Payson Doctors In Project With Medical Students


Three Payson doctors are among physicians working with medical students from the University of Arizona as part of the Rural Health Professions Program. Amalia Pineres, David Cluff and James Schouten are participating.

For four to six weeks in June and July the physicians volunteer as preceptors — or mentors — to UA students between their first and second years of medical school. The students work with the physicians at their practice and reside in their communities.

The students are matched with rural physician-preceptors based on medical specialty interest and community preference. Physician specialties include family practice, pediatrics, internal medicine, obstetrics and gynecology and surgery.

Forty-two rural communities are participating in RHPP.

Pineres, who practices family medicine, is mentoring Magdalena Espinoza of Phoenix.

Pineres has been an RHPP preceptor since 1999 and is a clinical assistant professor of family and community medicine with the UA College of Medicine.


Dr. David Cluff


Dr. James Schouten


Payson physicians David Cluff and James Schouten go over a file with their visiting medical student Megan Hunt, who starts her second year of medical school at the Phoenix campus of the University of Arizona Medical School Aug. 9. She was in Payson through the month of July.


Megan Hunt

Cluff and James Schouten, who also practice family medicine, are mentoring Megan Hunt of Chandler. They have been RHPP preceptors since 2004.

Espinoza and Hunt are attending the University of Arizona College of Medicine — Phoenix.

Pineres first worked with RHPP in Globe and since coming to Payson, has had two other students she has mentored in addition to Espinoza.

“I like working with medical students and want to work with those interested in the area. I also hope to get students who might come back and serve the community,” Pineres said.

She said what has impressed her most about Espinoza is her compassion. “She’s kind and she cares. Physicians get caught up in the day-to-day grind, so starting kind she’s better off and the patients are really lucky to have her. It reminds me how important compassion is.”

Pineres said Espinoza is always curious, always wanting to learn.

“We’re looking up stuff all the time and I learn stuff every day.”

Espinoza will start her second year of medical school Aug. 9. She applied for the RHPP because she wanted to see what it was like in a rural setting.

“I had never done anything in the rural area before.”

The students are sent where the program places them. Once there, they can arrange for their own housing or the program will provide it. Espinoza, who is rooming with Hunt, was provided a cabin in Strawberry.

Both she and Hunt said the biggest challenge they have faced during their month in the Rim Country has been the commute from Strawberry to Payson while Highway 87 is undergoing road work.

Building relationships

Espinoza said the most rewarding thing about the program has been, “getting to see people over and over and building a relationship. It’s different than just seeing someone once.”

She said the most surprising thing she has learned is how to talk to people.

“Dr. Pineres is a really good teacher and I hope to come back. It has been a really positive experience,” Espinoza said.


Dr. Amalia Pineres


Magdalena Espinoza


Dr. Amalia Pineres mentored medical student Magdalena Espinoza through July as part of the Rural Health Professions Program, which she has participated in since 1999.

She said if given the opportunity she would recommend participation in the program to other medical students. “It gives you a chance to learn and see medicine from a different perspective.”

Hunt applied for the RHPP to have a chance to see how medicine is practiced elsewhere.

She likes the experience and may consider a rural practice when her education and residency work is completed. “It is not something I had on my radar before.”

She has watched the doctors with their patients, completed medical histories and physicals during the month she has been with Cluff and Schouten.

“The people have been really nice and the office staff has been really amazing, and so have the doctors of course.”

Hunt said she has discovered she likes primary care, but has not yet thought about a specialty.

“You get a lot of hands-on. The patients are friendly and help you learn. It’s a way to see a different way to practice medicine.”

Hunt graduated from ASU with a degree in history, but has always wanted to go into medicine, following the footsteps of an uncle who was a doctor and always had good things to say about the profession.

“Megan is very enthusiastic and willing to learn and that makes a difference,” Schouten said.

He said he was really surprised by her clinical skills, which were beyond his expectations for a first-year medical student.

“The patients enjoyed it,” he said.

Four students have come to Schouten and Cluff through RHPP, one was Payson High graduate Kara McCarty.

Schouten said he participated in the RHPP as a way of paying back a debt.

The medical school he attended had a similar program, in which he participated. Had it not been for that experience, he would not have considered a rural practice.

It is hard to recruit doctors to rural areas, but through these kinds of programs future physicians get to see what the life would be like, he said.

Cluff said he participates in the RHPP because he has always been interested in training students here.

Both he and Schouten won a rural teaching fellowship and make use of their skills with the RHPP.

“Working with medical students is interesting because it gives the opportunity to explain things that are happening while the patient is in the room. The patients learn from it too.”

Good exposure

He said participating in the program is good for “exposure for people who’ve never been in a rural situation and to see what it’s like. Just about all of our young people leave town to get an education, some come back, but not too many.” With the program the medical students get to see that it’s a nice way to live (in a rural area).

“And there’s nothing like a student to keep your skills up,” Cluff said, talking about the personal benefits he has found with the program.

“And it keeps you young too,” he added.

Every summer for the past 14 years, physicians in Arizona’s rural communities have volunteered to mentor medical students from the University of Arizona College of Medicine.

The physicians are rural faculty members in the UA College of Medicine’s Rural Health Professions Program, established in 1997 by the Arizona Legislature to encourage medical school graduates to practice medicine in rural communities.

The students will continue to work with their preceptors over the course of their three remaining years of medical training, returning to the rural communities in their third and fourth years.

“This program helps nurture students’ interest in a rural practice,” said Carol Galper, assistant dean for medical student education, UA College of Medicine.

“I hope more doctors in Payson will reach out and take students from this program and in residency to train. Right now, not many do,” Pineres said.

This year, 11 students attending the UA College of Medicine in Tucson and six students attending the UA College of Medicine — Phoenix were selected for RHPP.

“With the expansion of the medical school to include the Phoenix campus, AHEC funding enables us to provide RHPP opportunities to Phoenix-based students as well,” said Galper.

RHPP students develop long-term relationships with their rural physician-preceptors, who act as medical and career counselors, helping the students make informed choices when they decide where they will practice medicine.

“We now have other graduates throughout the state, with more graduates returning each year,” said Galper. “It is exciting to see these physicians return to Arizona and to have them teach our RHPP students. RHPP has come full circle.”

For more information about RHPP visit the Web site http://omse.medicine rhpp.


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