A Typology of Rural Residency Training to Support Educational Research and Prospective Applicants

Proposal: Rural communities struggle with recruiting and retaining sufficient clinicians to meet community health needs. A growing body of evidence has shown that rural residency training predicts rural practice—even more strongly than rural origin does—and that rural training is also associated with long-term retention in rural practice. An urban-centric graduate medical education (GME) system has historically meant a lack of support for rural health professional education, but federal and state investments in diverse rural residency training options are growing.

This increasing attention to rural training, while welcome and overdue, has also posed several questions and challenges. Which rural training models are most effective and most worthy of investment to ensure their success and diffusion? Perhaps most importantly, how can medical students with an interest in rural practice be made aware of these opportunities, and how can residency programs identify interested students? Key differences in rural training experiences include residency location (rural or urban) and degree of resident participation in rural training (e.g., through a “track” or elective rotations). Until “Rural Track Program” definitions were recently established in regulation and accreditation, no widely accepted classification system for rural GME existed, making it difficult to conduct educational research, compare published results, or identify and navigate the options available to residency applicants.

Experts and leaders of The RTT Collaborative, a nationwide non-profit cooperative of rural programs in medical education and training, have developed a framework that defines six types of residency programs based on rural training configurations and rural practice yields (https://rttcollaborative.net/rttc-participating-programs/typology-of-participating-programs/). In this session, the presenter, a researcher who has led numerous studies on this topic and contributed to the development of the typology, will describe the typology’s uses for residency applicants, rural medical educators, and other researchers who wish to contribute to the body of evidence on what works to prepare a rural physician workforce. The session will also include a brief overview of a publicly available map (https://rttcollaborative.net/rural-programs/residency-map/) and database (https://rttcollaborative.net/download/6546/?tmstv=1704652897) of rural medical school programs and rural residencies in family medicine, internal medicine, psychiatry, and surgery.