The mentorship model shaping rural medicine

Dr. Randy Lee ’90 is helping to develop a mentorship model to strengthen rural medicine in Hamilton, Texas, where access to quality health care depends on those who provide care beyond any urban hospital’s reach.

A family medicine physician and preceptor for the Texas A&M University Naresh K. Vashisht College of Medicine, Lee is a fifth-generation Hamiltonian. Raised on a cattle ranch, he enrolled at Texas A&M to become a veterinarian. However, during his junior year in college, as he was applying to veterinary school, his plans took a sharp turn.

“When my granny Jack got sick with emphysema, Hamilton had limited health care facilities and providers,” Lee said. “She had health insurance, family support and transportation to seek specialty care elsewhere. These resources were not available to many of our neighbors, which meant they might not have access to care when needed. So, I decided to make a change to make a difference.”

Lee’s new goal was to return home as a primary care physician, establish his practice and provide continuity of care for his community.

“Rural people are farmers and ranchers, small business owners and public servants,” Lee said. “They deserve quality health care, and so do those who travel the roads that pass through our community.”

Lee earned a Bachelor of Science degree in biomedical science from Texas A&M, graduated from the University of Texas Southwestern Medical School in Dallas and completed family practice residency at John Peter Smith Hospital in Fort Worth. He is board-certified by the American Board of Family Medicine.

“I sought a practical, immersive medical education that included emergency room, trauma, burns, psychiatry, obstetrics and other medical specialty experiences to prepare me for a full-service, rural family medicine practice.”

Homecoming

Lee returned to Hamilton in 1997 and co-founded the Family Practice Rural Health Clinic with Dr. Jerry Jenkins, a classmate from medical school.

“We saw patients in our practice, the hospital and in nursing homes to meet the surging demand,” Lee said. “We needed a sustainable strategy to recruit and retain more doctors, so we began precepting and mentoring students from various programs.”

This model has proven effective.

“Several of our current family medicine practitioners were students, trainees or residents in Hamilton prior to joining our staff,” Lee said. “Before hiring them, we got to know their interests and help develop their skills, and they were able to see how opportunities in our clinic matched their practice goals.”

The Rural Medicine Program at the Vashisht College of Medicine recently formalized an agreement with the Hamilton Healthcare System to ensure that future Aggie doctors have an opportunity to work with Lee and his colleagues.

“The college is a leader in community-based health care,” Lee said. “Being an Aggie, I knew this was a terrific opportunity not only for students, but also for our patients, hospital and town. Clinical rotations in small communities expose students to experiences that may inspire them to become rural practitioners.”

Such was the case for Josh Carter ’15, ’26.

“I was introduced to rural medicine after my first year of medical school through the Rural Medicine Program,” Carter said. “I did clinical rotations in four small Texas communities where I learned about the complexity of rural medical cases, scarcity of resources and the rewards of helping those with limited access to health care. After those experiences, I could not see myself doing anything else.”

In his fourth year of medical school, Carter did a clinical rotation in Hamilton.

From clinic to classroom

“The continuity of care model that Dr. Lee established in Hamilton is exactly how I want to practice,” Carter said. “I plan to develop lasting relationships with my patients and provide them with a lifetime of quality health care.”

Carter learned firsthand about the impact of continuity of care during his four-week rotation.

“We had an older patient who presented to the emergency room with a complex pneumonia. He was extremely sick, and it was clear he would have benefited from transferring out for a higher level of care,” Carter said. “But even after a very candid conversation about the severity of his illness and limited local resources, he insisted on being treated in Hamilton.”

Lee listened to the patient and reframed the care plan. Transferring him out was no longer an option, so the medical team optimized the patient’s treatment in Hamilton.

“This was my first opportunity to treat a patient in an emergency setting, be part of their hospital treatment team and then take care of them in an outpatient setting,” Carter said. “I believe the benefits of continuity of care led him to say, ‘No, I don’t want to be transferred to another facility; I trust my doctors.’ It was a valuable learning experience, and it stayed with me.”

Balancing patient care and teaching

Rural preceptors like Lee navigate long hours, limited resources and the responsibility of shaping future physicians while providing compassionate, high-quality care. To balance these demands, Lee matches student skill development with patient needs.

“If a student needs to develop their communication skills, then we ask them to take a patient’s medical history or talk with a family,” Lee said. “I aim to teach students not only how to succeed as practitioners, but how to flourish. That is the legacy I want to leave.”

Carter credits the physicians from his rural clinical rotations with providing transformative experiences and helping him develop his skills. His time in Hamilton made such an impact that he returned for a second rotation a few months before graduating.

“Dr. Lee pushes me to be the best I can be, always challenging me, but also guiding and supporting me,” Carter said. “He is an amazing teacher and mentor, and he truly has a passion for the future of rural medicine.”

Carter earned a Bachelor of Science degree in biomedical science from Texas A&M and will graduate from medical school in May.