students are split into three groups as they toured the sprawling, single-story building with white siding along U. S. 90 on the west side of town. The county of 13,000 residents has just one full-time family medicine physician – and no specialists – which requires the Florida Department of Health facility to offer a wide range of services.
Those include prenatal care, family planning and immunizations, wellness programs, infectious disease services, emergency preparedness and response resources, and public health.
A food bank stands just outside the building, ready to assist those who otherwise may not have, or be able to afford, nourishment for their families.
Students encounter similar experiences on each of the other legs. In addition, they have the opportunity to get a feel for what living in a small town is like, whether it’ s visiting popular sites, strolling through the quaint downtown areas, or engaging in panel discussions with providers and residents.
With two traffic lights, Monticello has one more than first-year medical student Judd Smith’ s Panhandle hometown of Jay, located north of Pensacola and virtually bordering the Alabama state line.
“ It’ s been incredibly important just to be exposed to just how different everything is here,” Smith said.“ A lot of my classmates are from larger cities across the state … so, for them to be able to have this experience, to be able to just see how different things operate, to be able to be in a town with only one provider, no specialist even around, I think it ' s really important.”
Smith has a different perspective than most of his classmates. His father and grandfather represent two generations of primary care physicians in Jay. He plans to extend that lineage to a third generation, returning to serve the Jay community following residency.
“ The relationships with the patients are just so incredibly important,” he said.“ I ' ve been able to have a lot of experiences within the clinic and in the hospital, see the way that they interact with their patients. It ' s incredibly personal, and I really like that a lot. It goes beyond just the medicine itself. It’ s a strong personal connection.
“ Knowing the patient, the patient ' s parents, the patient ' s children – I really like that aspect of it.”
Walking around downtown Monticello provided the students opportunities to visit the historic theater, grab a latte in the local coffee shop and check out stores. Those encounters left impressions, as well.
22 FSUMED | MED. FSU. EDU
“ Going into the health department was cool to see the kind of resources that they have available,” said PA student Kathryn Zelsman, who made a coffee shop stop before wandering across the street and into a business.“ There is a thrift store that ' s operated by volunteers, and those proceeds go back to an animal shelter. That just speaks a lot to their character as a town.
“ And every interaction that you have is really friendly and personable. I don ' t think you get that in larger cities. Like, every time a door is open for you, it ' s a small-town feel. It makes a lot of us students more interested in serving communities like that because you know you ' re needed, and the people are so grateful for it.”
The students weren’ t the only first-time participants in RuLE.
Ransome Eke, M. D., Ph. D, MBA, an associate professor in the Department of Family Medicine and Rural Health, joined the faculty in November 2024 from the Mercer University School of Medicine in Macon, Georgia. There, he was an associate professor of Community Medicine and principal investigator for the CDC-funded Health Equity Navigators program, a project dedicated to reducing health disparities in Georgia ' s rural and underserved communities.
This, however, was a unique experience for the Nigerian-born and trained Eke, who had a fellowship in Greenville, South Carolina, and received advanced degrees from Tulane University School of Public Health and Tropical Medicine in New Orleans, Louisiana, and the University of Memphis School of Public Health in Tennessee.
“ We don ' t take [ students ] on orientation the way we saw it here, which was very impressive,” Eke said.“ We sent them to their preceptors … but we don ' t go with them as a group to learn about the place, the locality, the facilities – all the opportunities right there. I was really blown away by this.”
While the needs are apparent in these rural communities, challenges exist, both in terms of funding resources and the complexity that comes with being the 24-7 family doctor.
During the health department visit, Zelsman asked one of the providers what kind of value would a PA bring to the community.
“ She said, honestly, we would have to do more lobbying to get them to have positions available just because they don ' t have the resources and the funding to employ more people,” Zelsman said.“ That tells you a lot right there.”
Limited resources, financial and otherwise, are an obstacle all rural areas face. Then there’ s the matter of responsibility that comes with those positions.