• September 16, 2019

Rural resident enjoying his stint in Fort Stockton - Odessa American: Lifestyle

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Rural resident enjoying his stint in Fort Stockton

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  • Chosen Path

    Ivan Becerra is in his 3rd year of residency in the TTU Rural Residency program.

Posted: Sunday, September 8, 2019 6:00 am

Starting his third year in Fort Stockton as a resident in Texas Tech University Health Sciences Center rural training tracks, Ivan Becerra said he’s glad he chose this path.

Born in Laredo and raised mostly in San Antonio and Austin, Becerra earned his bachelor’s degree in biology from Trinity University.

“To be honest, I just wanted to get into residency. It’s really competitive so I was happy to go (to West Texas). I applied to a bunch of different states and I was happy to go wherever would take me. I’m not only glad it was in Texas, but I’m glad I landed here. It’s been rewarding in ways that I didn’t know it would be. I think sometimes previously in my younger life I’ve been really resistant to going where I’ve been sent and it’s always worked out well, so I’ve actually come to be really appreciative of being out here,” Becerra said.

Becerra is affiliated with Pecos County Memorial Hospital in Fort Stockton and tends to patients once a week at the Texas Department of Criminal Justice units in town.

Dr. Timothy Benton, regional chairman, associate dean for clinical affairs and professor at Texas Tech health sciences, said residents serve one year in Odessa and two years in the rural area. He is approved for sites in Alpine, Fort Stockton, Andrews and Sweetwater. Next year, the rural sites will be full with 10 residents all together.

There are two rural training programs in Texas. The other one is at University of Texas at Tyler.

Benton said he placed his first resident in Fort Stockton in 2014. He said Texas Tech health sciences built relationships with the sites that helped them understand the locations.

The site has to be approved by the Accreditation Council for Graduate Medical Education.

“… The ACGME has certain requirements for the residents’ education, so a site has to have those educational elements, meaning there needs to be opportunity for them to see a certain number of patients over those two years, a variety of patients with varying needs whether it be gynecology, obstetrics, surgery, orthopedics, pediatrics. That’s how we choose the sites,” Benton said.

There are 39 rural track programs nationwide, according to the Rural Training Track Collaborative, Benton said.

“There’s huge rural need all over the nation. Rural hospital closures across the nation are becoming a little bit of a crisis being recognized at the federal level now, too. The federal government is trying to put money into stimulating the development of rural training tracks,” Benton said. “Texas leads the nation in rural hospital closures, so we definitely have need.”

He noted that the rural training programs prompt residents to practice in the rural areas.

“That’s part of why I think it’s good to train at the rural site because they get a broad experience, but also from the perspective of rural. In the urban setting in the first year, you have all the subspecialists right down the hall,” Benton said.

He added that residents have to be supervised by attending physicians.

“That’s one of the advantages of this is it multiples their manpower, but it also increases access to care so the resident functions semi-independently, too. They have their own schedule of patients they see in addition to the supervisor,” Benton said.

Becerra said the process of interviewing for the rural program was essentially the same as the core program in Odessa, except they had an extra couple of days where they interview at all the rural sites and you can rank them.

He said he wants to be like a Swiss Army knife — useful in a number of different scenarios — so family medicine called out to him. Becerra expects to graduate in June 2020.

“… I couldn’t see myself practicing in one part of the body, or one system exclusively for my career. I find a lot of … fulfillment out of knowing enough about a wider swath of knowledge than just overly specializing into one niche so I find that to be just for me personally more useful and more applicable in different scenarios,” Becerra said. “I always fancied myself as being kind of versatile, so that’s kind of what called my attention to it.”

He added that he didn’t know about the rural track option until he interviewed for the residency program.

“We kind of overlap with some of those specialty areas and we get to do a lot more procedures, so it’s a lot more hands-on. Even six months before I came out here, I didn’t know that I would be out in Fort Stockton, so to me it’s been a very pleasant surprise. It’s been a challenge, very challenging. Residency in and of itself is a challenge, but particularly training in an area where you feel like maybe there’s more uncertainty as to is this patient appropriate to stay here should we ship them back to MCH (Medical Center Hospital) where they have a higher level of care?”

“Sometimes when you’re the most uncomfortable is when you grow the most and I’ve learned that in spades here in the last year. I’ve found that, again, it’s been a challenge but everyone’s been so welcoming out there. They’ve made me feel at home and supported and they’ve been very considerate of my situation being out there without knowing anybody,” Becerra said.

The day, overall, is the same schedule, but you never know what’s going to come in, “but I do appreciate the variety that practicing out there offers,” Becerra said.

“I think my favorite things are the procedures because I feel like the common perception of family medicine is that we’re just for the lumps and bumps like we don’t get to do some of the more exciting stuff like help deliver. Sometimes deliveries entail C-sections, or like the appendectomies, or doing certain procedures that usually our specialists take care of over here. That to me I find something fulfilling and gratifying about working with my hands and being able to see something done that I’ve helped with,” he added.

The other part of the variety is the prisons he visits once a week.

“We see a lot of interesting stuff out there because you would think in a lot of ways they have very similar health concerns as the general population there. There are plenty of diabetics; plenty of hypertensives. I see a lot more musculoskeletal and orthopedic type stuff, minor albeit minor, but we see a lot of that stuff, both because there aren’t as many specialists that do go out there or participate in those types of settings, but also because a lot of these guys had kind of a rough life and they’ve been involved in a lot more stuff than the general population,” Becerra said.

He also enjoys being able to educate the inmates.

“The other thing I like about working out there with those patients is that they often have a lower understanding of what’s going on with their health and why they’re being treated the way they’re being treated, so what I also enjoy a lot about working with them is I get to do a lot more teaching. They are a lot more receptive to listening and having people explain to them why am I taking these pills …,” Becerra said.

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