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 rural areas and 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 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 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
• WA AHEC Scholars Program

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

Results

Since 2008, 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 2024:

• 266 TRUST Scholars have graduated since the program's inception in 2008.
• 64% of these graduates matched into primary care residency programs. An additional 8% of TRUST graduates matched into General Surgery, 5% matched into Psychiatry, and 5% 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.
• "Newport hospital welcomes newest doctor," Bonner County Daily Bee, 2024
• TRUST Program celebrates 10 years of training rural Idaho physicians, Idaho Capital Sun, 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).
• "On the Air: Medical Students Shine in Radio Program," Gonzaga University, 2024

Challenges

TRUST is a growing program, which means that significant resources and increasing coordination are required at each of the WWAMI sites. A somewhat decentralized network of campuses, clinics, faculty, and staff must work together to achieve the goals of the program equally across regions that vary in size, need, and demographics. Additionally, the TRUST program is not immune to changes in federal and state policies, and this has forced program administrators to adapt to changing guidelines as they come from government agencies and from the University of Washington at large. Staff and faculty have been nimble and resilient, showing that the future of the TRUST program remains strong.

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

Frank Batcha, MD, Interim TRUST Director
TRUST Program
batchf@uw.edu