The Rural American Surgeon
Welcome to ”The Rural American Surgeon,” a podcast series dedicated to providing insights, resources, and a community for the surgeons of rural America. Your host, Randy Lehman, is an established authority on the multifaceted aspects of rural surgery—from the unique professional benefits and challenges, rural surgical training paradigms, current reimbursement landscape, and how to create triple win opportunities for sustainable rural surgery in partnerships with hospitals and rural communities. This podcast is designed for both rural general surgeons and rural surgical specialists who are seeking not just advice and guidance on practicing in rural areas, but also inspiration to foster valuable partnerships across our great land. Each episode is a deep dive into topics such as mastery of rural surgery, the rural lifestyle, fighting professional isolation, building a system to ensure surgical services are offered at a high level, using scarce resources wisely, achieving personal financial freedom, accessing a wealth of outside surgical resources, and inspiration at a high level of why what we do is important.
Episodes
Dr. Levi Smucker joins host Dr. Randy Lehman on The Rural American Surgeon to discuss his path to rural general surgery, from growing up in Pennsylvania and training at Bassett Healthcare in Cooperstown to building his practice in Goshen, Indiana.
He shares how a close knit group of six surgeons has given him strong mentorship, broad operative experience, and the opportunity to develop his own areas of expertise while serving multi...
Dr. Joon Shim, program director at Bassett Healthcare in Cooperstown, New York, joins host Dr. Randy Lehman and Jacob on The Rural American Surgeon to discuss how Bassett prepares residents for the realities of rural general surgery.
Dr. Shim explains how residents begin gaining operating room experience from day one and train across a broad spectrum of surgical cases without competing with surgical fellows.
The conversation explore...
Stuart Ferguson returns for part two of his conversation on The Rural American Surgeon to explore the practical realities of providing urologic and general surgical care in the remote Shetland Islands.
Stuart discusses the limitations that come with practicing in a small island hospital, including equipment decisions, limited critical care capacity, weather that can prevent patient transfers, and the need to know when a case should ...
Stuart Ferguson, a consultant general surgeon in Scotland’s remote Shetland Islands, joins The Rural American Surgeon to discuss what it takes to practice surgery 200 miles into the North Sea and why he deliberately built his career around becoming a broad surgical generalist.
Stuart shares his training journey from Glasgow and Northern Ireland to colorectal surgery, global health work in Zambia, and Scotland’s Rural Sur...
Dr. Amiri, program director at Marshall University, and fourth year surgery resident David Kanarowski join The Rural American Surgeon to discuss Marshall’s dedicated rural general surgery residency and how it prepares surgeons for independent practice in rural communities.
They explain how residents spend roughly two thirds of their training at rural hospitals, gaining early operative experience without competing with other re...
Dr. Anne O’Rourke, program director at the University of Wisconsin, joins The Rural American Surgeon to discuss how UW’s rural surgery track prepares general surgery residents for independent rural practice.
She explains how the five-year program combines training in Madison with recurring rural rotations, giving residents experience with the broad skill set rural surgeons need, including endoscopy, C-sections, trauma s...
Our “Training the Rural Surgeon” miniseries continues as Dr. Randy Lehman and Jacob Steffen are joined by Dr. Frank Wood from the University of Oklahoma and Dr. Barclay Stewart from the University of Washington to examine how residency programs are building the next generation of rural surgeons.
Dr. Wood explains why Oklahoma created a dedicated rural surgery track, how residents train in Lawton, and why broad clinical e...
Our “Training the Rural Surgeon” miniseries continues as Dr. Randy Lehman and Jacob Steffen are joined by Dr. Mariela Rivera, Program Director at Mayo Clinic in Rochester, Minnesota. They discuss how Mayo Clinic’s rural general surgery track equips residents for the broad scope of rural surgical practice.
The conversation explores the structure of the rural track, training across Mayo Clinic Health System sites, fl...
Our “Training the Rural Surgeon” miniseries begins with Dr. Randy Lehman joined by medical student Jacob Steffen, Dr. Mel Johnson from Gundersen, and Dr. Lauren Dudas from WVU to examine how residency programs prepare surgeons for broad scope rural practice. The discussion covers operative volume, subspecialty exposure, rural rotations, and why some programs intentionally train residents in urology, ENT, OBGYN, and crit...
The operating room rewards preparation long before it rewards confidence.
In Part Two of this conversation, Dr. Randy Lehman continues mentoring medical student Jacob Steffen through the realities of surgical training: knot tying, OR etiquette, retraction, camera driving, tube placement, handling responsibility, and earning trust inside a surgical team.
Dr. Lehman explains why great surgical residents often separate themselves early ...
In surgery, responsibility comes before confidence.Medical students entering a Sub I are expected to manage patients, present clearly, stay organized, and earn trust before they feel fully comfortable doing it.In this Part One episode, Dr. Randy Lehman mentors medical student Jacob Steffen through rounds, presentations, list management, tube management, and operating room etiquette.Jacob explains why the students who stand out are ...
Today Dr. Lehman sits down with the most special guest, his daughter Charlotte.
And this time, she’s in the host seat asking the hard-hitting questions!
She covers everything from fear in the operating room to money, parenting, and of course, the grossest thing dad’s ever seen in surgery.
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Locums surgery is often treated as temporary coverage, but many rural hospitals rely on it to maintain consistent access to care. Surgeons step in without relocating, often filling roles that cannot support full time hires.
Megan Hoot, a physician recruiter at CompHealth, has spent over eight years placing surgeons into roles that often become long-term solutions. She has worked closely with Dr. Randy Lehman across multiple assignme...
In rural surgery, there’s no “waiting until you feel ready.” There’s only action, because sometimes you’re the only one.
Dr. Scott Nelson, a colorectal surgeon in Grants Pass, Oregon, built a solo practice after losing his partner early in his career. What followed was years of figuring it out in real time, often without backup.
In this episode, Dr. Randy Lehman and Dr. Nelson break down what it actually...
In rural surgery, not everyone fits the environment the same way.
The work doesn’t slow down, and the community expects you to stay, serve, and carry responsibility without backup.
Today Dr. Randy Lehman speaks with Dr. Jesse Van Maanen, a rural general surgeon practicing near where he grew up. They examine why surgeons with rural roots or early commitment tend to integrate more naturally, and why moving rural to escape a busy ...
A complex operation only works if it can be executed reliably inside the system you have.
In this Part Two episode, Dr. Randy Lehman continues with Dr. Cate Straub, focusing on how pancreatic surgery is actually performed without consistent teams, subspecialty backup, or standardized support structures.
She walks through operative sequencing, vascular decision making, and how technique changes when you cannot rely on experienced assi...
She started with one distal pancreatectomy alongside a senior partner and built a referral base by handing out her personal phone number across rural Washington.
Dr. Randy Lehman and Dr. Cate Straub focus on what it actually takes to keep complex cancer care local when patients are otherwise absorbed into distant systems. Mentorship, referral control, and internal case review became the structure that made pancreatic surgery possibl...
In rural surgery, you are often the one covering problems that would be handled by multiple specialists elsewhere.
Today Dr. Randy Lehman speaks with Dr. Bob Sticca, surgical oncologist and national leader in rural surgery. They examine how rural training has evolved, why scope of practice remains wider, and which surgeons are most likely to build lasting rural careers.
The discussion centers on difficult gallbladders–includi...
Rural patients shouldn’t receive lesser care simply because of geography. Delivering that standard takes intentional systems, good data, and the right team around you.
Dr. Randy Lehman sits down with rural surgeon and ACS Governor Dr. Jill Ties to talk about how she built a breast surgery program inside a critical access hospital in Wisconsin.
They walk through the real work behind it: aligning with administration, earning the ...
Rural practice can feel isolating, especially when you’re the only surgeon in the building…
Dr. Randy Lehman sits down with Dr. Steven Bodney, former ACS Governor and longtime Indiana surgeon, to talk about what it really takes to build a durable career in that environment.
Dr. Bodney reflects on his Army training, transitioning into solo rural practice, and helping build a new county hospital from the ground up. He shar...
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