   A report of no more than 5000 words (approx. 20 double spaced pages, 12pt. font). The Rural Placement Report will be evaluated by faculty from the Division of Community Health, Discipline of Family Medicine and Faculty teaching Ethics/Humanities. Rural Preceptors will contribute a report mark, on a voluntary basis if workloads permit, which will be averaged with the Faculty member from the Discipline of Family Medicine.

   The ethics/humanities component of your Rural Report will be graded on a Satisfactory/Not Satisfactory basis. Unsatisfactory work will be returned and must be re-submitted until a satisfactory standard has been achieved.

   A passing mark of 65% must be achieved on the Preceptors Pass/Fail assessment and on all three components of the report. Three copies of the report are to be submitted. The Rural Report will include the following:

1. To be aware of the student's objectives in this component of the First Year Community Health course.
2. To provide a base for the student in the office/hospital/clinic allowing the student to meet patients in a supervised manner with key informants.
3. To arrange meetings with hospital/clinic staff, community health personnel (Eg. Community Health Nurse, Directors of old age homes, Social Workers, Local citizens, etc.) in advance of the dates of the placement.
4. To prepare a two week schedule for each student and send this schedule to the student and the Coordinator of the Rural Placement at least one month prior to the start of the placement.
5. To spend time initially to review the objectives of the placement with the student. Periodically throughout the placement as required. At the end of the two week period, to review the accomplishments of hte student in fulfilling the course requirements.
6. To evaluate the student on his/her accomplishment of the course requirements on a Pass/Fail basis.
7. To mark the reports of students who visited the site if time permits.

   Any first year medical student at Memorial University of Newfoundland is eligible for the Rural Placement Prize of $300.00.

   As part of the requirements for first year, Community Health students must submit a report concerning their two week Rural Placement Visit. All reports submitted are automatically considered for the prize. The submissions will be judged on the basis of originality, scientific merit, presentation, and overall contribution to Rural Community Health.

   The prize jury consists of:

• Associate Dean - Division of Community Health
• Community Health Preclerkship Coordinator
• Rural Placement Coordinator
• Discipline of Family Medicine - Liaison for Rural Placement

   The Faculty of Medicine will pay for certain expenses related to medical students' travel to Rural Placements. Expenses covered by the Faculty of Medicine are as follows:

1. Travel
   

      Normally limited to return bus fare from St. John's to assigned community within Newfoundland, or equivalent bus fare if student travels by plane. Where travel is by private vehicle, the student will be reimbursed only for actual gas expenses incurred to fulfill the requirements of the placement.

      A limited number of students, subject to the training positions available, travelling to the St. Anthony area and Labrador, New Brunswick and PEI will have their travel arranged by Janet Bartlett - Division of Community Health. Any such students must submit their airline tickets to Community Health within 10 days of their return to St. John's.

2. Accommodations
   

      Wherever possible, both in Newfoundland and Labrador, free accommodation is arranged. For students placed at Newfoundland sites which cannot supply free accommodation, the student will be reimbursed following the visit for any accommodation charges. This will occur upon presentation of an invoice to Janet Bartlett - Division of Community Health. Tickets, invoices or gas receipts must be submitted as soon as possible after the student's return and no later than 10 days upon completion of the rural placement, for processing by the finance office.

      Once placements have been allocated, details regarding accommodation can be obtained from Janet Bartlett - Division of Community Health.

3. Meals
   

      Meals are the responsibility of the student. Costs vary with the location.

NOTE: Each request for allowable expenses should be supported by a receipt, paid bill, etc. for every item claimed. Claims not supported by such vouchers cannot be paid.

Dr. C. O’Maonaigh
Rural Placement Coordinator
Division of Community Health, Telephone: 729-3157
email: conleth@mun.ca

Dr. Cheri Bethune
Liaison, Discipline of Family Medicine
Rm H2402, Telephone: 737-6741
email: cbethune@mun.ca

Ms. Janet Bartlett
Instructional Assistant
Rm H2847, Telephone: 737-6216
email: jbartlet@mun.ca

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