July 29, 2025
My calling to Family Medicine came early in my medical school journey. With a background in public health and lived experience as a low-income, first-generation immigrant, I envisioned a career grounded in community — one that serves individuals and populations through equitable, accessible care. The AAFP National Conference (now called FUTURE), the AAFP Foundation’s Emerging Leader Institute, and my second-year rotations confirmed what I had already intuited: Family Medicine is my path. Now, as a fourth-year student preparing for residency, I find myself reflecting more deeply on the kind of physician I hope to become and discerning the core values and environments that will shape how I practice. That’s why the NCAFP’s Summer Immersion Program in western North Carolina could not have come at a better time.
I applied to the program with a few key questions in mind: What does training at a rural residency entail? How might it support my career goals? What does rural Family Medicine — particularly in non-academic models — look like? Could I see myself in that environment? I’m happy to report that the program answered all of these questions.
The first week of my program happened at the Mountain Area Health Education Center (MAHEC) - Boone Residency. There, we were introduced to rural health through the lens of rural abundance. This concept stayed with me throughout my time in western NC — while hearing how communities came together after Hurricane Helene, feeling genuinely welcomed by clinic staff and patients, and reading on my host’s quiet patio with the mountains in view. While we discussed the serious challenges rural communities face, we were also encouraged to recognize and build on the strengths these communities offer: their deeply rooted relationships, resilience, and resourcefulness. Through conversations with the NC Office of Rural Health and MAHEC Rural Fellowship directors, we were challenged to consider how those strengths could be harnessed to improve health outcomes.
Another highlight of this first week was spending time with the MAHEC Boone residents. I shadowed them in hospital and clinic settings, where I gained valuable insight into the day-to-day of being a rural trainee. Getting to know the residents socially gave me and the other students a strong sense of the residency’s vibrant culture, whether we were at a local brewery, on a group outing to Grandfather Mountain, or helping one resident complete a community engagement project. Everyone seemed genuinely happy to be there together, and I realized how vital that kind of camaraderie is for thriving during residency. One of the most inspiring moments was visiting Seven Peaks Family Medicine, a nearby practice founded by three recent MAHEC Boone graduates. It was truly powerful to see how the relationships formed during residency evolved into the collaborative, sustainable practice at Seven Peaks. Thanks to training in wilderness medicine, point-of-care ultrasound, addiction care, and advocacy, our first week was packed with meaningful learning that enhanced my understanding of rural Family Medicine.
During my second week, I transitioned over to Jefferson, where I joined Dr. Landon Allen (pictured above) at his direct primary care (DPC) practice, New River Family Wellness. Having never been exposed to DPC before, I was eager to explore this care model. Over the course of the week, I gained insight into the philosophy and practical realities of running a DPC practice. I especially appreciated hearing Dr. Allen’s motivations: how he stepped away from insurance companies and large health care systems to spend more time with patients, build stronger relationships, reach underserved patients, and provide holistic, individualized care. I also got a behind-the-scenes look at the business side of running an independent practice, including budgeting, logistics, and troubleshooting. Dr. Allen routinely faces issues that demand creativity and hands-on problem-solving. Observing how he navigated them increased my appreciation for the breadth of skills required for independent practices.
What stood out most, though, was how deeply embedded Dr. Allen is in Jefferson. He began the week with a tour of town, helping me contextualize the local health care landscape and better understand the gap his practice fills. As we passed local businesses or community members, he often said, “That’s my patient” — a tangible reminder of how connected he is to the people he serves. Beyond clinical care, Dr. Landon also serves through local organizations and has become a trusted local voice in medicine and public health. Witnessing how a family physician can support the community far beyond the exam room was both moving and motivating.
I had plenty of extracurricular fun along the way, too! I went kayaking with Dr. Allen, played a tabletop RPG with my hosts, and discovered some amazing Thai food. Once again, I saw rural abundance in action: full of connection, warmth, and joy.
I’m incredibly grateful to the NCAFP, the NCAFP Foundation, MAHEC Boone, Dr. Landon Allen, Dr. Daniel Moore, Dr. Toria Knox, and everyone else who made this opportunity possible. It truly opened my eyes to the scope of Family Medicine (particularly in rural areas). I feel more prepared to take on the residency application process with an expanded interest in rural programs and a clearer vision of the environments where I can thrive. I also loved getting to know my fellow medical students from across the state and to share their interest in family medicine: shout out to Anna Pyne (Wake Forest), Tim Patron (East Carolina), and Jordan Gentry (Campbell)!
Having participated in this summer program and other NCAFP programs (like Family Medicine Day and White Coat Wednesday), I feel even more committed to giving back however I can and to advocate for increased investment in these transformative opportunities at the NCAFP Foundation. I’m excited to share my experiences with my peers at Duke and with my fellow trustees on the AAFP Foundation Board of Trustees. I wholeheartedly encourage all North Carolina medical students to apply next year, even if rural medicine hasn’t been on your radar. It certainly wasn’t on mine until this experience, and I now look forward to continuing to explore all that Family Medicine has to offer in rural communities.
Andrea Augustine is a fourth-year medical student at the University of North Carolina School of Medicine. She has served on the NCAFP Foundation’s Board of Trustees and currently serves as the Student Trustee on the AAFP Foundation Board of Trustees.
This article appears in the summer 2025 issue of the The North Carolina Family Physician, the quarterly magazine of the NCAFP.
