John Klein: PRIME Developer

John Klein is a lawyer. He will soon be a doctor. He could soon be making over $300,000 a year or more in a matter of days without even doing a residency or subspecialty training. He has spent most of his life in large cities -- attending college in Washington, DC and law school in New Orleans before returning to his home town of Omaha for medical school. How could he possibly hold one of the keys to finding more doctors for rural areas?

John has a different calling. He has a heart for people in need. As he has taken his legal and medical training, he has applied what he has learned. He also discovered the power of giving people a chance to help each other.  

"As a lawyer in medical school I get a fair bit of ribbing from my classmates, and I suppose a lot of that is deserved in the legal profession," John said. "Still, one of the basic ideas I took away from my legal background is that most law is ultimately about setting up systems to organize and motivate people. Even bad law does that. What happened in the Enron scandal was essentially an attempt to organize a crooked system and reward greed as a motivation. On the other hand, a system that draws on people's better motivations can have some really positive effects. My experience has been that once a system is set up, there's no problem finding people motivated to put it into action."

His previous project involved working with inner city clinics. He worked with high school students from all over Nebraska to get children's books donated to a literacy effort. Students from 26 high schools across the state responded with more than 30,000 books. John remembers a particularly generous effort by the students in Alma, NE, population 1200, who collected more than 2800 books. As one newspaper covering the book drive noted, collecting two books from every man, woman, and child in Alma, and getting their household pets to chip in 400 more." (Those involved in getting doctors to small towns have also taken notice, since Alma needs a doc. Anyone want a town with a great heart? Alma, NE is the place for you!)

John realizes the potential in each of us, particularly in students who care. In his final year he has developed the PRIME project. The PRIME project involves medical students going out to rural high schools and taking an hour or two to lecture students. Lectures are obviously the least exciting part about medical school and high school, but John has found a way to attract their interest and to meet their needs as well as the needs of the country.

He has developed four different one hour sessions that help students understand how they are already learning concepts that they could apply in medical school. The algebra lecture teaches the basics drug half-life and illustrates the removal of alcohol, caffeine, and other substances from the body. The biology lecture involves basic genetics. The focus in chemistry is acid-base changes in the body. The optics of vision is the subject for the physics lecture.

The key to the program may not be the quality of the teaching or the content, but who the teacher is. In this case the teacher is the medical student who has traveled out to the rural community to give the talk. Such medical students, especially from rural communities, are a visual confirmation that rural students can make it past the significant and growing obstacles of college and medical school grades and finances just for a start. The encouragement in the students has been overwhelming. Medical school faculty at the University of Nebraska Medical Center such as Robert Bowman and Paul Paulman encouraged John and helped him to understand the rural needs, but the program was his effort entirely. Bowman notes that John's effort may do more for rural areas that his past 20 years as a rural doctor and an accomplished rural medical educator.

John's research findings from the project are also interesting. Even though Nebraska has well established programs to admit students directly to medical school from rural high schools, only a small percentage of such students knew that this program was for them.

The design of the PRIME program is not without other advantages, such as encouraging rural high school teachers in their important work, helping students understand the dangers of alcohol because of the way it is eliminated from the body, and helping medical students to stay connected to communities where they hopefully will return for practice. In only a few months, PRIME has spread to seven states and two other nations. It appears to be an idea whose time has come.

John is planning a career in emergency medicine, but this career, no doubt, will only be another vehicle to help additional people in great need.

PRIME Table of Contents

Introduction and Endorsement

Hope: Students From the Underserved, For the Underserved

Rural Student Interest Groups

Restoration of Communities, Nations, People: Role of Rural Family Docs


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