David Deci, MD

BELLEVILLE — “I’m a product of AHEC,” begins Dr. David Deci, MD, who works as a Family Medicine physician in rural Belleville and also directs the Primary Care Clerkship curriculum for third-year medical students at the UW School of Medicine and Public Health. “From the very start, I have had an appreciation of AHEC. My professional values were established there.”

Following his residency at North Carolina’s Mountain AHEC, Dr. Deci embarked on a career in rural medicine that has included 15 years in the Shenandoah Valley, Virginia; 9 years in West Virginia; and the past 2.5 years in Wisconsin. All along, his work has been related to rural and small communities; a focus, he says, that has reinforced the value that community brings to education: “the essential need for our learners to be in the community, beyond the four walls of the classroom.”

Dr. Deci explains that his passion for rural settings was typically not shared by incoming students assigned to month-long rural rotations during his tenure at West Virginia University: “Students would go kicking and screaming into the rural areas, then come back and tell us it was the best thing they did in medical school.”

He hopes for a similarly enthusiastic outcome here in Wisconsin. To help medical students develop interdisciplinary vision and understanding of public health concepts, Dr. Deci encourages students to make broad connections while embedded within local community agencies and health departments. Each student is required to complete 24 hours of service work on a community-based project during the Primary Care Clerkship, typically a half-day on site per week. Some of the projects occur in small towns and outlying communities, through placements arranged by Wisconsin’s regional AHEC centers and local partners across the state.

Dr. Deci points out that prior to sending students out into the community, the UW prepares students with two years of classroom work that is, for the most part, theoretical: “making sure you lay the foundation, and establish the relevance to the learner.” The transition to working on site in local communities becomes an entirely different way to learn – taking their education to the next level of solving population health challenges. “The AHEC projects are their first opportunity to apply these concepts, and understand what it means, out in the community,” he says. “All students need public health knowledge, and the only way to do that is to take the classroom into the community.”

The projects also expand students’ teamwork skills beyond working with other students. “Bringing students into teams with others in the community, developing value for what everyone brings to the plate – that’s where empathy begins. Wonderful innovative ideas come from community members; our power comes by facilitating the energy in the community. One of the themes I’d like our students to learn is community engagement and community empowerment.”

Getting a wide array of community projects launched and establishing academic criteria for evaluating the quality of the work have been highlights of the first part of Dr. Deci’s term as Faculty Director. Initial reports from students who have completed projects during Summer and Fall 2011 have been very encouraging. “Learners find meaning through these projects because they realize they contribute to the community,” he says. “Learner engagement in projects through AHEC have a longer life and allow them to see the power to make change on a larger level.”

The multi-week projects are also helpful because students typically see a patient only briefly during the primary care clerkship. Dr. Deci explains: “Over the course of an 8-week rotation, relationships with individual patients are fleeting; the 24-hours of the community project offers the opportunity of deeper connection in the community.”

Deeper connections in the community are something Dr. Deci knows from personal experience. He unreservedly models the principles of community engagement in his daily practice. When speaking of Belleville, he is quick to mention with affection several of the local events there, including “UFO Day” – an alien-themed festival at Halloween. Staff members of the Belleville Family Medicine practice appear in the UFO Day parade, including their families.

“It’s a perfect match,” he says, referring again to Belleville’s rural setting – not an alter-ego as an extraterrestrial. The practice in Belleville was founded on the principles of community service, and its reasonable proximity to the UW campus adds appeal. “The best of two worlds: a forward-thinking, resourced, medical school with phenomenal people and being part of a small community where I can really get to know the patients.”

“There are advantages of being a Family Medicine doctor on the front line,” Dr. Deci concludes. “I can give credible stories from my own practice, and that speaks powerfully to students. It’s exciting to be at the cutting edge of molding medical education and using my small-town lens to guide.”