Alaska is an amazing place to live and to practice family medicine. It is an enormous state — over 660,000 square miles (more than twice the size of Texas). There are only about 600-700 miles of roads in the state. 75% of its land and 30% of its population are off-the-road-system – accessible only by boat or plane. Limited accessibility, coupled with extremes in weather, makes health care delivery challenging. To meet those challenges, Alaska has developed a unique medical system including community health aides, small regional hospitals staffed by family physicians, radio medicine (now evolving into telecommunication/telemedicine), and an efficient system for air transportation. Family Physicians in rural and bush Alaska practice the full scope of family medicine and are responsible not only for medicine in their own communities, but also in outlying villages.
There is no substitute for direct rural experience. The residency encourages as much rural experience as is allowed by the Graduate Medical Education guidelines. A six-week block in the R2 year is spent in either Bethel at the Yukon-Kuskokwim Delta Regional Hospital or in Dillingham at Kanakanak Hospital. The experience includes heavy patient volumes, pathology rarely seen elsewhere, frequent patient transport (often in adverse weather conditions), obstetrics, village site visits, and the challenging task of evaluating patients by phone through discussions with community health aides. R3’s spend eight weeks in rural rotations elsewhere in Alaska, often being one of only a few physicians, hours from the nearest major medical facility. These rotations help residents to understand the uniqueness of delivering health care in Bush and rural Alaska.