Qualtrics Survey | Qualtrics Experience Management

Rural PDU is a learning community sponsored by the Rural Medical Training Collaborative (RMTC), to bring together new physician leadership at rural programs, especially those at new and developing rural residency programs. All rural residency physician leadership (PD, APD, Site Director, other) are welcome to apply. The group size will be limited and selection is based on number of applications and diversity of program representation. Participants must be willing and able to actively participate in a one-hour monthly meeting on the Second Wednesday of the month at 12:00 pm CST (1:00 pm EST, 11:00 am MST, 10:00 am PST). Cost for participation is $250 for individuals from a participating program within the RMTC, and $500 for individuals whose residency programs are not participants of RMTC. Fees will be due prior to beginning the program. Applications are open through August 9th.

If you are interested in participating, please complete the following information:

First name:

Last name:

Credentials

MD
DO
Other (participation limited only if extra space available)

Role:

Program Director
Associate Program Director
Site Director
Other

Length of time in the role:

Less than one year
1-2 years
3-4 years
5 or more years (may only be approved through special consideration)

Email address:

Residency Program Name:

Sponsoring Organization:

City:

State:

Zip code:

Program type:

Rurally located Program - minimal urban experience (3 months or less training in an urban area)
Rural Track Program (including legacy RTTS) - at least 3 months of urban experience and greater than 50% training in a rural location, considered by CMS as a "rural track program" if it meets the OMB definition of micropolitan or non-CBSA
Urban Program with a Rural Track - a defined track for selected residents who spend greater than 50% of their residency training in a rural location, also considered by CMS as a "rural track program" if it meets the OMB definition of micropolitan or non-CBSA
Urban Program with a Rural Pathway - a structured sequence of rural training experiences for select residents, but less than 50% of total training
Urban Program with a Rural Focus - as indicated by a mission statement and at least 2 months of required rural experience; also termed in the literature as "rural centric"
Urban Program with Rural Outcomes - as measured by greater than 35% of graduates, or more than 3 residents a year on a three-year rolling average, locating in an initial rural place of practice
Rurally Invested Program - any other program who chooses to join The RTT Collaborative and pay an annual participation fee, e.g. a health equity track or fellowship
Other

How long has your program had residents:

Developing (no residents yet)
1-2 years
3-4 years
5 or more years

How many total residents are in your program and at your site (ex. 5-5-5 program = 15 Program residents; a 1-2 RTP with 2 residents per class = 4 Site residents):

Program Total
Site Total (if applicable)

Do you have the ability and support from your program to participate in monthly interactive meetings on the 2nd Wednesday of the month at 12:00 pm CST (1:00pm EST, 11:00am MST, 10:00am PST)?

No
Maybe
Yes

Why are you interested in participating in the the Rural PDU learning community?