Emily Onello, MD, Profiles Rural Medical Educators

This interview originally appeared in the winter edition of Minnesota Family Physician, the Minnesota Academy of Family Physician’s quarterly magazine.


The new Profiles of Rural Medical Educators book shares the perspectives of 16 medical school faculty from across the U.S. who are thought leaders in supporting and developing our rural medical workforce. Many of the faculty profiled are nearing the end of their careers and have made it their life’s work to address rural doctor shortages. They have much wisdom to share, and this book is meant to serve both as a guide for the next generation of rural medical educators and a resource for rural communities and government policy makers when it comes to addressing rural physician recruitment and retention.

The e-book is available online (at no cost) via the National Rural Health Association Rural Medical Educator Group at www.ruralhealthweb.org/programs/rural-medical-education. Paper copies are also available upon request (email econello@d.umn.edu).

This one-of-a-kind resource is authored by Minnesota Academy of Family Physicians member and University of Minnesota Medical School, Duluth campus, faculty Emily Onello, MD.

Emily Onello, MD, with Profiles of Rural Medical Educators

Onello directs and teaches several medical student courses, serves as a medical student faculty advisor, helps to develop and evaluate medical student curriculum and serves as adjunct faculty at the University of Minnesota Duluth Family Medicine Residency.

She is the current course director of the Duluth campus’ Rural Medical Scholars Program, a longitudinal rural family medicine experience for first- and second-year medical students. The program’s 80-plus family physician preceptors were recently recognized with the Minnesota Rural Health Team Award (by the Minnesota Rural Health Conference in November 2020).

Onello has also published a variety of peer-reviewed articles, and her research interests include rural physician workforce challenges, vaccination attitudes and environmental health.

We asked her to share more about Profiles of Rural Medical Educators and its message.

CAN YOU give A HIGH-LEVEL OVERVIEW OF YOUR BOOK?

The book reveals the opinions of individual medical school educators on rural workforce shortages, sharing from their own lives—what has worked, what hasn’t, where misconceptions can delay progress, what they think are long-term solutions and more.

It’s my hope that readers new to this topic will realize that there are experts out there. Often, people who don’t know a lot about rural training programs can view the rural doctor shortages with defeatist hand wringing and pessimism. Yet, over the past half-century, we have learned a lot about what works and what doesn’t in terms of recruiting and retaining rural doctors.

The most important message, I hope, is a positive one. We know what works—we, as a nation, need to act decisively to expand personnel and resources in addressing rural physician shortages.

WHY DID YOU WRITE Profiles of rural medical educators?

The motivation for this book was my realization that many of the thought leaders on the subject of rural physician workforce development were nearing the end of their careers, and I wanted to archive and share their knowledge.

I hope that the book provides a resource—a “playbook,” of sorts—for educators who are preparing physicians for rural and frontier medical practice.

But I hope that it is also used by people and organizations with a vested interest in the health of people in rural places. The book highlights the need for more resources to be dedicated to workforce shortages. Many of the educators recognize that success is only possible with strong and lasting partnerships with rural communities and rural health care organizations. I hope that the book will result in action on the local, state and federal levels to robustly support rural physician training and retention programs.

WHO DO YOU THINK SHOULD READ THIS BOOK?

The book invites a broad readership, including rural communities who are looking to address local physician shortages. Rural communities have long recognized the need to be innovative with finite resources, collaborate with others toward a common goal and look for solutions locally. This book reinforces many of these rural values to think long-term, build partnerships and invest in the future.

Also, this book can be a quick primer for medical educators at large, tertiary academic medical centers and policy makers at the state and federal levels. The vast majority of medical students across the U.S. are not trained in rural communities. Most medical schools are located in urban centers far from the practices of rural, full scope family physicians. I hope that leadership at medical schools and in government may use this book to understand that resources must be allocated differently to address the urgent need for rural physicians.

WHY IS IT IMPORTANT TO RECOGNIZE EXPERTS IN RURAL MEDICAL EDUCATION?

Without an awareness and recognition of the expertise of rural medical educators, it becomes easier for society to dismiss the rural physician shortages as inevitable and irreversible. Yet such a dismissal has dire consequences for rural communities who experience limited access to many important mental, physical and dental health services. Rural residents demonstrate poorer health in a multitude of categories.

The educators in the book represent over 500 years of collective experience! They have studied which approaches and programs yield the best results. They have the experience and wisdom to guide us toward success. As I say in the book’s preface, “…an adequate rural physician workforce is not an impossible fantasy. Instead, it is a potential reality that will demand new commitments, resources, partnerships and passion to realize.”

WHAT ARE THE “TAKE HOME” MESSAGES?

Though the educators differ in their responses to many of the questions, common themes emerged.

Many respondents recognized the necessity for long-term organizational commitment to training rural doctors. As James Boulger, PhD (Minnesota), noted, “Dabblers need not apply”.

Partnerships with rural communities are paramount, with Joseph Florence, MD (Tennessee), encouraging us to “promote presence—BE in rural; live and work in rural communities; place students to live and train in rural communities.” Ray Christensen, MD (Minnesota), echoes this theme, saying, “All med students need a rural experience.”

Lisa Dodson, MD (Wisconsin), adds that programs should “develop and reward rural faculty and provide meaningful financial and educational support for those hard-working rural docs in the trenches.”

ANYTHING ELSE TO SHARE?

As many of the featured educators are “passing the baton” to the next generation of educators, I look forward to a Profiles “2.0” where I can feature the future successes of new rural medical educators across the U.S.

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Post author: Emie Buege, communications

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