Medically Underserved Areas/Populations and GME

Consistent with its mission to improve health care and population health, the ACGME seeks to enhance physician workforce development in communities that face physician shortages in various specialties.

As part of this effort, the ACGME developed a framework to encourage the development of graduate medical education (GME) that will result in enhanced access to and availability of health care in medically underserved areas (MUAs) and medically underserved populations (MUPs). Medically underserved areas and populations (MUA/Ps) are places or communities in which groups of people have unmet health or health care needs.

This framework outlines initial actions addressing graduate medical education in MUA/Ps.


MUA/P Advisory Group

Submission Deadline

The ACGME seeks resident/fellow and senior clinical executive leader (e.g., CEO, CMO, CNO) nominations for the MUA/P Advisory Group. This group advises the ACGME on matters related to MUA/P and GME. The nomination deadline is April 26, 2024.
Learn more.

Rural Initiatives

ACGME Rural Track Program Designation
Consistent with Section II of the MUA/P framework, the ACGME has developed processes addressing ACGME-accredited programs that seek to create “rural tracks” as defined in rules and regulations of the Centers for Medicare and Medicaid Services (CMS) in 42 CFR §413.79(k), including a separately accredited ACGME Rural Track Program designation that is available both for an existing program (with a permanent complement increase and new rural site(s)) or as part of the application for a new program. Visit the Rural Track Program Designation web page to learn more.

Rural Health Matters
ACGME President and CEO Thomas J. Nasca, MD, MACP joined University of Nebraska Medical Center and University of Nebraska Omaha Chancellor Jeffrey P. Gold, MD on RFD-TV’s Rural Health Matters in April 2021 to discuss the COVID-19 pandemic’s effects on rural America, GME, physician well-being, the current state of the US health care system, and more. In this excerpt, Dr. Nasca describes pathways for new physicians who want to serve rural communities and the role of academic partnerships in providing education to address health care needs.

The Teaching Health center Graduate Medical Education Program: A Permanent Funding Imperative
A.P. Philips et al., August 2023

Establishment of a Fellowship in Street Medicine
M. Kiazand et al., June 2023

The ACGME Framework for Medically Underserved Areas and Populations and Graduate Medical Education
L. McDougal et al., April 2023

Graduate Medical Education Training and the Health of Indigenous Peoples
M.J. Owen et al., February 2023

A Scoping Review of Indigenous Health Curricular Content in Graduate Medical Education
M. Rashid et al., February 2023

Avoiding Unethical Altruism in Global Health: Revisiting Ethics Guidelines for International Rotations for Medical Residents
S.R. Ross et al., February 2023

Vulnerable yet Unprotected: The Hidden Curriculum of the Care of the Incarcerated Patient
M.I. Suh et al., December 2022

Evaluating the Teaching Health Center Graduate Medical Education Model at 10 Years: Practice-Based Outcomes and Opportunities
C. Smith Davis et al., October 2022

It’s Time to Stop Pointing Fingers: The Role of GME in Addressing the Issue of Unmatched US Medical School Graduates
K.M. Andolsek et al., August 2022

Family Medicine Residencies: How Rural Training Exposure in GME Is Associated With Subsequent Rural Practice
D.J. Russell et al., August 2022

CMS Finalizes Rules for Distribution of 1000 New Medicare-Funded Residency Positions and Changes to Rural Training Track Programs
K. Schleiter Hitchell et al., April 2022

Federal Bills Raise Cap on Medicare-Funded Residency Positions and Modify Graduate Medical Education Policies
K. Schleiter et al., August 2021

Rural Residency Training as a Strategy to Address Rural Health Disparities: Barriers to Expansion and Possible Solutions
E.M. Hawes et al., August 2021

Cultivating Healthy Governance in Rural Programs
R. Longenecker et al., April 2021

Rural Workforce Years: Quantifying the Rural Workforce Contribution of Family Medicine Residency Graduates 
P. Meyers et al., December 2020

A Roadmap to Rural Residency Program Development
E.M. Hawes et al., August 2020

Developing Graduate Medical Education Partnerships in American Indian/Alaska Native Communities
M.A. Sundberg et al., December 2019

Community Health Center Engagement and Training During Obstetrics and Gynecology Residency
A.Y. Cheng et al., October 2019

Preparing Physicians for Rural Practice: Availability of Rural Training in Rural-Centric Residency Programs
D.G. Patterson et al., October 2019

International Medical Graduates in the US Physician Workforce and Graduate Medical Education: Current and Historical Trends
A.A. Ahmed et al., April 2018

A Free Clinic Continuity Experience During Residency Is Associated With Practice in Underserved Areas
S.M. Petrany et al., October 2017

Teaching Health Center Graduate Medical Education Locations Predominantly Located in Federally Designated Underserved Areas
S.C. Barclift et al., May 2016

Boston Health Care for the Homeless Program – Harvard Dermatology Collaboration: A Service- Learning Model Providing Care for an Underserved Population
J. Sheu et al., December 2014

Impact of Global Health Experiences During Residency on Graduate Practice Location: A Multisite Cohort Study
W. Liaw et al., September 2014

Rural Primary Care Physician Workforce Expansion: An Opportunity for Bipartisan Legislation
R.E. Rieselbach et al., December 2013

A Pilot Curriculum to Integrate Community Health Into Internal Medicine Residency Training
J. Catalanotti et al., December 2013

Resident Education in Free Clinics: An Internal Medicine Continuity Clinic Experience
A.T. Pincavage et al., June 2013

An Experiential Community Orientation to Improve Knowledge and Assess Resident Attitudes Toward Poor Patients
E.A. Wallace et al., March 2013

County Jail as a Novel Site for Obstetrics and Gynecology Resident Education
C.B. Sufrin et al., September 2012

Residents’ Attitudes and Behaviors Regarding Care for Underserved Patients: A Multi-Institutional Survey
M.L. Wieland et al., September 2011

An International Health Track Is Associated With Care for Underserved US Populations in Subsequent Clinical Practice
A.W. Bazemore et al., June 2011

Reflective Practice and Competencies in Global Health Training: Lesson for Serving Diverse Patient Populations
J. Castillo et al., September 2010