Wisconsin Collaborative for Rural Graduate Medical Education

Description

The Wisconsin Collaborative for Rural Graduate Medical Education (WCRGME) was created to address a critical challenge: the persistent shortage of primary care physicians in rural communities. Recognizing that exposure to rural practice during residency is key to recruiting and retaining physicians in these areas, healthcare organizations across Wisconsin joined forces to develop rural training opportunities for physician residents.

Originally launched in 2012 as the Wisconsin Rural Training Track Collaborative, the initiative soon evolved into WCRGME. While WCRGME does not operate as a formal membership organization, it serves as a collaborative network of partners committed to strengthening rural graduate medical education (GME). What began with nine healthcare organizations from communities such as Ashland, Baraboo, and Monroe has grown into a statewide effort involving more than 60 rural hospitals, residency programs, and partner organizations.

WCRGME provides technical assistance and strategic support to both established programs and those in development, helping not only to expand rural GME but also to ensure the long-term sustainability of these programs. Partners meet regularly via Zoom to share best practices, address challenges, and develop collaborative solutions. In addition, WCRGME promotes Wisconsin's rural training opportunities through presentations and social media campaigns to medical students both in-state and throughout the region.

The Rural Wisconsin Health Cooperative (RWHC) spearheaded the creation of WCRGME with a grant from the Wisconsin Rural Physician Residency Assistance Program (WRPRAP), funded by the state legislature through Wisconsin Act 190 (effective July 1, 2010). The initial grant has been renewed through 2026, with ongoing funding anticipated into future years to sustain this workforce initiative

Services offered

WCRGME offers the following training programs:

• 3 rural surgery programs
• 10 family medicine programs
• 3 psychiatry programs
• 3 internal medicine programs
• 2 OB/GYN programs
• 6 primary care fellowships
• 1 pediatrics program
• 1 medicine/pediatrics program
• 1 dermatology program

Additional services available:

• New program planning
• GME informational sessions
• Rural rotation site development
• Accreditation and financial planning
• Professional development for program directors and program administrators
• Faculty development
• Best practice resources
• Coordinated medical student recruitment
• Outcomes tracking and data reporting on state GME efforts

Results

• Total GME position increase of 300 once all programs achieve full complement size in 2028.
• Creation of new rural-focused programs in a wide range of specialties ranging from family medicine to general surgery to psychiatry. The state created the first OB/GYN rural track in the nation.
• Over 30 rural rotation sites established including rural hospitals, health centers, VA facilities, and tribal organizations.
• Statewide faculty development conference with attendance of over 50 rural physicians in a wide range of specialties.
• Third cohort of the GME Leadership Academy developed in partnership with the Wisconsin Northern GME Consortium (WiNC) and Medical College of Wisconsin - Central Wisconsin Campus.
• Annual statewide Medical Education Administrators and Coordinators (MEAC) workshop held to support professional development needs of program coordinators.
• Annual training opportunities for program administrators held virtually include a coordinator leadership institute, recruitment workshop, and rural administrators' fundamentals (RAFT) training.

WCRGME received the Wisconsin Rural Partners award in 2015 in recognition of being one of Wisconsin's top rural development initiatives.

Publications:

Bruksch-Meck, K., Crouse, B., Quinn, G., McCart, L., & Traxler, K. (2018). Graduate Medical Initiatives to Develop the Physician Workforce in Rural Wisconsin. Wisconsin Medical Journal, 117(5), 201-207.

Challenges

• Growing residency training in certain areas of the state remains challenging, especially in Northern Wisconsin where geographic distances can create barriers to expansion of GME.
• Medical student interest in rural training can be challenging as programs grow not only in the state, but across the nation. Engagement with a medical student advisory committee is helping WCRGME effectively promote these opportunities.
• GME funding is complicated and there are many options available to rural hospitals. Understanding of Centers for Medicare & Medicaid Services (CMS) reimbursement, hospital types, and alternative funding sources is essential in development of GME at a regional scale.

Replication

WCRGME serves as an independent technical assistance entity that support rural residency programs and training sites statewide. This approach is an emerging, replicable model that helps hospitals and other organizations secure start-up funding while also providing the guidance and resources needed for programs and launch successfully and thrive long-term. By leveraging networks among rural healthcare facilities and traditional residency programs, WCRGME creates strong, sustainable rural training opportunities.

WCRGME's Start a Rural GME Program section provides statistics, information, explanation of different versions of rural training programs, and future steps.

Contact Information