BILLINGS — In 2008, in an effort to ensure health care in the rural and underserved pockets of the state, the Montana Targeted Rural Underserved Track (TRUST) was created.

It uses an innovative four-year rural and underserved medical school curriculum as its foundation and selects a group of five Montana WWAMI students. Prior to starting medical school, these students engage in a two-week experience that matches them with a mentor and a community they will continue to connect with during the next four years.

In the first and second year of medical school, students take a class in rural health care. TRUST students participate in a special health policy journal club and participate in evening sessions with a select group of rural and underserved providers from around Montana.

In the summer between the first and second year of medical school, the students return to their TRUST site to complete the one-month experience, which includes a short community-based research project. TRUST students in the second year move to Seattle and participate in an Underserved Pathway, which allows students to focus on the care of underserved populations throughout medical school. In the third year of medical school, students return for the fifth time to their TRUST site to complete a five-month experience in rural and underserved medicine.

The goal of the TRUST program is to select students with rural and underserved backgrounds who are most likely to return to these areas. The students are also encouraged to choose specialties that serve those areas, generally a primary care specialty such as family medicine, internal medicine and pediatrics.

“This is a very innovative program,” said Dr. Jay Erickson, assistant dean of the Montana WWAMI Clinical Office.

It draws on successful programs already within the University of Washington School of Medicine as well as drawing upon successful aspects of other rural medical education programs nationally and internationally.

“The TRUST program highlights the commitment that the Montana WWAMI program is making to help meet the physician workforce needs in Montana,” Erickson said.

Over the 37 years of the Montana WWAMI program, at least 40 percent of graduates who practice have returned to Montana, Erickson said. Nationally the state return rate for public medical schools is 39 percent. When you add the graduates from other WWAMI states who return to practice in Montana the overall return rate is 55 percent.

“We hope with the changes we are initiating in the Montana WWAMI program this return rate will improve especially in the specialties and areas where there are needs,” Erickson said.

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