The Rural American Surgeon

Dr. Ronald Weigel returns for Part 2 of his conversation with host Dr. Randy Lehman on The Rural American Surgeon. The discussion continues with a practical look at what cancer care rural hospitals can safely keep local, when patients should be referred, and how smaller hospitals can build sustainable surgical programs even without 24/7 general surgery coverage. Dr. Weigel explains that common can...

Dr. Ronald Weigel joins host Dr. Randy Lehman on The Rural American Surgeon to discuss the American College of Surgeons Commission on Cancer’s new rural accreditation pathway and what it could mean for hospitals, surgeons, and cancer patients in rural communities. Dr. Weigel shares his path from engineering and surgical training at Duke to cancer research, leadership at the University of Iowa, and...

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 are...

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 surgic...

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...

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,...

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 w...

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 endoscop...

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,...

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 Healt...

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 urolog...

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 resid...

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 explai...

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. 🌐 Connect with The Rural American Surgeon: https://www.theruralamericansurgeon.com/   Join us on Facebook: h...

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. R...

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 a...

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...

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 whe...

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...

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 d...

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 wi...

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 fro...

Today Dr. Randy Lehman reflects on the practices he employs to live a life of intention, including conferences, family rhythms, financial tracking, and the systems he’s built to avoid simply bouncing around through life.  From residency to rural practice, from debt payoff to financial independence, he shares the exact goal-setting framework he uses annually.  If you’re a surgeon trying to build a...

Which is better, robotic or laparoscopic inguinal hernia repair? In this Part Two episode, Dr. Randy Lehman is joined again by Dr. Amy Vertrees, founder of the BOSS Business of Surgery Series and a career coach for surgeons, for an in-depth technical breakdown of both approaches. They compare every step of the operation, from port placement and mesh selection to managing seromas and preventing rec...

Today, Dr. Randy Lehman sits down with a surgeon who traded stability for autonomy. Dr. Amy Vertrees, an Army-trained general surgeon who built a thriving private practice covering three hospitals, breaks down the challenges and victories of modern rural surgery. They explore what makes rural practice unique, why fellowship isn’t always necessary, and how to build a surgical team that lasts. Plus,...