title: The WWAMI Targeted Rural Underserved Track (TRUST) Program: An Innovative Response to Rural Physician Workforce Shortages.
abstract: OBJECTIVE
  Too few physicians practice in rural areas. To address the physician workforce needs of the Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) region, the University of Washington School of Medicine developed the Targeted Rural Underserved Track (TRUST) program in August 2008. TRUST is a four-year curriculum centered on a clinical longitudinal continuity experience with students repeatedly returning to a single site located in a rural community or small city.
  
  
  METHODS
  The overarching theme of TRUST is one of linkages. Students are strategically linked to a rural community, known as their TRUST continuity community (TCC). The program begins with a targeted admission process and combines new and established programs and curricular elements to form a cohesive educational experience. This experience includes repeated preclinical visits, clerkships, and electives at a student's TCC, and rural health courses, the Underserved Pathway, and the Rural Underserved Opportunities Program (which includes a community-oriented primary care scholarly project).
  
  
  RESULTS
  TRUST was piloted in Montana in 2008. With the matriculating class of 2015, every state in the WWAMI region will have TRUST students. From 2009 (the year targeted admissions began) to 2015, 123 students have been accepted into TRUST. Thirty-three students have graduated. Thirty (90.9%) of these graduates have entered residencies in needed regional specialties.
  
  
  CONCLUSIONS
  Next steps include implementing a robust evaluation program, obtaining secure institutional programmatic funding, and further developing linkages with regional rural residency programs. TRUST may be a step forward in addressing regional needs and a reproducible model for other medical schools.
authors.affiliation: T. Greer is professor of family medicine, University of Washington School of Medicine, Seattle, Washington. A. Kost is assistant professor of family medicine, University of Washington School of Medicine, Seattle, Washington. D.V. Evans is associate professor of family medicine, University of Washington School of Medicine, Seattle, Washington. T. Norris is professor of family medicine, University of Washington School of Medicine, Seattle, Washington. J. Erickson is clinical professor of family medicine, University of Washington School of Medicine, Whitefish, Montana. J. McCarthy is clinical associate professor of family medicine, University of Washington School of Medicine, Spokane, Washington. S. Allen is clinical professor of family medicine, University of Washington School of Medicine, Boise, Idaho.
authors.forename: Thomas
authors.initials: T
authors.lastname: Greer
authors.forename: Amanda
authors.initials: A
authors.lastname: Kost
authors.forename: David V
authors.initials: DV
authors.lastname: Evans
authors.forename: Tom
authors.initials: T
authors.lastname: Norris
authors.forename: Jay
authors.initials: J
authors.lastname: Erickson
authors.forename: John
authors.initials: J
authors.lastname: McCarthy
authors.forename: Suzanne
authors.initials: S
authors.lastname: Allen
mesh_terms: D002982:Clinical Clerkship / Q000458:organization & administration; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000458:organization & administration*; D006801:Humans; D008507:Medically Underserved Area; D009009:Montana; D020380:Needs Assessment; D010820:Physicians / Q000600:supply & distribution*; D016730:Program Development; D019035:Rural Health Services; D012577:Schools, Medical; D000078329:Workforce