Since the 1980's researchers, clinicians, government, local communities and others have been writing about the challenges facing emergency departments (EDs) in Ontario. Whether the most pressing issues have been wait time for care, compensation, standards, or human resources, stakeholders have worked to find the best, most sustainable solutions. Some efforts have been successful, however many re-surface to again challenge the current models for emergency services - and specifically for ED human resources. The complexity of delivering health care services, ED services and recruiting health professionals into a predominantly rural geography is large. For one, there is no standard definition of rural Ontario and rural healthcare upon which to build policy. One definition from Statistics Canada defines rural and small town as the population living outside the commuting zones of larger urban centres. In addition, minimum standards for Emergency Department operations do not exist. These standards would include a definition of what constitutes an ED in terms of personnel (nursing and physician) and skill set (nursing and physician).