Wisconsin’s landscape offers a swift transition from Madison’s urban center to rolling hills hugged by trees or rock formations and speckled with farmland or dairy cows. While children across Wisconsin receive care at Madison’s American Family Children’s Hospital, many are treated in the state’s rural areas, directly within their home communities, by local pediatricians.
In Wisconsin about 25% of the population lives in a rural community. However, only 11% of Wisconsin physicians practice in rural areas. The need for doctors of all specialties, including pediatrics, is great. To address this gap, the University of Wisconsin Pediatrics Residency Program partners with pediatricians in rural areas to offer resident rotations.
During these rotations, residents spend a week adapting the training they are receiving at the University of Wisconsin to treat patients in rural communities. Embodying the Wisconsin Idea, the rotations allow residents to apply clinical training directly to local patient needs and aim to inspire future rural pediatricians.
Allison Emmet, MD, chief resident, Collin Ellenbecker, MD, class of 2026, and Katie Doerner, MD, class of 2026, all completed rural rotations in 2026. These residents rotated in La Farge, Wisconsin, about two hours northwest of Madison. La Farge is part of the Driftless Region of Wisconsin, an unglaciated area known for steep ridges, deep valleys, and scenic beauty, with a population of about 700.
To highlight this experience, we asked Drs. Emmet, Ellenbecker, and Doerner to share photos and videos from their rotations, covering everything from commuting to the clinic to exploring the community on foot or by car.
Emmet had this to share about her experience treating patients from the Plain community in La Farge, Wisconsin:
“’Do you have any special children in your family?’” This is a question unique to the work of Dr. Katie Williams at the Clinic for Special Children in La Farge, Wisconsin. The clinic serves the region’s Plain communities in providing a medical home for children with genetic disorders and medical complexity. I had the privilege of learning from Dr. Williams, her colleagues, and their patients during a week-long rotation at the clinic.
I first heard Dr. Williams speak as part of our Global Health Pathway and was excited to learn more about the Amish and Mennonite communities and her work in rural Wisconsin. We frequently interact with families from the Plain community at American Family Children’s Hospital when they are admitted, but these experiences are typically in the setting of more severe illness. This rotation, therefore, served as a special opportunity to interact with these families in a more familiar location closer to home when their children are well. During the rotation, I observed both genetic consultations with new families to the clinic and follow up visits with children who have established diagnoses and needed lab monitoring, and pre-operative evaluations.
As someone interested in primary care, I enjoyed observing a different clinic setting that blended the needs and practices of the Plain community with more traditional medical practice. Dr. Williams and her colleagues set a beautiful example of meeting patients where they are and finding solutions that fit best with their family’s resources and goals. Each test and medication is that much more intentional when these families do not have insurance coverage, and the clinic has established fair to discounted pricing within their pharmacy and lab, and even resources for free genetic testing for families through partners in the UK. The trust established between the clinic and the community through their openness, creativity, and commitment to care of this population was easily evident. The families are equally committed to their children receiving care to support their flourishing and were eager to share their children’s progress and positive qualities at visits. I really appreciated the disposition of the community in calling these little ones ‘special children,’ as they firmly believe their differences are a gift that enriches the life of the family.
One theme that emerged in the discussions with the families and the team at the clinic was the importance of connection. First, the clinic has positioned itself in close proximity to the communities it serves, and the striking beauty of fall in Wisconsin at the end of harvest time was on full display on my drives to some of the surrounding farms and Amish communities. We made a house call to one of the patients’ homes, and it was a special opportunity to go beyond the clinic and truly enter the community of the patients. The clinic also supports connections between families through events or written correspondence to unite individuals with the same diagnoses. I enjoyed hearing about the wonderful success of annual events at the nearby nature reserve where families see the clinic team for a visit but also share a potluck that meets their children’s unique metabolic needs. Further, I was moved by the stories of families with special children seeking out other families with similarly diagnosed children to share experiences, hope for the future, or even tips on how to safely prepare milk for their child with a metabolic condition.
I feel immensely grateful for the opportunity to engage in a rural rotation and to learn more about care of the Plain community. This experience reinforced the value of knowing and participating in the community we serve as clinicians, the joy of longitudinal patient relationships, bringing an open mind to all interactions and patient practices, and crafting plans that meet the individual needs of our patients. As someone who did not grow up in Wisconsin or in a rural setting, I relished the opportunity to see a new part of the state with a heavy agricultural focus and some of the small towns that our patients come from. I would wholeheartedly recommend engagement in a rural rotation to any medical student or resident, especially those interested in primary care, in order to witness and learn from the deeply valuable, unique clinical practice of our amazing colleagues in these settings.”
If you are a rural-practicing pediatrician and would like to partner with a resident on a rural rotation, please email Kari Bruckner, GME program administrator, Department of Pediatrics or Hannah Wakefield, MD, MPH, assistant professor, rural pediatric medicine elective director, Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics.