Abstract
PURPOSE: Rural family medicine residency programs (RFMRPs) encounter unique hardships that threaten their sustainability and efficacy despite their recent success at addressing the rural physician shortage. The aim of this study was to explore strategies employed by RFMRP program directors from across the United States to strengthen their programs in the context of evolving paradigms in graduate medical education (GME). METHODS: The authors conducted a qualitative semistructured telephone interview with 19 program directors of RFMRPs in June and July of 2020. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic content analysis. FINDINGS: Two major themes emerged: (1) community enrichment and (2) the ability to evolve to meet demands. Community enrichment had five subthemes: evaluate local resources, prioritize community buy-in, design a robust continuity clinic, identify or cultivate a local physician champion, and support faculty and physician preceptors. Programs evolving to meet demands had four subthemes: frequently revisit program mission to align with scope of family medicine, redefine expectations in medical education, integrate longitudinal experiences, and implement innovation in curriculum design. CONCLUSIONS: Community enrichment and programs' ability to evolve to meet demands are important attributes of a successful RFMRP. Our findings highlight strategies utilized by RFMRPs to help meet the needs of the changing landscape of rural family medicine GME and help identify best practices for developing RFMRPs.