Educational Benefits of Rural Rotations: Insights From General Surgery Residency Program Leaders

Rural rotations have become increasingly common. However, little is known about whether they offer educational benefits for residents who do not eventually practice in rural facilities.

Starting with an ACGME-provided roster of general surgery programs, the authors conducted a website review (12/2022-7/2023) of the 342 civilian programs located in U.S. states to identify 81 programs (24%) offering elective or required rural rotations in the U.S. Because previous research is scant, the authors then adopted a qualitative approach and designed a semistructured interview schedule to learn from program leaders what educational benefits their rural rotations might provide residents and whether any noted benefits applied to all residents or just those open to practicing in a rural location. The first author conducted 30-minute telephone interviews with 58 general surgery program leaders for a participation rate of 72% (58 of 81). Interviews were conducted in 2 blocks (8/2023-11/2023 and then 7/2024-8/2024) and focused on the 2023-24 academic year. Interviews were recorded, transcribed, and analyzed collaboratively by the first three authors.

All program leaders described how their rural rotations provide educational benefits that transcend the issue of practice location. The authors identify and describe 4 prominent themes from the interviews: access to cases, particularly those deemed core or "bread-and-butter" general surgery; exposure to rural practitioners who model broad-spectrum general surgery; insights into resource-limited practice settings; and the learning advantages of increased responsibility, leadership development, and mentorship typically present in small rural facilities.

Program leaders touted the educational benefits of rural rotations for all residents, a finding that might prompt more programs to consider such opportunities. Academic-rural partnerships could become a routine component of residencies.