From Philadelphia to Bar Harbor: UPenn Resident Gains Perspective and Experience on Rural Emergency Medicine

Pictured left to right: Daniel Childers, UPenn 3rd Year Resident and MDIH Emergency Department Physician, Dr. Joseph Nabozny

For Daniel Childers, a 3rd Year Resident in Emergency Medicine at the University of Pennsylvania, two weeks at Mount Desert Island Hospital’s Emergency Department offered a change in pace, scenery, and perspective. Trading the fast-paced, highly resourced environment of an academic medical center in urban Philadelphia for an eight-bed rural ED on an island in Maine proved to be an invaluable learning opportunity.

“It’s a very different practice environment,” Childers said. “When you come into a setting like this, the first thing you realize is it’s all on you. You have to be comfortable with such a broad array of skills. Until patients leave the emergency department to go somewhere else, it’s all on you, you’ve got to do almost everything.”

Childers’ rotation was made possible through the partnership between Penn Medicine and MDI Hospital, which offers residents the chance to experience rural healthcare firsthand. Mount Desert Island Hospital’s groundbreaking teaching partnership with Penn Medicine, established in 2011, has evolved into a model for future urban-rural partnerships across the nation and has established MDI Hospital as a premier rural hospital for emergency medicine and critical care. The first-of-its-kind collaborative has brought the two organizations together for teaching and learning opportunities across the continuum of care, emphasizing the importance of rural medicine exposure while supporting MDI Hospital’s summer staffing model. Penn Medicine is among the most prestigious academic medical institutions in the world, and their emergency department is an internationally renowned level 1 trauma center.

During his rotation, Childers was able to stay at MDI Hospital’s Kogod Center for Medical Education, a completely donor-funded residential building in downtown Bar Harbor that provides housing and resources for visiting medical students and residents. Thanks to the generosity of the Kogod Family, the new construction, climate friendly, eight-bedroom residence center allows visiting students and residents to focus on their work while they are here, and not have to worry about finding housing. In 2024, MDI Hospital hosted more than 60 students and residents from leading institutions such as University of Pennsylvania, Tufts University, and University of New England.

“It’s incredible,” Childers said of the Kogod Center. “It allows me to get so much out of every single day I spend here. I didn’t have to waste time finding housing or commuting now that I’m here. I can finish a shift, grab dinner downtown, or head into Acadia National Park, it’s all right here.” A vision the Kogod Family had in mind when building the unique asset to the hospital’s medical education program.

Practicing medicine in a rural area, during the peak summer season brought even more unique considerations to his rotation. At least half of the patients Childers saw during his time on MDI were visitors without a local medical home on the island, requiring extra care during discharge planning to ensure they understood follow-up needs before heading home.

While the cases and environment were different from what he sees in Philadelphia, the experience broadened Childers’ skills and deepened his appreciation for rural practice. “It’s very important for residents who usually work in high-resource settings to have experiences like this,” he said. “Even though we train at Penn, most of us won’t necessarily work at a place like Penn. This helps us develop our skills and understand the range of practice settings out there.”

For Childers, MDI Hospital stands out for its collegial team, close-knit community, and as he put it, “It doesn’t hurt that it’s an incredibly beautiful place to be spending a couple of weeks,” he added with a smile.

“It’s such a beautiful race,” she said. “The scenery is breathtaking, and the crowd energy is amazing. My mom has come up both years to cheer me on, which also makes it really special.” Whether she’s racing along the island’s winding roads or venturing into Acadia’s trails, Caitlin has found that being outdoors recharges her and deepens her appreciation for the intersection between health, resilience, and nature, a passion that has inspired her next step.

After residency completion this year, Caitlin is pursuing a fellowship in Wilderness Medicine, a field that perfectly blends her love for the outdoors with her dedication to emergency care. “Working at MDI Hospital has been an example of the merger between helping people in challenging environments and working closely in nature that I hope to experience during fellowship,” she said.

Reflecting on her time at MDI Hospital, Caitlin expressed deep gratitude for the people and experiences that have shaped her journey. “I plan to use the skills I have learned across my rotations at MDI Hospital going forward into my medical career so that I can provide great patient-centered care,” she said. “I will also remember the wonderful people I have met and cared for here who have helped shape my medical training to date.”

Whether running along the rugged coastline or responding to patients in the ED, Caitlin has found that MDI offers the perfect mix of challenge, inspiration, and community. It’s no surprise that for her, coming back to Mount Desert Island felt less like returning to a rotation, and more like coming home.

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