National Rural Health Day: Unique collaboration helps Essentia develop general surgeons for rural communities

November 16, 2023  By: Louie St. George

Dr. Samantha Leonard

Born and raised in the small town of Mount Pearl on the island of Newfoundland, Canada, Dr. Samantha Leonard has a deep appreciation for the challenges that beset the delivery of high-quality health care in small, remote communities.

She has experienced them firsthand.

“I had a lot of insight into the disparities with rural health,” Dr. Leonard says.

That insight informed her career path. Dr. Leonard knew she wanted to practice medicine in a rural setting, where she could make the greatest impact. As a second-year resident at the Western Michigan University Homer Stryker M.D. School of Medicine in Kalamazoo, she learned about a general surgery rural residency program being developed by the University of Minnesota, in collaboration with Essentia Health.

Dr. Leonard’s curiosity was piqued. She joined the program the following year.

“It was kind of a no-brainer for me to apply and get all that training,” she says.

The University of Minnesota’s General Surgery Rural Track at Essentia Health recruits one resident to the five-year program annually. Residents remain in the Twin Cities for the first three years and then spend the fourth and fifth years training at Essentia’s hospitals in Duluth, Brainerd, Detroit Lakes and Virginia. They work alongside general surgeons, trauma surgeons, urologists, ENTs, obstetrician/gynecologists and others. There are rotations for core surgeries as well as specialties. The goal is to prepare them for practice in rural communities, to produce Jacks and Jills of all trades.

Essentia provides lodging for the residents when they’re on rural rotations and supports their stipend and benefits during these years of training. It’s part of Essentia’s commitment to making key investments in rural health, which requires innovative solutions for increasing challenges — such as workforce development — to ensure expert and compassionate care remains available for all the patients and communities we’re privileged to serve. This past week, in fact, Dr. Leonard and her team completed the first robotic surgery at Essentia Health-Moose Lake. Now equipped with a da Vinci surgical robot, they will be able to perform myriad minimally invasive procedures that result in enhanced patient outcomes.


Dr. Leonard finished her residency and practiced in Michigan for five years. She joined Essentia Health-Moose Lake this past June. There, she does a little bit of everything — a colonoscopy today, gallbladder surgery tomorrow. There aren’t as many specialists in rural hospitals as exist in big-city medical centers.

“I wear all the hats,” Dr. Leonard says. “I have to actively and constantly learn. The days are never the same.”

Moose Lake Clinic 

For Dr. Leonard, that’s part of the appeal. She relishes the variety. For others, however, it can be intimidating and a barrier to practicing in rural communities. Especially if they haven’t trained in smaller cities. That reality formed the impetus for the general surgery rural residency program.

According to the Minnesota Department of Health, of the estimated 1,000 general surgeons completing their residencies in the United States, only 15-20% practice in rural communities. Further, studies suggest physicians are most likely to practice in areas where they train. In Minnesota, more than 95% of surgical residency training takes place in the metro area, yet 45% of the state’s population resides in Greater Minnesota.

“It’s hard for us to recruit,” Dr. Leonard admits.

At Essentia, where about 84% of our service area is considered rural, it is critically important that we address this disparity. Training future general surgeons while simultaneously exposing them to the perks of practicing and living in rural communities has been a practical approach to offsetting this shortage.

“The residency program is a big success,” says Dr. Melissa Najarian, a general surgeon at Essentia and the program site director. “Through support from Essentia, the University of Minnesota and the state of Minnesota, we are able to train critically needed rural surgeons. Thus far, three of our six graduates are working in smaller communities in Minnesota, providing surgical care close to home for their patients. Teaching is one way we can give back to our next generation of caregivers in Greater Minnesota and beyond.”

Dr. Leonard’s message to current and future physicians? Practicing medicine and performing lifesaving procedures in a smaller community brings immense gratification.

“If not you, then who? You are there for that community,” Dr. Leonard says proudly. “They rely on you. It’s hard work, but it has such great rewards.

“The gratification I get is that I can tell the patients that their surgery will be performed in Moose Lake. They don’t have to travel. And that sigh of relief from them is so worth it.”

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