By Tara Bannow

The Bulletin

Cydney Heims’ patients at Volunteers in Medicine in Bend are much different from those at Bend Memorial Clinic or St. Charles Health System. For one, most don’t have insurance and all are low income — requirements of the clinic. Many are Hispanic and speak Spanish, which gives Heims, a third-year medical student at Oregon Health and Science University, a chance to use the language she learned growing up in Portland.

“There is kind of a different cultural interaction with health,” she said. “It’s nice to understand that a little bit better.”

Heims is working at the clinic as part of her rotation, or clerkship, in family medicine. In their third year of medical school, doctors in training try their hands at different specialties — things like emergency medicine, obstetrics and gynecology and pediatrics — to decide which one they’ll ultimately choose. Students fulfill their family medicine rotations at dozens of clinics across the state, but Volunteers in Medicine is the only free clinic on the roster.

Peggy O’Neill, the medical student education administrator in OHSU’s family medicine department, said she wishes students had more opportunities to learn about treating diverse and low-income populations, but there aren’t many clinics that accept students, an agreement that requires the clinics’ doctors to serve as mentors.

“The patient population has a tendency to be a little more receptive to students,” she said. “They’re grateful for the medical care they receive at Volunteers in Medicine, so they’re more receptive to talking to students and sharing their stories with them.”

Students who perform rotations at small clinics like Volunteers in Medicine also tend to get more hands-on experience with patients compared to those who do so at OHSU or other academic medical centers. In those settings, there are residents, medical school graduates receiving supervised training, who have seniority over third-year medical students.

“A lot of times you’re either shadowing or you’re not working as closely with the patients,” Heims said.

But at Volunteers in Medicine, Heims meets with patients, takes histories, performs physical exams and then presents her assessments to one of the clinic’s co-medical directors, who help determine a treatment plan or see the patient themselves in more complex cases. The medical directors, both doctors, also sign off on patients’ prescriptions.

“I think a lot of times we treat them more like doctors than a lot of clerkships do,” said Dr. Jim Ritzenthaler, a co-medical director at the clinic. “Sometimes clerkships can be an experience where you’re just following somebody around.”

Volunteers in Medicine has been taking on medical students for about the past six years. In that time, Ritzenthaler and his fellow co-medical director, Dr. Bob Hakala, have earned reputations at OHSU for being strong teachers, Heims said. Heims has also done rotations at St. Charles hospitals and BMC, which train medical students in a number of different specialties.

Teachers are important, but Volunteers in Medicine’s patients also help make its rotations popular.

“They really appreciate the care that they get,” Ritzenthaler said. “Everything here is free. That’s a pretty good price.”

— Reporter: 541-383-0304,