Medically Underserved Areas/Populations: Partnerships to Establish and Sustain Rural GME

March 25, 2022
For those participating in the 2022 ACGME Annual Educational Conference, Session 042 on Friday, April 1 from 11:30 a.m.-12:30 p.m. Central will provide information on partnerships to establish and sustain rural GME. Connect with ACGME staff members in the ACGME Hub if you have questions or would like more information.

ACGME Rural Track Program Designation Update
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. In 2019, the ACGME Board of Directors approved an accreditation framework to provide additional support and review accreditation processes to promote the development of graduate medical education (GME) that will result in enhanced access to and availability of health care in medically underserved areas and populations (MUA/P).

In alignment with its accreditation framework for MUA/P and GME, 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). 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 Rural Track Programs (RTPs) across specialties.

In June 2021, the ACGME opened submissions for new programs seeking RTP designation (Type 1) at the time of application for ACGME accreditation. All residents/fellows enrolled in ACGME-accredited programs with RTP designation (Type 1) complete rotations in both urban and rural settings, with more than 50 percent of their educational experiences occurring at rural participating sites. To date, the ACGME has received requests for RTP designation (Type 1) from programs seeking accreditation in the specialties of family medicine, internal medicine, obstetrics and gynecology, psychiatry, and surgery.

The ACGME now plans to begin offering an additional type of RTP designation (RTP designation Type 2) to coincide with an update to rural tracks in federal law and CMS policy. The Consolidated Appropriations Act, 2021 has introduced a modification to the definition of “rural tracks” that was recently promulgated in the CMS FY 2022 IPPS Final Rule. Effective for cost report periods on or after October 1, 2022, CMS regulations allow for rural tracks as an expansion of an existing ACGME-accredited program with the addition of a new rural participating site.

To align with this change, the ACGME is offering Rural Track Program designation (Type 2) for already-accredited programs seeking to expand by adding a new rural track. Beginning in May 2022, programs will be able to request Type 2 designation using a new section currently being built in the Accreditation Data System. Programs seeking designation will be asked to add at least one new rural participating site where residents/fellows in the rural track will complete required assignments. The designation request will also include the completion of a permanent completement increase.

Learn More
Are you planning to attend the 2022 ACGME Annual Educational Conference? If so…

SES042: Medically Underserved Areas/Populations and GME: Partnerships to Establish and Sustain Rural GME
In this session, the ACGME will provide an update on implementation of the framework for MUA/P, including the ACGME’s RTP designation. Participants will learn from program directors and institutional leaders about their experience developing partnerships to establish and sustain rural GME rotations in various clinical specialties.


    1. Laney McDougal, MS-HSM – Director, Medically Underserved Areas/Populations and GME, ACGME
    2. Thomas Gearan, MD – Internal Medicine Program Director and Assistant Designated Institutional Official, Maine Medical Center
    3. Karen J. Brasel, MD, MPH – General Surgery Program Director, Assistant Designated Institutional Official, and Professor of Surgery, Oregon Health & Science University
    4. Jim A. Clardy, MD – Director, Center for GME and Professor of Psychiatry, University of Arkansas for Medical Sciences
    5. Jennie Kirby, MPA – GME Director, University of Arkansas for Medical Sciences

Note: Conference participants with Premium registration have access to watch this and other sessions through May 1 even if they miss it during the live conference dates.

  • Visit the MUA/P and GME booth in the ACGME Hub in the virtual conference platform to speak face to face with the ACGME’s MUA/P and GME team on Wednesday (March 30), Thursday (March 31), and Friday (April 1) from 2:00-4:00 p.m. Central.

Also, the ACGME MUA/P and GME staff will host an informational webinar about the ACGME Rural Track Program Designation: Type 2 on Thursday, May 5, 2022 at 3:00 p.m. Central, including Q and A. Register now.

Stay tuned for more information in future ACGME e-Communications and on the ACGME’s Rural Track Programs web page.

Additional Resources:

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Guest blogger Laney McDougal is Director of Medically Underserved Areas/Populations and GME. She has been at the ACGME since April 2020 and has been part of the GME community since 2011.