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Montana TRUST
Targeted Rural Underserved Track
WWAMI
Lisa Benzel
Montana WWAMI
TRUST Director
Develop specific rural medical education
programs
• “Medical educators and policy makers can
have the greatest impact on the supply
and retention of rural primary care
physicians by developing programs to
increase the number of medical school
matriculates with background and career
plans that make them most likely to pursue
these career goals.”
Howard K. Rabinowitz, MD, et al., Journal of the
American Medical Association, 2001
Rural/Underserved
Communities
TRUST takes students from
rural/underserved communities,
nurtures connections and returns
physicians to practice.
Summary of Montana TRUST
The overall goal of the TRUST Program is
to increase the number of Montana
WWAMI students choosing primary care
or other needed specialties and then
returning those practitioners to the rural
and underserved areas within the state of
Montana.
Admissions
Student admitted to UWSoM via
separate process
Components of Montana TRUST
1. Admissions
+ Admit 33% 10/30 TRUST students to first
year class
+ Selected by the University of Washington
School of Medicine Admissions Committee ( 4
members are Montana physicians)
Components of Montana TRUST
1. Admissions
Suggested Guidelines:
+ rural and/or disadvantaged background
+ prior career experience in health related work
+ significant volunteer experience in rural or
underserved medical settings
+ strong commitment to service
+ Montana rural high school graduate and
+ graduate of a Montana public college/university.
First Summer
Experience
Continuity Community orientation
Components of Montana TRUST
2. First Summer Experience
+ Trust students are matched with a physician
mentor in a rural community, or in clinic which
serves underserved populations (FQHC)
+ Prior to matriculating in medical school the
students spend 2 weeks observing the rural or
underserved physician and exploring the health
community of the rural or underserved location.
Foundations
Phase
•Continuity Community visits
•Underserved Pathway
•Rural Health Course I
•Rural/Underserved Opportunity
•Continuity Community Oriented
Scholarly Project
Components of Montana TRUST
3. Foundations Phase of Medical School;
TRUST Student Pathway
The TRUST students:
+ spend two 4-day weeks with previously assigned rural
or underserved physician mentor (continuity visits)
+ enroll in the University of Washington School of
Medicine Underserved Pathway
+ be assigned a College mentor with significant rural or
underserved background
+ participate in rural health elective at MSU (Med 560)
+ Journal Club
+ Osler’s Evenings
+ encouraged to attend a national, regional or state rural
health conference/meeting
Components of Montana TRUST
3. Foundations Phase of Medical School;
TRUST Student Pathway
The TRUST students:
+The TRUST students participate in the
Rural/Underserved Opportunity Program (R/UOP) of the
UWSOM.
+This is a one month assignment in a rural or
underserved community under the supervision of their
previous physician mentor and takes place during the
summer following completion of the first two terms of
medical school (During this time students complete a
community research project – iii3).
Clinical Phase
•Continuity Community linkages
•Underserved Pathway
•Rural Health Course 2
•WRITE (18+ weeks)
Clinical Phase
The TRUST students will:
+ continue site visits
+ participate in Underserved Pathway activities
+ participate in weekly College mentor teaching
sessions
+ Rural Health2 elective
+ Journal Club
+encouraged to attend a national, regional or
state rural health conference/meeting
Career Exploration
Phase
•Continue Continuity Community
Linkages
•Underserved Pathway
•Rural Clinical Elective
•Residency Linkages
Components of Montana TRUST
TRUST students will:
+ Continue with community linkages and
underserved pathway
+ Rural Clinical Elective
+ 4-5 electives to help establish practice
specialty
+ Residency Linkages
+ encouraged to attend a national, regional or
state rural health conference/meeting
Residency
(Including Rural Training
Tracks)
TRUST graduates match into
rural/underserved residency
programs
Components of Montana TRUST
TRUST Scholars will be encouraged to:
• Choose a primary care residency program, or
a residency program in selected specialties
that complement rural or underserved
practices
• TRUST works to develop close connections
with regional residency programs
• Continue Continuity Community Linkages
Rural/Underserved
Communities
TRUST takes students from
rural/underserved communities,
nurtures connections and returns
physicians to practice.
Components of Montana TRUST
9. Upon completion of their residency
training:
The TRUST students will be encouraged to
select a rural practice site in the state, or to
practice in a Federally Qualified Health Center
within Montana. Physicians choosing these
underserved locations will have access of up to
$100,000 of loan repayment through the
Montana Rural Physician Incentive Program
(MRPIP) as well as NHSC programs.
Success in meeting rural physician
workforce needs
• Specific rural focused programs that:
1. Provide pipeline programs
2. Select the right students
3. Provide the necessary rural educational
components
4. Rural exposure and mentorships
5. Close contact and advising
6. Links with residency programs
7. Programs to assist with return to the state
8. Programs that retain providers after
employment