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 has developed 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 (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 new framework outlines initial, high-priority actions needed to address accreditation in MUA/Ps.
ACGME Rural Track Program Designation
Consistent with Section II of the MUA/P framework, the ACGME is developing processes addressing ACGME-accredited programs that are also “rural tracks” as defined in rules and regulations of the Centers for Medicare and Medicaid Services (CMS) in 42 CFR §413.79(k).
Under current CMS regulations, urban teaching hospitals have an opportunity to obtain reimbursement for direct GME (DGME) and indirect medical education (IME) financing by partnering with rural hospitals and other rural sites to create separately-accredited rural track programs (RTPs). In RTPs, residents are assigned to certain types of participating sites in rural areas for more than half of the length of their residency program.
While CMS does not limit the creation of RTPs to specific specialties, RTPs have historically been created in the specialty of family medicine only (some RTPs in Family Medicine are often called “1-2 programs.”). Recognizing that alignment of ACGME processes with CMS regulations will facilitate the expansion of opportunities to address the health care needs of medically underserved areas through the development of rural track programs, the ACGME has developed a common, criterion-based process for designating ACGME-accredited RTPs across specialties.
RTPs may share resources with already existing ACGME-accredited programs, and residents/fellows in RTPs may have overlapping rotations with residents/fellows in those programs. Requests for RTP designation may identify the existing programs as Rural Track Related Programs (see definition below).
By providing a standardized method for identifying RTPs in a variety of specialties, this designation will support hospitals seeking to create new pathways for physicians who wish to practice in rural areas.
Review the ACGME RTP Designation Instructions Document for instructions on requesting a designation.
As part of the ACGME RTP designation request, the program director must provide an ACGME RTP Rotation Information Form using the attached template. This form is required in addition to the block diagram that is part of the program’s accreditation application.
For questions about the ACGME Rural Track Program designation, review the ACGME RTP FAQ Guide.
ACGME Definition of Terms Specific to MUA/P:
|ACGME Rural Track Program (RTP)||An ACGME-accredited program with a unique 10-digit identifier in which residents/fellows gain both urban and rural experience with more than half of the education and training for each resident/fellow taking place in a rural area (any area outside of a Core-Based Statistical Area (CBSA)).|
|ACGME Rural Track Program (RTP) designation||A classification provided by the ACGME that identifies Rural Track Programs at the time of application for accreditation.|
|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 Rural Track Program residents/fellows and may share resources.|
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
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A Free Clinic Continuity Experience During Residency Is Associated With Practice in Underserved Areas
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Teaching Health Center Graduate Medical Education Locations Predominantly Located in Federally Designated Underserved Areas
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An Experiential Community Orientation to Improve Knowledge and Assess Resident Attitudes Toward Poor Patients
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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
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