Rural Graduate Medical Education: Choosing the Road "Less Traveled By"

Despite active efforts to improve access to health care for people who live in rural communities, the need for developing a physician workforce that is committed to rural practice, and with the professional and personal skills that will best fit with the needs of the rural community, is only increasing over time. Supporting and solidifying the rural graduate medical education landscape must be a crucial piece of any plan to address gaps in rural health care. Embracing creative solutions that address the most important barriers to this development has high potential for meeting the health care needs of rural communities, with emphasis on the rural community stakeholders assuming the central role in planning efforts. In particular, essential innovations include developing a culture of learning in rural settings using concepts of a teaching health neighborhood and advancing interprofessional models of care; incorporating concepts of "place-based training" with focus on relational connectedness; enhancing a spectrum of potential partnerships, including rural and urban regional entities, the Health Resources and Services Administration, and other federal agencies (e.g., the Indian Health Service and Veterans Health Administration among others) to support the ability of rural health entities to embrace medical education; and advocating for federal and state funding initiatives to ensure the sustainability of training programs in rural communities. Although not sufficient to guarantee improved access to health care and better health outcomes among rural communities, robust collaborations to develop interprofessional training and enhancement of the entire pipeline of health professions training and practice holds significant promise for improving the health of rural populations.