Targeted Rural Underserved Track (TRUST) Program

Description

The Targeted Rural Underserved Track (TRUST) program is designed to train and prepare University of Washington medical students for future careers working in underserved rural areas and underserved small cities throughout Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI). This longitudinal medical school experience matches interested students with expert physician preceptors located in targeted communities across WWAMI, allowing students to become an integral part of the system and form deep connections to their continuity sites. TRUST is centrally administered through the University of Washington School of Medicine (UWSOM) Office of Rural Programs.

TRUST seeks to provide a continuous connection between underserved communities, medical education, and health professions in the WWAMI region. The program's goal is to create a full-circle community by guiding qualified students through a special curriculum that connects communities to the UW School of Medicine and its network of affiliated residency programs in an effort to help meet the workforce needs of the region.

The TRUST program has received support from:

• Washington Academy of Family Physicians and its Foundation
• Montana WWAMI Medical Education Program
• Washington Area Health Education Centers
• Idaho Medical Association
• University of Washington Department of Family Medicine
• University of Washington School of Medicine

The TRUST Program was originally funded by 2 Health Resources and Services Administration (HRSA) Title VII Grants.

Services offered

This unique curriculum connects underserved WWAMI communities to the University of Washington School of Medicine and affiliated residency programs. A separate admissions process allows selected students to gain experience and build relationships with specific rural communities or small cities over the course of the student's medical school career.

TRUST is connected with existing courses and programs at the University of Washington, such as:

• Rural/Underserved Opportunities Program (RUOP)
• WWAMI Rural Integrated Training Experience (WRITE)
• Underserved Pathway
• WWAMI AHEC Scholars Program

The TRUST Continuum shows students' involvement in TRUST throughout their medical school careers. (Some programming is dependent upon regional availability.)

Results

For the last sixteen years, the TRUST program has had a positive impact on the region. A key feature of the University of Washington's efforts to address workforce shortages, TRUST has allowed for regionally based students to earn an M.D. while remaining close to home and in the communities that need providers most. As of 2023:

• 235 TRUST Scholars have graduated since the program's inception in 2008.
• 64% of these graduates matched into primary care residency programs. An additional 9% of TRUST graduates matched into General Surgery, 5% matched into Psychiatry, and 4% matched into Obstetrics and Gynecology residency programs - serving key workforce needs in rural communities.

The following articles offer a glimpse into how the TRUST program's efforts are received by students, preceptors, and regional partners alike:

• Kardonsky, K., Evans, D.V., Erickson, J., & Kost, A. (2021). Impact of a targeted rural and underserved track on medical student match into family medicine and other needed workforce specialties. Family Medicine, 53(2): 111-117.
• Guest Opinion: The physician who saved my life is now my medical school mentor, Billings Gazette, 2023
• TRUST Program celebrates 10 years of training rural Idaho physicians, Idaho Capital Sun, 2022
• Guest Opinion: Local student gives back … one patient at a time, Idaho County Free Press, 2022
• Meet University of Washington School of Medicine Student Brian Cedeño of the #Husky100, YouTube, 2022
• Keen, M., Bienz, D., Keys, T., Schaad, D., & Evans, D. (2019). The WRITE stuff: A rural longitudinal integrated clerkship addresses workforce needs. Journal of Regional Medical Campuses, 2(5).

Challenges

Since the TRUST program is somewhat decentralized, it requires significant resources from each WWAMI site. In addition, as the program grows, it takes more time to provide ongoing coordination as well as balance the celebration of differences against maintaining consistency.

Replication

To learn more about the TRUST program, visit:

• The Information for Applicants section to see the qualifications for applicants applying to the TRUST Program.
• The Curriculum section for an overview of the program's academic timeline.
• The Q&A section for answers to commonly asked questions relating to the program.

Contact Information

Kim Kardonsky, MD, Clinical Assistant Professor & TRUST Program Director
TRUST Program
kardok2@uw.edu