Wisconsin Collaborative for Rural Graduate Medical Education
- Need: Family physicians in the rural areas of Wisconsin.
- Intervention: A collaborative was created that provides leadership, technical assistance, and training for expanding rural graduate medical education in Wisconsin.
- Results: The collaborative expanded rural graduate medical education rotations, residencies, and fellowship opportunities for training rural family physicians in Wisconsin.
Description
The
shortage of family physicians in rural areas is an
ongoing problem. To address this shortage, rural
healthcare organizations in Wisconsin came together to
develop a solution that would provide rural training
opportunities for physician residents, increasing their
exposure to rural communities and their experience in
rural practice. What began as the Wisconsin Rural
Training Track Collaborative in 2012 was soon renamed the
Wisconsin Collaborative
for Rural Graduate Medical Education (WCRGME).
While WCRGME does not have a formal membership, they collaborate with many organizations from multiple communities. At the beginning of WCRGME, 9 healthcare organizations from Wisconsin towns like Ashland, Baraboo, and Monroe came together to promote the development of Rural Training Tracks (RTTs) in Wisconsin. Two consultants were hired to help assess GME opportunities at seven inaugural sites. They shared general information regarding the development of rural GME training experiences and next steps in the process of establishing these rural experiences.

Currently, 62 different organizations in communities around the state are working with WCRGME, all of which are at varying stages of rural graduate medical education (GME) development, from initial interest to fully functioning Rural Graduate Medical Education Training Sites. WCRGME provides new opportunities to establish more sustainable rural graduate medical education programs, thus more rural physicians.
WCRGME members meet regularly via teleconferencing in order to discuss needs and challenges, share ideas and resources, brainstorm collaborative solutions, and provide support for new initiatives. WCRGME also markets the state's rural training opportunities through national conferences, presentations and its website.
In
2012, the Rural Wisconsin Health Cooperative (RWHC)
received a 3-year $150,000 start-up grant from the
Wisconsin
Rural Physician Residency Assistance Program (WRPRAP)
that allowed for the development of WCRGME. WRPRAP is
funded by the Wisconsin state legislature through the
passage of
Wisconsin Act 190 which became effective July 1,
2010. The initial grant has been renewed through 2021
with continued funding anticipated in the future through
WRPRAP and other sources. Most of the organizations that
worked with WCRGME at their launch also received separate
grant funding from WRPRAP to either explore or develop
their rural training opportunities.
Services offered
WCRGME's offers the following rural-focused programs:

- 2 residencies in a rural continuity clinic for an urban resident
- 5 Wisconsin rural fellowship programs
- 27 rural rotations
- 15 urban residencies with rural tracks
- 4 rural training track residency programs
Additional services provided:
- Initial assessments for sites
- Informational presentations
- Annual Medical Education Administrators and Coordinators Workshop
- Annual Rural and Community Medical Educators Faculty Development Conference featuring a pre-conference Rural Research Spotlight Poster Fair
- Assistance with GME funding questions
- Development of statewide rural GME directory and website
- Provide rural-sensitive education, certification, and mentoring for faculty, community preceptors, and administrators/coordinators
- Accreditation and administrative assistance
- Project management
- Best practice resources
- Promotion of rural rotation opportunities at national and regional conferences, including the Family Medicine Midwest Conference and the American Academy of Family Physicians (AAFP) National Conference
- Initiatives to recruit medical students into rural residency training, including promotional videos, and presentations
- Rural Graduate Medical Education
- Technical assistance
Results
- Rural GME slots increased to 35 slots with more under development.
- Developed integrated rural training tracks in general surgery, psychiatry, and OB/Gyn
- Increased interest from urban partners and hospitals wanting to offer rural experiences to their residents
- A faculty development conference aimed at rural and community preceptors is held annually
- Medical Education Administrators and Coordinators (MEAC) are now served by an annual workshop developed to train and provide networking opportunities
- Rural Coordinator Leadership Program in development
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
- Even when a healthcare facility has the desire to start a GME program, there may not be anyone on staff who is familiar with starting or running a residency. Also, a rural hospital wanting to develop a GME program needs to find a partner willing to sponsor them.
- WCRGME quickly realized that each of its members was in a different place with regards to organizational capacity, interest, and expertise. This resulted in the need to tailor presentations and training for different experience and interest levels.
- Centers for Medicare & Medicaid Services (CMS) reimbursement for graduate medical education is complicated, but essential to learn.
Replication
A centralized organization that can meet the needs
and provide technical assistance for rural sites is a
great model. Rural healthcare facilities often have the
desire and interest to become sites for rural graduate
medical education, but not necessarily the experience or
resources. A collaborative like WCRGME can provide those
things.
WCRGME's Start a Rural GME Program section provides statistics, information, explanation of different versions of rural training tracks, and future steps.
Contact Information
Lori Rodefeld, Director of Rural GME Development & SupportWisconsin Collaborative for Rural GME
lrodefeld@RWHC.com
Topics
Graduate medical education
Networking and collaboration
Physicians
States served
Wisconsin
Date added
November 15, 2012
Date updated or reviewed
September 29, 2021
Suggested citation: Rural Health Information Hub, 2021. Wisconsin Collaborative for Rural Graduate Medical Education [online]. Rural Health Information Hub. Available at: https://www.ruralhealthinfo.org/project-examples/712 [Accessed 25 May 2022]
Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.