ACGME Rural Track Program Designation
Building capacity for GME can be challenging in rural communities, many of which are in medically underserved areas. GME partnerships between participating sites in urban, rural, and other settings play an important role in enhancing physician supply in workforce shortage areas.

In alignment 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). An ACGME Rural Track Program (RTP) is an ACGME-accredited program in which all or some residents/fellows gain both urban and rural experience with more than half of the education and training for the applicable resident(s)/fellow(s) taking place in a rural area (any area outside of an urban Core-Based Statistical Area (CBSA)).

Recognizing that improved identification of such programs may help to facilitate the development of GME in rural and underserved areas, the ACGME has developed a common, criterion-based process for designating ACGME-accredited RTPs across specialties.

The following processes are available to obtain ACGME RTP designation:

  • Permanent complement increase and identification of new rural site(s) for an existing program
  • Application for a new program*

*New programs may share resources and overlapping resident/fellow experiences with an already existing ACGME-accredited program. Requests for RTP designation during the program application process may identify an existing program as a Rural Track Related Program (see definition below).


The following table summarizes the two processes for ACGME RTP designation:

Rural Track Program RTP – track within existing program RTP – new program
Rural Track Program

Request Initiated By

RTP – track within existing program

RTP – track within existing program
Program director

RTP – new program

RTP – new program
Designated institutional official

Rural Track Program

Criteria

RTP – track within existing program

RTP – track within existing program
Greater than 50 percent GME in rural Prospective Payment System (PPS) hospital and/or non-provider site(s)

RTP – new program

RTP – new program
Greater than 50 percent GME in rural PPS hospital and/or non-provider site(s)

Rural Track Program

Criteria

RTP – track within existing program

RTP – track within existing program
Rural area = county outside of an urban CBSA

RTP – new program

RTP – new program
Rural area = county outside of an urban Core-Based Statistical Area (CBSA)

Rural Track Program

Criteria

RTP – track within existing program

RTP – track within existing program
Some required non-rural GME

RTP – new program

RTP – new program
Some required non-rural GME

Rural Track Program

Criteria

RTP – track within existing program

RTP – new program
New rural site(s) (not required for current program residents/fellows)

RTP – new program
Rural Track Program

Criteria

RTP – track within existing program

RTP – new program
Faculty members at new rural site(s) are not supported by a current rural participating site

RTP – new program
Rural Track Program

Required Forms

RTP – track within existing program

RTP – track within existing program
RTP Rotation Information Form (rural track resident/fellow experiences only)

RTP – new program

RTP – new program
RTP Rotation Information Form

Rural Track Program

Required Forms

RTP – track within existing program

RTP – track within existing program
The specialty-specific RTP Questionnaire is required, if available (see below).

RTP – new program

RTP – new program
The specialty-specific RTP Questionnaire is required, if available (see below).

Rural Track Program

ACGME Approval Process

RTP – track within existing program

RTP – track within existing program
ACGME MUA/P and GME staff member reviews designation information

RTP – new program

RTP – new program
ACGME MUA/P and GME staff member reviews designation information

Rural Track Program

ACGME Approval Process

RTP – track within existing program

RTP – track within existing program
Review Committee reviews* the permanent complement increase request and site changes

RTP – new program

RTP – new program
Review Committee reviews* the program application

*The designation process is independent of accreditation review. Programs are encouraged to review the applicable specialty-specific Program Requirements and contact the executive director of the relevant Review Committee with accreditation-related questions.


Specialty-Specific RTP Questionnaires

The following Review Committees currently use a RTP Questionnaire to obtain additional information for programs seeking ACGME RTP designation:

The specialty-specific ACGME RTP Questionnaires can also be found on the Documents and Resources page of the relevant specialty’s section on the ACGME website and are submitted as part of the ACGME RTP designation request as indicated on the form. Questions concerning this form can be directed to staff members of the relevant specialty Review Committee, whose contact information may be found on that specialty’s section of the ACGME website.

ACGME Definitions of Terms Specific to MUA/P
ACGME Definitions of Terms Specific to MUA/P

ACGME Rural Track Program (RTP)

An ACGME-accredited program in which all or some residents/fellows gain both urban and rural experience with more than half of the education and training for the applicable resident(s)/fellow(s) taking place in a rural area (any area outside of an urban CBSA).

ACGME Definitions of Terms Specific to MUA/P

ACGME Rural Track Program (RTP) designation*

A classification provided by the ACGME that identifies RTPs either with the approval of a permanent complement increase request and the addition/identification of at least one new rural participating site or at the time of application for accreditation.

ACGME Definitions of Terms Specific to MUA/P

ACGME Rural Track Related Program

A separately accredited program in the same specialty at the same Sponsoring Institution in which residents/fellows have some overlapping education and training experiences with the ACGME RTP residents/fellows and may share resources (for new program RTPs).

*The ACGME RTP designation is independent of any rural track designation by CMS and does not guarantee that a program will meet CMS eligibility requirements for GME or other financial support. Direct questions about the CMS rural track policy to the local GME finance staff and/or the PPS hospital’s Medicare Administrative Contractor.