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Rural Health Information Hub

Targeted Rural Underserved Track (TRUST) Program

  • Need: There is a shortage of rural physicians in the Northwestern United States.
  • Intervention: University of Washington medical students are receiving training through the TRUST program in rural, underserved communities across a five-state radius.
  • Results: Long-lasting connections have been formed among regional and underserved communities, medical students, and rural health professionals, with the goal of producing more rural physicians.


TRUST Logo 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:

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:

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

TRUST Continuum 2024


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:

2023 TRUST Leadership Retreat
The WWAMI TRUST Clinical Deans, TRUST Director, and Rural Programs Assistant Dean pose for a photo at the 2023 TRUST Leadership Retreat in Coeur d'Alene, Idaho.


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.


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

Health workforce education and training

States served
Alaska, Idaho, Montana, Washington, Wyoming

Date added
December 8, 2014

Date updated or reviewed
March 15, 2024

Suggested citation: Rural Health Information Hub, 2024. Targeted Rural Underserved Track (TRUST) Program [online]. Rural Health Information Hub. Available at: [Accessed 25 June 2024]

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.