MONROE — Dr. Serene Bethune graduated from the residency program at Monroe Clinic Friday, making her the initial graduate of a program that had not existed throughout the state in 20 years of family medicine.

Bethune spent time in Monroe in December 2014 as a fourth-year medical student.

“I had the opportunity to come and experience the clinic and the town firsthand for 30 days, and I fell in love,” Bethune said.

She was the first doctor in a program that has since admitted six to learn more about family medicine. During a residency, a young doctor out of medical school engages at a practical level with a mentor to specialize in certain areas of medicine. Now that Bethune has finished her residency at Monroe Clinic, she plans to spend three years at Crusader Community Health in Rockford.

Bethune said early in the process, she signed up with the Health Resources & Services Administration program National Health Service Corps, which repays portions of student loan debt to those who commit to practice medicine in an area designated as “underserved.” Rockford is one of those areas. She will work in family medicine with the ability to also practice obstetrics, which will allow her to treat pregnant patients.

Medical Education Coach Lori Rodefeld said Bethune’s graduation was a notable day.

“There hadn’t been any growth of family medicine, so we were kind of the first out of the gate to start family medicine programs and there have actually been several more that have started after us,” Rodefeld said. “It’s been beneficial to the community because we’re able to recruit our future workforce.”

The two graduating members of the year-long emergency medicine fellowship program are also important because Monroe Clinic has the only program in the Midwest, she added. A fellowship is completed by doctors who want to acquire additional training.

Like Dr. Theo Lyotard, a Switzerland native who completed the emergency medicine training and looks forward to going to Virginia to practice wilderness response medicine, which is done “in austere environments without any, or few, resources,” he said. Generally, wilderness doctors are in areas where hospitals, clinics or evacuations are not accessible, “so you have to kind of make do with what you have,” Lyotard said. It usually involves people running, hiking, climbing and getting “themselves into trouble,” he said.

Lyotard chose Monroe as a transition from family medicine to emergency response training because of “the place, the people,” and said “it kind of flew by, but it’s been a fun year.” He noted the most important lesson he left the fellowship with was “some self-confidence.”

“You kind of build it up every day when you work,” Lyotard said, adding that in learning medicine, details are a focus, but being a part of the daily schedule in an emergency room, “you take in some basic tricks and confidence” to utilize in the real world.

Dr. Ameen Taleb, who also completed the fellowship program, plans to return to Monroe Clinic.

“I think the opportunities that Monroe offered in the rural training for emergency medicine compared to other programs that I interviewed and the volume of the patients, the staff, procedures load and the community; things that fit my goals,” Taleb said.

Dr. Darren Pipp, director of the fellowship program, teaches those who already completed a residency in family medicine but wish to learn more about emergency care.

“We take that knowledge and we sort of tweak it a little bit so that they become emergency room physicians,” Pipp said. “We teach them more about acute care, some of the procedural skills they need; you know, how to manage an airway on a patient.”

He said a state grant has helped address a doctor shortage, which greatly impacts less populated areas.

“We’re training emergency room doctors to work in, hopefully, smaller community hospitals in the state of Wisconsin, which is where there’s a need,” Pipp said. “They’re already physicians, most of us in the ER have 20 or 30 or so years of experience, so we mentor them.”

Across the country there seems to be need in all fields of medicine, but particularly in rural areas and in emergency medicine, Pipp said.

“Most emergency room physicians gravitate to large trauma centers, large cities,” he said. “So we’re trying to create a little niche to train folks to want and be more prepared to work in rural communities.”

Rodefeld said by implementing the program that requires extensive work and time, Monroe Clinic can match potential applicants for programs through a screening process.

“We have a lot of great things happening with medical education,” Rodefeld said. “It’s been a great thing for Monroe Clinic, because it’s about workforce. It’s great to teach, but when you can hire some or all of your graduates, that really helps.”

And those like Bethune can help underserved areas in a number of ways, by first working in the Rockford area before returning to Monroe Clinic to contribute to the number of physicians practicing in rural areas. She plans to return after three years. Bethune said she feels “a healthy mix of both” nervousness and excitement to take on medicine post-residency, and though tends to be modest, expressed confidence in the future of practicing without a mentor by her side because she has learned “a sound clinical foundation.”