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.

TRUST sponsors include:

• 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, underserved communities frequently 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:

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

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

Results

The TRUST program has succeeded in incorporating the instruction of rural health professionals into medical students' educations while longitudinally serving regional and underserved communities. As of 2017:

• 211 TRUST Scholars have graduated since the program's inception in 2008.
• 63% of these graduates matched into primary care residency programs. An additional 20% of TRUST graduates matched into general surgery residency programs which serves as another key workforce need in rural communities.

The following articles offer a glimpse into how the TRUST program is impacting specific medical centers:

• 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.
• 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, Assistant Professor of Family Medicine, Director
TRUST Program
206.685.9497
kardok2@uw.edu