LTU’s PA Students Assist in Bridging the Rural Healthcare Gap

Lawrence Technological University’s Physician Assistant program is improving access to healthcare in rural Lower Michigan with a $1.7 million grant. Funded by the U.S. Department of Health and Human Services, this five-year initiative places second-year PA students in underserved hospitals and clinics, where they enhance care for local residents while gaining invaluable hands-on experience.

Four second-year PA students were the first cohort to participate in the rural rotation.

Roshell Quarker, volunteer coordinator for the PA program, completed rotations in internal and family medicine and is currently completing her third rotation in pediatrics. Due to a shortage of specialists in rural areas, Quarker noticed primary care providers were more well-rounded to help patients with limited access to specialty care. She gained skills not typically seen in family practice, such as joint aspirations, steroid injections, OB/GYN care, and pap smears.

She noticed patients often delayed care with appointments booked months in advance due to the disparity. During her internal medicine rotation, she shadowed the only rheumatologist within 100 miles, who saw up to 25 patients daily, with appointments booked months in advance. Despite the shortage of providers, the close-knit community fostered strong patient-provider relationships, which was refreshing to Quarker. “This dynamic is important in building trust in healthcare—a crucial element given the system’s history of distrust,” Quarker explained. When it came to patient education, Quarker spent time explaining the need for medications and vaccinations to help patients understand their effects and importance.

“This experience has been incredibly rewarding, helping me develop primary and specialty skills, be resourceful, and think critically. It’s broadened my perspective on healthcare disparities and the social determinants of health, deepened my empathy, and reinforced my desire to make a meaningful difference in such communities.” Quarker highly advises other PA students to participate in rural rotations, “With the rotations, we saw the importance and difference the patient-provider relationship had. It was a great opportunity to learn about the diversity that is around us, and I highly recommend this experience.”

Alec Johnson, who completed his rotation in family medicine and cardiology, worked with many blue-collar workers and found each appointment to be a meaningful opportunity. He immersed himself in the community to understand available resources and described rural medicine as unpredictable and keeping you on your toes, but still made sure to spend ample time helping patients understand their health and guiding them to the right resources. Johnson recognized patients often combined all their problems into one visit, and there was a stigma of being tough, causing many to delay their care. The cardio rotation also allowed him to notice patients ignored many heart problems before they became severe.

“Rural medicine allowed me to take my time and get to know the patients as if they were my own. The one-on-one interactions allowed me to develop care plans that truly helped them. Patients were hesitant at first, but by listening and connecting, they open up, trust you, and invest in their health. It’s a reminder that connection comes before treatment,” Johnson said. Even in his current urban clinical setting, he prioritizes sitting with patients, offering full attention, and explaining their condition clearly—skills he obtained during rural medicine.

Johnson is thankful for the opportunity, as not all PA programs offer such rotations. “It’s incredibly rewarding and beneficial for these communities, which face a growing provider shortage. This experience raises awareness for rural needs and deepens our understanding of patients and their challenges.”

James Wellington completed rotations in family medicine and cardiology. He noticed significant psychiatry and mental health deficits, with patients experiencing anxiety, depression, schizophrenia, and bipolar disorders. “Many of my patients were hardworking farmers. It was eye-opening to see how many had untreated medical concerns because they didn’t want to take time off. The communities also lacked awareness about symptoms that signal serious health issues; improving outreach and education is crucial.”

Like his peers, Wellington also noticed primary care providers taking on additional responsibilities when specialists were unavailable and found preceptors to be the most thorough and emphatic, providing personalized education. “Jess, a nurse practitioner in my family medicine rotation, dedicated time to teaching me skills applicable everywhere, not just in rural medicine. During an ENT exam, I missed a bulging eardrum, but she patiently showed me how to position the otoscope to clearly visualize it, ensuring I understood. She joined me during exams, and her real-time feedback helped me refine my attention to detail skills, which will benefit me as a PA in any setting,” Wellington explained.

The experience taught Wellington to listen more deeply to his patients. “Medicine is vast, and patients cannot always recognize serious symptoms. While addressing their main concern is important, hearing out other issues can reveal critical information and strengthen the provider-patient relationship. This rotation taught me the value of slowing down, asking the right questions, and ruling out potential emergencies.”

Wellington encourages other PA students to participate in the HRSA grant. “It is a unique opportunity to experience rural healthcare, which is both purposeful and rewarding. Rotations are about broadening your perspective, and I’d highly recommend students take advantage of this experience to learn and grow.”

Kylie Dunn completed her rotation in family medicine. Dunn was inspired to work in rural healthcare to assist underserved populations and learn from providers who were adaptable in delivering care with limited resources. “Rural communities require a more well-rounded, community approach to medicine than in an urban or suburban area. The providers I worked with were knowledgeable in many different aspects of medicine, had pride in serving their community, and formed genuine connections with their patients, increasing patient trust in medical decision-making,” Dunn explained. She faced a few challenges during her time in the rural rotations, such as seeing patients with poor or no insurance, who were more likely to wait until health concerns became chronic.

When it came to patient education, Dunn emphasized looking at the patient as a whole. “The communities required extensive patient education on preventative health such as diet modifications, increased daily physical activity, proper sleep habits, and participation in education for school-aged children.” The experience helped Dunn build on her patient communication skills, connect with patients and their families, and learn the importance of well-rounded patient care and preventative medicine education.

Dunn also advises other PA students to participate in the rural rotation: “It was a unique opportunity that will guide me in providing excellent care throughout my career as a physician assistant, and an opportunity to see the world of medicine through a different lens”

LTU’s PA students witnessed the challenges and rewards of rural medicine. From bridging gaps in specialty care to helping communities that truly benefited from the medical attention provided, the students gained hands-on experience in underserved areas that will shape their future not only as PAs but also as healthcare leaders.