West River welcomes first class of residents

A new era of learning has started at West River Health Services.

(Left to Right) Kumari Singh, Jeff Hostetter and Jeffrey Bruning stand outside the front door of West River Health Services. (Herald Photo)
(Left to Right) Kumari Singh, Jeff Hostetter and Jeffrey Bruning stand outside the front door of West River Health Services. (Herald Photo)

Herald Editor

A new era of learning has started at West River Health Services.

About a year ago the hospital, in conjunction with the Center for Family Medicine in Bismarck and the University of North Dakota, joined together for the 1-2 Rural Training Track program. The 1-2 format means the students spend their first year of residency in an urban area and subsequent year in a rural area. The students spent the first year in Bismarck, and now follow up the rest of the program in Hettinger.


Though resident Dr. Kumari Singh has spent a few days a month in Hettinger in the last 11 months, she and Dr. Jeffery Bruning began work full-time July 5 in Hettinger.

In the past few years, the North Dakota legislation has made some changes to assist rural healthcare facilities. Program Director Dr. Jeff Hostetter previously told the Record that rural healthcare has become a priority with the state.

“Rural healthcare had become a priority of the Department of Health and Human Services because of the depopulation of rural physicians in the United States, and North Dakota in particular,” said Hostetter. “Our mission is to do things that work to get people to stay in rural areas, and Rural Training Track turns out to have the best data and best retention rate.”

The site director, Dr. Catherine Houle, a regular physician with West River, echoed those sentiments. The hope is that younger doctors will see the benefits of rural medicine and stay in the smaller communities to practice as aging physicians begin to retire, according to Houle.

“Most residents end up within about 100 miles of where they did their training,” Houle said.

The students spent time in rotation in Bismarck, with a portion of their training being done with their continuity clinic. In the continuity clinic the residents attended to regular patients for ailments and checkups.

Houle said that having new medical residents should help the current staff with their practices.

“Anytime you have a learner in your environment it keeps the regular physicians on their toes,” Houle said. “So now we have learners at a higher level, so we even have to be more on our toes which is okay.”


The duo will perform similar duties with West River. They will spend time at the other satellite clinics through rotations, while getting to know regular patients at the main clinic in Hettinger.

Bruning said his knowledge base and the way he thinks about medicine has grown in the year he has spent in Bismarck.

“Gaining so much knowledge in that year, just as how you actually view a patient and do the workup, so that you can figure out what’s going wrong, and then the treatment process and know when you’re comfortable to take care of things and when you have to either refer or ask for help,” said Bruning. “As far as that, yeah I’ve gained a lot of knowledge.”

Bruning said the real adjustment he is making is getting comfortable with the processes West River employs.

Singh said that after being in the program a year she has higher expectations for herself.

“I think that you expect more from yourself because you’re more accountable with things, there’s less physicians,” Singh said. “Therefore you need to have a better understanding of things and be more of an expert at things.”

She has always been attracted to a smaller hospital and previously told the Record that she wants to work in a rural area some day.

“I like that when you’re in a smaller hospital, it seems that people are more willing to go out of their way and help you out,” Singh said. “It does seem like there’s a lot of teaching here, and there’s good communication.”

Singh said at a larger facility it could take time to get a question answered, but at a smaller facility resources are easier to come by.

A big part of rural medicine is being community oriented, and both doctors fully expect to participate in events around the area. The main part of their presence in Hettinger will be to further their training, but even small appearances around the community will help them get some facial recognition with the citizens of the area.

Both have already been greeted warmly by the community and are looking forward to getting to know more people. Singh herself was taking a casual walk down the street in Hettinger and was pleasantly surprised to get a warm “hello” from two fellow walkers.

“If you’re going to do rural medicine, it’s good to maybe have that exposure of being in a community where people know each other and they’re familiar with each other,” Houle said.

The doctors are now taking patients and appointments can be scheduled by contacting the clinic. Houle said the facility is very happy to have the duo in Hettinger as they open the door to a new chapter with West River Health medicine.

Share this post