Blackstone Rural Track

Welcome to the Blackstone Rural Program

The best of both worlds come together- the excellence of academic Family Medicine and the reality of rural Family Medicine. The Blackstone Rural Program located in Blackstone, Virginia, is a division of the St. Francis Family Medicine Residency, sponsored by Bon Secours Health System, and is affiliated with Virginia Commonwealth University School of Medicine.

Our program is a 2-2-2 integrated rural training track. Residents spend their intern year in clinical practice at St. Francis Family Medicine in Midlothian, VA and the upper two years in clinical practice in rural Blackstone, VA. This rural continuity practice is interspersed with specialty rotations in pediatrics, cardiology, OB, sports medicine, and many other specialties at Bon Secours St. Francis Hospital in Midlothian, VA and St. Mary’s in Henrico, VA.

Blackstone Family Practice had a long history of training high quality residents for over 30 years with approximately 2/3 of the graduates practicing in rural areas upon graduation. Our goals remain the same. Our biggest strengths are in our wide scope of practice, our multiple procedures, our greatly experienced faculty and our ability to cater to individual learning needs. We also participate in the education of medical students at all levels. We would love to have you visit!

Marissa W. Esquivel, MD

Position: Blackstone Site Director

Medical School: The Medical College of Virginia at Virginia Commonwealth University

Hometown: Midlothian, Virginia

Residency: St. Francis - Virginia Commonwealth University

Certification: American Board of Family Medicine

Medical Interest: Global health

Outside Interests: Loves decorating cakes, trying new recipes, and spending time with friends and family.

Steven N. Spence, M.D.

Undergraduate: University of Virginia, 1973

Medical School: University of Virginia, 1977

Residency: Riverside Regional Medical Center, 1980

Certification: American Board of Family Medicine

Medical Interests: complex medical problems, teaching

Outside Interests: fishing and woodworking 


*Note: Blackstone residents work extensively with faculty from the Hull Street location as well, listed at Meet the Faculty.


The residents will follow the St. Francis Family Medicine Curriculum, however, our residents will see their continuity patients at Blackstone clinic site. PGY-1’s will spend on average 1-1/2 day a week and PGY-2/3 will spend on average 2-full days a week at the Blackstone facility. 


Blackstone Family Practice Center is a state of the art 10,000 square foot facility housing 22 patient rooms. Our new facility opened in 2009. We have a large procedure/acute care room where we handle emergent and acute care cases and perform multiple procedures including wound repairs, skin biopsies, colposcopies, and many more. We have our own state of the art radiology suite and in house laboratory, all in a small rural environment.