Navigating Practicum Placement Gaps in Rural Areas

For public health students living in rural areas, finding a practicum placement can feel like an insurmountable challenge. The shortage of qualified sites and preceptors outside of urban centers creates real barriers that require creative problem-solving and often a willingness to think differently about what a practicum can look like. If you are navigating this challenge, know that you are not alone, and there are strategies that can help.

Understanding the Rural Practicum Gap

Rural communities face a well-documented shortage of public health professionals and infrastructure. County health departments may have only a handful of staff members, none of whom have the credentials or time to serve as preceptors. Nonprofits working on health issues may be stretched thin, operating with minimal budgets and volunteer-heavy workforces. Hospitals and clinics focus primarily on clinical care with limited capacity for population health work.

This shortage creates a paradox: the communities that most need public health interventions often have the fewest opportunities for students to gain experience working in them. Programs based in urban areas may not fully understand these constraints, leaving rural students feeling unsupported as they search for placements.

Assessing What Exists in Your Area

Before assuming there are no options nearby, conduct a thorough inventory of potential sites within a reasonable distance. Consider organizations you might not initially think of as public health placements. Agricultural extension offices often work on nutrition and food security. Schools have nurses and wellness coordinators. Faith-based organizations may run health ministries. Tribal health programs serve Indigenous communities. Community action agencies address social determinants of health.

Reach out to these organizations even if they have never hosted a practicum student before. Many are doing public health work without using that terminology and would welcome the support a motivated student can provide. Your practicum could help them build capacity while giving you hands-on experience.

Making the Case for Non-Traditional Preceptors

One common barrier in rural areas is finding a supervisor who meets your program's preceptor requirements, typically someone with an MPH or equivalent credentials and several years of experience. When such individuals are scarce, work with your program to explore alternatives.

Some programs allow students to have a site supervisor who provides day-to-day guidance while a separate faculty member or credentialed professional serves as the official preceptor of record. This arrangement can open doors to placements that would otherwise be unavailable.

Prepare a strong proposal for your practicum coordinator explaining the public health relevance of a non-traditional site and identifying how preceptor requirements can be met creatively. Come to this conversation with potential solutions rather than just problems.

Embracing Remote and Hybrid Options

The expansion of remote work has created new opportunities for rural students. Many public health organizations now offer virtual practicums where you can contribute meaningfully without being physically present. State-level agencies, national nonprofits, research teams at universities, and consulting firms may all have remote positions.

A hybrid model can also work well, combining remote work with occasional in-person visits to a site that would be too far for daily commuting. Discuss with potential preceptors whether this arrangement might meet their needs while making the placement feasible for you.

When pursuing remote options, be intentional about building relationships despite the distance. Schedule regular video calls, participate actively in virtual meetings, and seek opportunities to demonstrate your work to the broader team.

Developing Your Own Placement

In some cases, the best approach is to work with your program to develop a placement that does not currently exist. This might involve partnering with a local organization that has never hosted a student, identifying a community need that your practicum project could address, or connecting with a statewide initiative that needs someone to do local implementation work.

This approach requires more effort upfront, including writing a detailed proposal, identifying learning objectives, and securing appropriate supervision. However, it can result in a practicum that is uniquely tailored to your interests and genuinely valuable to a community that needs support.

Advocating for Systemic Change

While navigating your immediate situation, consider how you might contribute to longer-term solutions. Document your experiences finding a placement, including what worked and what barriers you encountered. Share this feedback with your program so they can better support future rural students.

Connect with other rural students to share resources and strategies. Advocate for your program to develop relationships with rural organizations and to consider policy changes that address the preceptor shortage, such as allowing non-traditional credentials or providing incentives for rural preceptors.

Finding Meaning in the Challenge

The difficulties of securing a rural practicum can feel frustrating, but they also reflect the very challenges you will face as a public health professional working in underserved areas. The problem-solving skills, persistence, and creativity you develop through this process are directly applicable to your future career. Many public health leaders began their work by finding ways to make things happen in resource-limited settings. Your practicum search is early practice for that essential skill.