Students Participate in Porter Internships

The College has a large pre-medical program: this year, more than 50 Middlebury students applied to medical school. One of the College’s best opportunities for pre-medical students is the Porter internship. Run by Dr. Hannah Benz, the CCI pre-medical advisor, and Dr. Eric Benz, an orthopedic surgeon at Porter Hospital, the program allows for 15 students to shadow doctors at the hospital during J-term. This year, I was fortunate enough to be one of the participants.

Students are placed with a home preceptor, with whom they spend the majority of the month. Preceptors are doctors from pediatrics, orthopedic surgery, ER, cardiology and family care. Their mentorship is perhaps the most important aspect of the Porter internship. Porter interns gain exposure to an certain area of medicine, as well as receive close guidance and advice about medical careers and the U.S. healthcare system.

Students are also able to participate in electives and shadow doctors in different areas of medicine. Interns can spend a day observing the hospital lab and blood bank, working alongside a nurse in home health, watching surgeries or shadowing radiologists.

I quickly learned that the technical aspects of medical knowledge, such as knowing which tests to run or drugs to prescribe, are only a part of a doctor’s job. Medical expertise also relies on a doctor’s ability to navigate the healthcare system and understand their patients on a personal level. For instance, my preceptor had to deal with health insurance companies denying medical coverage to patients, or pharmaceutical companies raising drug prices beyond a patient’s financial means. One patient with Wilson’s disease, a dangerous but treatable disorder that leads to the insufficient metabolization of copper, had their annual treatment expense raised from $888 to $26,000. My preceptor was forced to find an alternative, albeit less effective, generic drug for this rare disease.

Andrew Holtz ’16.5, a Porter intern who shadowed a doctor in the ER, gained valuable insight on some of the difficulties that face ER doctors.

“I was able to learn how the providers in the ER approached difficult conditions such as depression, alcoholism and drug-seeking behavior,” Holtz said. “It’s easy to become detached from the world around us while at Middlebury, and the internship was successful in showing me the problems that many of our neighbors suffer from.”

The goal of the internship is to help students decide whether they want to go into medicine. Dr. Tim Cope, a retired family physician and current teacher at UVM medical school, participated in the pioneering year of the internship program in 1976.

“There wasn’t any structure at first,” he said. “It was me and one student. The program grew over time. It took a while, maybe 10 years. For a while, we had another parallel program in medical anthroplogy, which was run by David Napier [a former Middlebury professor of anthropology]. Students could go anywhere to witness rural medicine. Some went to Scotland to be in the rural areas of the Highlands.”

Dr. Cope and David Napier carried out a study of Vermont physicians to assess their  levels of career satisfaction. Results indicated that physicians who had more experience with medicine before becoming a doctor were happiest with their jobs.

“I think the idea of the internship is not to convince people to go into medicine,” Cope said. “It’s to help them figure out what they want to do. The people I think I have helped the most are the people who thought they wanted to go into medicine, and then said, ‘Nope, that’s not for me.’ You are looking at a commitment of seven years of training and a tremendous amount of money. We don’t want someone to get into it and be terribly unhappy.”

It was reassuring to see Porter Hospital behind the scenes and gain a deeper understanding of its inner functions. Often, modern institutionalized medicine can seem impersonal. People lose their identity when they put on an ascetic patient gown and are whisked down the white, antiseptic halls of a hospital. Their blood is drawn and sent off to basement labs for tests, their biopsies carted down to pathologists and their bodies placed under massive machines for images they may never see. But at Porter Hospital, I was able to witness the care and concern put into every step of a patient’s treatment by doctors, nurses and lab technicians alike. Such personal treatment is a benefit of having a rural hospital in a small community.

I encourage pre-med students and students unsure about medical school to apply to the Porter Internship next J-term. It was a valuable insight into careers in medicine, and the doctors and lab technicians I shadowed were all eager to teach and give advice. The application for the Porter Internship is made available late summer, and the deadline is early October.