TRUE Program

Currently, most models for health care delivery in the United States focus on urban-based teams of sub-specialists providing hospital care while primary care physicians provide community-based outpatient care to a geographically dispersed population with limited access to specialty or highly technical care. However, in reality the role of the rural or remote physician goes well beyond provision of community-based outpatient care. Rural physicians are increasingly responsible for patients with needs often outside the scope of the urban primary care physician – providing emergency medical care, obstetric and gynecological service, simple surgeries and care of patients with complex medical needs. The growing opioid epidemic and the rise in mental health challenges requires additional skills as well.

Additionally, the rural and remote physician is also called upon to serve in leadership roles related the community health – providing technical assistance to address community health education and promotion needs, addressing systemic issues related to health care access, troubleshooting and addressing community health issues through quality and performance improvement and provision of leadership to allied health services and organizations locally, to name a few.

In short, the typical physician working in tribal, rural, and/or medically urban underserved communities is asked to serve many roles not typically required of physicians who practice in resource-rich urban or metropolitan environments. In order to better prepare future physicians to fill these roles, medical education must incorporate curricula and learning activities focused on the unique needs of these essential community leaders in health and health care delivery.

Utah is currently in the top quintile of states with a projected primary care physician shortage in 2025 and these shortages are particularly acute in areas that serve tribal, rural and/or medically urban underserved communities (MUC). The aim of the graduate certificate program is to prepare and encourage medical students training in Utah to choose residencies and careers in primary care that serve tribal communities, rural communities, and/or medically urban underserved communities (MUCs) after they graduate. This will be accomplished by supporting the development of medical school curricula, clinical training site partnerships, and faculty training programs, with the goal of educating medical students who are likely to choose career paths in primary care, especially for tribal communities, rural communities, and/or MUCs.