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Rural Road to Health

Rural Road to Health

Written by: Veronika Rasic
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 A journey down the rural road to health. This podcast explores rural health topics through conversations with students, academics, clinicians, researchers, and people that live and work in rural areas.2023 Hygiene & Healthy Living Physical Illness & Disease Social Sciences
Episodes
  • Profs Sarah & Roger Strasser - Adventures in Rural Health Education & Research

    Profs Sarah & Roger Strasser - Adventures in Rural Health Education & Research
    Jun 20 2025
    Prof Sarah Strasser and Prof Roger Strasser, a trailblazing couple in the world of rural health, rural health research and rural medical education. Episode summary: 01.15 Sarah and Roger share how they became interested in rural health and some key highlights from their careers 15.30 What did they find most rewarding about living and working in rural areas and what was challenging? 20.50 How did they balance all their different roles with their family life? 29.30 What have been the most important research projects that they have worked on? 51.30 What is NOSM and what makes it different from other medical schools? 59.45 What were the enablers for the development of NOSM? 1:05.00 What has it been like to be a woman and trailblazer in the rural health space over time? 1:11.15 What do they see as being the research focus in rural health in the next 5 to 10 years? Key Messages: They have lived and worked in different countries and in different rural and remote communities. They both share a passion for rural communities and rural health. In 1991 the first National Rural Health Conference inspired a lot of activity around rural health in Australia. Monash University developed rural training pathways and the Monash School of Rural Health. Roger became the first Professor of Rural Health in Australia. Roger acted as the Founding Dean of the Northern Ontario School of Medicine in Canada for 17 years. This is a multi-site rural based full medical school. Sarah started her academic journey in Canada by teaching nurses about whole person medicine. She then became regional director of general practice training in Australia and then became the national director of rural health and covered Indigenous health. Sarah later became dean of Health Sciences at the University of Otago New Zealand. Most enjoyed: The sense of space and being part of the community. Having a very privileged role which lets you get to know the deep issues within the community. Using that privilege in an appropriate way and making a difference for the better. Relationships with the people and the community. Community connectedness. Challenges: Lack of child care that works for you. Lack of resources. Realizing how frustrating it is when things that you need on a daily basis run out or are not working, this can be a quick way to get burnout. Balancing their careers, different professional roles, and raising a family was challenging. Work-life balance gives the impression that work is not part of life. Roger prefers the concepts of work-style life-style mix. Research and teaching are integral to clinical practice. In the daily interaction with patients there are often questions that come up, occasionally there is not an answer in the literature or when asking a colleague. This can be part of a new research question to pursue. It is all woven together. It has been wonderful to see how things have changed over time. On one hand some things seem to stay the same, on the other side everything has changed. Over the last couple of years has been going to conferences that are full of people she does not know. Two threads of research. One was a series of studies asking people in rural and remote communities about their needs. They have a security need, they need to feel that there is a safety net. They first need a doctor and a hospital. Then looking at the sustainability of rural and remote services - 22 in depth case studies. Found that the ones that were doing well had active community participation in the running of the health service. Looked at issues of recruitment and retention of healthcare professionals. Explored contributing to factors of success and developed a rural workforce stability framework with 5 country partners. Active community participation again came up as a strong factor for success. The second thead was education and training for rural practice. Recognizing that there is a better chance of medical graduates going into rural practice with early exposure to rural contexts. Rural upbringing, positive rural clinical experiences and postgraduate training that prepares clinicians for rural practice are the three factors that have been shown to be most important. Immersive community engaged education. Seeking out the disconnects and trying to prove alternative ways of doing things. Don't accept things as they are, go and investigate and find out what needs to be done. Communication and dissemination is an important part of research, share what you find with the relevant people. Encourage community engagement and recognize the importance of patients as teachers. Rural practitioners are naturally effective teachers. Doctors more generally after time in practice through their interaction with patients develop a lot of skill in teaching. Importance of having contracts - doctors and the community knew how long they would be there and ...
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    1 hr and 23 mins
  • Prof Bill Ventres - Healthcare on the Margins & Storylines of Family Medicine

    Prof Bill Ventres - Healthcare on the Margins & Storylines of Family Medicine
    Jun 10 2025
    Prof Bill Ventres is a family physician, medical anthropologist and (recentrly retired) Distinguished Chair of Rural Family Medicine at the University of Arkansas in the USA. Episode Summary: 1.30 Bill tells us about his professional background and how he became interested in rural health 04.30 What made him choose to live in El Salvador? 09.30 What has he most enjoyed about living and working in rural areas? What did he find most challenging? 13.45 What is Arkansas like, what is the context there like? 19.00 Storylines of Family Medicine - why did he decide to do this project? 29.45 What are some insights about practicing in rural and remote contexts? 33.05 What insights has he had in his work on rural workforce development? 36.20 What were the main challenges for building a rural workforce? 38.55 What are some possible solutions to rural workforce challenges? 43.30 How are rural and urban practice similar and different? 49.15 What would his top advice be to policy makers? 51.10 Top three tips for students and early career professionals thinking about a rural career Key Messages: He has spent his career working with people who find themselves on the margins of society. He started his work in urban underserved settings. After spending some time in El Salvador he returned to Arkansas and started working in rural areas. He is now a student of Latin American Philosophy while living in El Salvador. Many people in rural and underserved areas feel left out, many people in rural and underserved areas feel on the margins of a greater society, and that the medical system does not really attend to their needs. He most enjoyed listening to the stories his patients told and hearing about the experiences that people had. That is one of the wonderful things about being in a small practice, one really gets to know the pulse of all the people in the community. The biggest challenge were the not so happy stories about access. No one wants to be number one in maternal mortality, it is a problem of rural poverty and exacerbated by a long history of exclusion and structural racism. Arkansas is economically the third poorest state in the USA. There is one larger city, Little Rock, famous for what happened in 1957 when the president sent troops so that 9 teenage black children could attend the local white public school and that was the beginning of desegregation. The rest of the state is rural. Walmart is based in northwest Arkansas, so that part of the state has seen a revival. There is huge income inequality. Storylines of Family Medicine - this is a published series of papers that shares reflections on family medicine from residents and family physicians. For caring for a community of patients the medical model does not work well for the kind of things that we encounter in family medicine. There is a transcendental nature to the work that we do in family medicine. The biggest cultural barrier is between medicine and real people. He was interested in hearing what motivated other people (family doctors), they told their stories of what was the one tenant of practice that motivated them. He asked 136 doctors to share their story in the form of short essays. Family medicine means attending to the needs of the patient whatever they may be in the context at hand. Modern rural medicine uses up to date knowledge transmitted to rural communities, rather than the traditional model which sends rural patients to urban centres. The presence of a physician and the presence of a hospital helps to support small rural communities. The future is in the hands of young family physicians. Find other practitioners who are like you and work together to speak up, advocate and receive support. We all need support, and in rural areas sometimes that is hard to come by. We need to find people who hold similar values and share a similar vision of the importance of the work we do. Challenges are financial, attitudinal, geographical, and unanticipated consequences of AI in medicine. Embed yourself in a community, find a community and do that work. Be open to a different way of seeing that work than what you learned in your medical training. We should be training people to be socially accountable to their community. Understanding the needs of rural communities form the biomedical point of view and the social community point of view. It is important to find people and institutions that are helpful. Finding someone whose ideas can resonate with yours. Some international organizations such as WONCA or TUFT and Deep End Project. Linking with organizations and groups like that to become a collective course. Burnout is about not having true meaning behind the work that you do. Have students in your office so that you can pass things on. People living in the interstitium of society are similar in rural and urban areas. Rural health is being ...
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    55 mins
  • Heather Sherriffs & Dan Martin - ScotGEM & Rural Training on the Orkney Islands

    Heather Sherriffs & Dan Martin - ScotGEM & Rural Training on the Orkney Islands
    May 30 2025
    Heather Sherriffs & Dan Martin are medical students on the ScotGEM training pathway. They share their experience of graduate entry medical training in Scotland, their placement on the Orkney Islands and how this is shaping their thoughts about their future careers. Episode summary: 01.15 Heather and Dan tell us a bit about their professional backgrounds and how they got interested in rural health 03.30 What have they found most rewarding about working in a rural setting? What has been most challenging? 06.45 What is ScotGEM? 09.30 What opportunities does ScotGEM give students? 12.30 How are hospital placements organized? 14.10 How is the course preparing them for working in a rural or remote setting? 16.30 What is Orkney like, the population, geography and care needs? 20.45 What has there experience been with weather and distance? 24.45 Who is part of the wider healthcare team on Orkney? 27.25 What does a standard GP day and week look like on Orkney? 30.30 What has surprised them about Orkney and primary care? 33.50 What are the two or three key learning point that they have gained from their placement in Orkney? 35.32 How has the experience changed their plans for their future career? 40.30 What is their advice to other postgrads who might be considering going into rural medicine? Key messages: Both Heather and Dan had completed different degrees before going into medicine, law and teaching. ScotGEM is a course to prepare students to become a general practitioner in rural and remote environments. It is a graduate entry degree. It is different to traditional courses as your lectures and placements are integrated, you see patients from day one and you have case based learning. The applied nature of the course really supports learning. They also have a longitudinal integrated clerkship in general practice which lasts 10 months. They have had a lot more one to one time with tutors and doctors at the hospital and in general practice, there is more exposure to clinical skills early on. There is more space to explore and try different things during your course. While on Orkney they spend one day a week at the local hospital during their GP longitudinal placement. Heather would be nervous to work in a rural or remote setting if she had never had a placement in that setting before. It is hard to imagine what the job entails if you have not seen it before. This course prepares you really well to work in a rural or remote setting. Dan says it is a certain skill set to be able to go out and stay in a rural or remote settings. Orkney is a set of islands off the northern coast of Scotland. There is a population of about 20000 people. There is an aging population with people needing quite a lot of social care. During COVID people returned to Orkney. The A&E on Orkney is GP lead and when the weather disrupts travel it can be challenging to manage more difficult emergencies. There are four permanent GP surgeries on Orkney and a small hospital in Kirkwall. The hospital has medicine, surgery, emergency and maternity. GPs to normal general practice but also have their specialist interests such as dermatology, mental health, palliative care or women's health. One of the GP surgeries specialize in diving medicine and have a hyperbaric chamber. There is a higher level of responsibility as a junior doctor, you might be the only doctor overnight running the medical and surgical department. The doctors say that they feel well supported. Just take every opportunity that you can get. If you are interested in something, turn up and ask questions. There is a lot that you can do to develop your clinical skills. It has helped them build their resilience. Dan is now considering a career in general practice and public health in a rural and remote context, he has become more interested in this following his placement in Orkney. Heather has always been interested in working somewhere remote or rural but the past year has solidified that interest and given her confidence to take a job in a rural or remote context. Applying to medicine later in life and having some life experience can be a bit of a super power going into medical training. Interpersonal skills and empathy are building blocks that you can use. Contact Heather: hs249@scotgem.ac.uk Contact Dan: dm332@scotgem.ac.uk Thank you for listening to the Rural Road to Health! Rural Health Compass
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    45 mins
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