As rural hospitals are closing in alarming numbers across the state, people in rural areas are relying more heavily on their primary care providers — a dwindling resource. Fewer up-and-coming physicians are choosing to specialize in primary care, and the struggle to find medical students who want to go into primary care and practice in rural areas is real.
Travis Williams, a fourth-year medical student at the UNC School of Medicine, is one of those dedicated individuals driven to go where the need is greatest. His path to medicine started somewhat unexpectedly.
Robert Williams, Travis’s father, was diagnosed with diabetes as a child and has experienced nearly every complication associated with the disease, including leg and finger amputations, kidney transplants and blindness. Travis and his mother, Joni, have been Robert’s caretakers for decades, and Travis felt like he knew every corner of the hospital and every doctor working there. Yet, he’d never considered medicine as a career option — he wasn’t sure he had the mind for medicine — until one fateful Christmas, when Robert was suffering from double pneumonia in the UNC hospital.
“He seemed to be getting worse and worse,” Travis recalled, “so my mom called one of his longtime physicians to come by and check in on him.”
The doctor left his own family on Christmas day to visit Travis’s father in the hospital. Travis saw how much the visit meant to his parents — that level of trust, of comfort, of reassurance, could only be found in a doctor-patient relationship. In that moment, Travis had an epiphany: medicine is about more than grades, and he realized he had something extra to bring to the profession.
“I’m unique in the fact that I’ve always been entrenched in having a very sick family member. I can relate to patients and their families. I know what it’s like to sleep in a hospital room all night — I guarantee I’ve done it 100 times. It’s a level of relatability that not everyone can offer, and it fuels me to keep going.”
When it came time to apply to medical school, the choice was simple for this Chapel Hill native.
But Travis knew he wouldn’t always stay in his hometown. He wanted to branch out from Chapel Hill, to serve another area of the state that had fewer high-quality health-care choices.
“I’m cognizant of how lucky my parents were to be five minutes away from the best hospital in the country. Not everyone in North Carolina gets that opportunity.”
Travis applied to the Kenan Primary Care Medical Scholars Program at the UNC School of Medicine. Founded in 2013 through a collaboration among the UNC School of Medicine, Mountain Area Health Education Center (MAHEC), and The William R. Kenan, Jr. Charitable Trust, the Kenan Scholars Program supports students specializing in primary care and seeking to serve in rural and underserved areas.
The school’s new curriculum — the Translational Education at Carolina (TEC) — appealed to Travis. TEC enables students to quickly integrate classroom learning with clinical practice, providing students with the room to explore diverse opportunities that will better inform their residency program decisions and future practice.
“It’s great to have more time applying our learning and navigating the shades of gray,” commented Travis, who spent the first 18 months in the classroom working in basic sciences and organ systems.
For the clinical practice portion of the curriculum, Travis headed to MAHEC in Asheville, North Carolina. He spent four months in a hospital and eight months in outpatient clinics. Referred to as “longitudinal learning and care,” this division of practice emphasizes the value of getting to know patients over a longer duration of time while seeing them in a variety of health-care settings. It’s a great way to ensure medical students connect with their patients and feel what it’s like to be embedded in a rural community — all of which Travis experienced.
Patients started remembering when Travis would be in the clinic, and they would plan their follow-up appointments around his schedule.
“I started to see the same people, over and over, which is great — that’s what you’re going to be doing if you want to do outpatient medicine.”
Travis has also developed strong relationships with his preceptors — teaching physicians — as well. His mentors include Dr. Charlie Baker, a Carolina Medicine alumnus who oversaw Travis’s summer internship in Linville; Dr. Bryan Hodge, family medicine preceptor in Hendersonville; and Dr. Eric Byrd, internal medicine preceptor and a legend with his patients in Hendersonville. These physicians’ decades-long commitment to western North Carolina and passion for bringing medicine to underserved areas of the state solidified Travis’s picture of his future.
“I jumped on the chance to learn from those committed to small-town medicine, and I’ve been incredibly lucky to reap the rewards.”
Travis is now in his fourth year of medical school, which places him in the TEC curriculum’s final phase. While most of his classmates are returning to Chapel Hill for electives, research and interviews, Travis is staying in western North Carolina.
“I know that I want to do family medicine, and I know that I want to do rural. Everything I need is up here.”
In a few short months, Travis will face one of his biggest decisions since choosing to attend medical school: where to complete his residency. The National Resident Matching Program will make the final call, but he is considering a number of opportunities, including programs in Hendersonville, Montana, Wyoming, Idaho and Alaska. He is staying true to his plans to pursue a family medicine residency in a community setting.
“I hope it will prepare me to practice in a small town that may not have as many resources as larger cities like Chapel Hill, or even Asheville. Whether my residency is in Hendersonville, or if I go off to another state for a few years, the goal and plan has always been to settle down in western North Carolina as a family doctor. North Carolina is my home, and it always will be.”
Travis and his partner, Scout, an emergency room nurse with ambitions of becoming a nurse practitioner, have big plans for the western North Carolina county where they will eventually spend their lives. Together, they hope to introduce their patients to healthy food choices, by growing a garden or partnering with local farmers. Travis wants to serve on boards that help with development in the county, participate in local events, and volunteer as a trainer for high school sports.
His patients will know him as a neighbor, listen to him as a doctor, and trust him in the toughest of times. Advocacy for patients and advocacy for community — are important lessons Travis learned from his mentors.
“I’ve seen how much of a force they have been in their respective communities. I only hope to emulate that in some fashion.”
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“In many parts of the world, the days surrounding childbirth are the riskiest period a mother and her newborn will ever face.”