Sarah Lassiter spent much of her childhood in Johnston County watching her father struggle to find a doctor he felt comfortable seeing for his heart condition.
“He would see them for one or two visits, and then he would get really discouraged,” Lassiter recalled. “He would never go back until he was discharged from the hospital the next time around, and then he’d find a new one, and the cycle would repeat itself.”
Her father’s frustrations led Lassiter to become a physician in rural North Carolina. After graduating from Campbell University’s School of Osteopathic Medicine, she spent three years in residency at Harnett Health in Dunn. Now she is a family medicine provider at Cape Fear Valley Primary Care, where she leverages her rural upbringing to relate to patients who might be skeptical of the health care system.
Lassiter is among the 65% of doctors who complete both medical school and residency in North Carolina and go on to practice in the state, according to research from the Cecil G. Sheps Center for Health Services Research at UNC-Chapel Hill.
Methodist University in Fayetteville, which will welcome its first class of 64 students this summer, hopes to train physicians like Lassiter who will remain in southeastern North Carolina, where rural communities need more medical providers.
“When you think about why this school exists, it was because there was such a dire need,” said Dr. Hershey Bell, founding dean of the Cape Fear Valley Health School of Medicine. “We’re going to forever change the health care people get in this region.”
Other colleges in the region are also focused on increasing health care access by cultivating homegrown talent. UNC Pembroke launched a doctoral nursing program last year, and it will open the state’s only optometry program at a public university in 2027.
Fayetteville State University plans to expand its nursing programs following a $2 million donation from Cape Fear Valley Health.
Southeastern North Carolina is one of the unhealthiest regions in the state. The life expectancy in much of the region is 6 to 10 years shorter than the state average, according to the N.C. Department of Health and Human Services. Residents have higher rates of diabetes and heart disease and lower birth weights. Counties in the region have among the highest drug overdose death rates in the state.
Nearly every county has a shortage of primary care and mental health providers, according to the U.S. Health Resources and Services Administration, a federal agency under the U.S. Department of Health and Human Services. Three of the nine counties Cape Fear Valley Health covers—Bladen, Sampson, and Columbus—are a maternity care desert or have low access to maternity care, according to the nonprofit March of Dimes.
Community Focus
Methodist University aims to get medical students invested in the community early on in hopes they will stay after graduation, Bell said. Students will help treat patients at the Cape Fear Valley Medical Center and in the school’s yet-to-be-developed free clinic in Fayetteville as part of their education. They will also participate in community service learning projects.
“They’re going to get to know these people, learn the families, learn the communities throughout the region,” Bell said. “And I think they’re going to fall in love.”
Fayetteville State uses a similar community strategy to keep its nurses in the area: Nursing students provide health screenings at the annual Umoja Festival, a local cultural fair in Fayetteville. They also travel around Cumberland County, providing health care through the school’s mobile health unit.
At UNC Pembroke, nursing students help distribute food and take residents’ blood pressure and other health measurements at the Lumbee Cultural Health Fair in Maxton. The program also has a mobile health unit and hopes to add more to better reach more rural parts of Robeson and surrounding counties.
Students who are from the communities where they go to school are more likely to remain local post-graduation, according to Erin Fraher, deputy director for policy and director of the health workforce research and policy program at the Cecil G. Sheps Center for Health Services Research. It’s why UNC Pembroke and Fayetteville State have worked to recruit locally.
Fayetteville State has graduated 523 nurses since 2023, said Jennifer Edwards, associate dean of the university’s Cape Fear Valley School of Nursing. She estimated 85% of them work in southeastern North Carolina.
“It’s very clear to us as educators that there’s a shortage, and there’s going to continue to be a shortage, and there’s even more of a need in rural areas,” Edwards said. “So it’s important for all of us to work together collaboratively to help meet those needs.”
About 40 students graduate from UNC Pembroke’s nursing programs each year, according to Jennifer Jones-Locklear, chair of the university’s McKenzie-Elliott School of Nursing. About half have stayed in Robeson and surrounding counties, Fraher said.
“In the end, it’s all about what kind of change can we make,” Jones-Locklear said. “Can our nursing students, in collaboration with the different disciplines that they’re working with, improve the health of southeastern North Carolina? Because if you make small changes here, I believe that it has a reciprocal effect, that it’s going to make changes on a larger scale.”
Methodist University hopes scholarships will lure local students to its medical school, where the annual tuition will be $68,500. The Cumberland Community Foundation contributed $1 million to scholarships, and the Cumberland County Board of Commissioners established a $1 million endowment for county residents.
Cape Fear Valley Health also created a loan repayment program for students who practice with the health system after graduation.
Keeping Doctors Local
Cape Fear Valley Health has 328 residency positions available for medical students to rank in the National Resident Matching Program, which determines their specialty and where they practice post-graduation.
Dr. Donald Maharty oversees Cape Fear Valley Health’s residency and fellowship programs and is the senior associate dean of graduate medical education for the medical school. He said the community focus incorporated into the medical school’s curriculum will encourage medical students to stay local for their residencies.
After residency, which can last three to seven years, he hopes students will want to continue working for Cape Fear Valley Health. Since 2017, when the health system began offering residency programs, 55% of participants have stayed to practice in the region, Maharty said.
“It becomes a family, and it becomes your community,” said Maharty. “Instead of, ‘I’m just passing through to get hired,’ it becomes personal. They’re proud of the health system.”
Lassiter said she enjoys working in Dunn, home to fewer than 8,500 people. Her patients feel at ease hearing her southern North Carolinian accent, she said, and appreciate her taking the time to explain her treatment recommendations. The farmers and factory workers she treats remind her of her father, who died of heart failure last year.
“They’re him,” Lassiter said. “I think he prepared me well to be able to build trust and relationships with them.”
Campbell University’s School of Osteopathic Medicine, Lassiter’s alma mater, has more than doubled the number of its graduates in residencies across the state. In 2017, when the school’s first class graduated, 16% of students went on to residency programs in North Carolina. In 2024, the figure jumped to 34%. Many of those residents are practicing in Harnett, Cumberland, Hoke, Sampson, and New Hanover counties, according to Fraher’s research.
Cape Fear Valley Health wants to expand its number of residency positions to over 400 in the next five to seven years, Maharty said.
Methodist University is open to building relationships with other health systems for clinical rotations and residency spots, Bell said. It’s already partnering with the Southern Regional Area Health Education Center, a family medicine residency program in Fayetteville that’s part of a broader statewide network of health education programs.
“For me, it’s really about helping students get that sense that it’s so much bigger than what they think it is,” Bell said. “That by entering a career in medicine and practicing medicine, they can touch entire populations.”
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