GME funding - To my knowledge, no rural community, rural physician, or rural hospital has received funding for rural rotations from GME. The only exceptions may be large rural hospitals or hospital networks that own the rural clinic involved, but these are very few. GME funding is possible, depending on the arrangements, but it will be slow in coming. Some favoritism may be shown training in Community Health Centers of Federally Qualified Centers, given past experience. Congressional offices may be able to help in this process. Types of Rural GME programs.
State Funding Some states provide funding for residency slots through central FP offices, Offices of Rural Health, AHECs, or special line item funding. Sometimes this is based on rural training. The most needy rural states should respond to efforts in this area. Conversion of existing slots to rural GME also makes sense, even in some of the more populated states. Programs with a rural track record could go back to the state for support in times of need or when expanding.
Rural Funding from Office of Rural Health Policy http://ruralhealth.hrsa.gov/funding/
Bureau of Primary Care/Primary Care Associations Some programs work with Community Health Centers and some programs are funded CHCs. There is new money each year for CHCs, but you would need to work closely with the State Dept of Health and the Bureau of Primary Care for a 2-3 year period. You would also need to be in a federal shortage area and it is likely that you would have to be networked in to an existing CHC network. CHCs have a board that governs the clinic and it is made up of at least 50% board members who are patients of the clinic. http://bphc.hrsa.gov/Grants/Default.htm
New AHEC and HCFA funds usually take some time. AHECS are usually more interested in students of all types, rather than residents as past studies have shown. HCFA funds some innovative projects, but usually relies on the regular GME funding. With the BBA, it is difficult to start new rural programs. List of AHECS http://www.hrsa.gov:80/terrorism/Basicahec.FY01.htm
Foundations also have more narrow definitions for what they will fund. A straight service provision is not as attractive to them as "interdisciplinary" or "COPC" was in recent years. They will always look at requests for funding, but usually these are better done through folks that have worked with them in the past in similar areas. Rural and minority makes good sense, working with native tribes or predominantly Black or Hispanic communities would be a good idea. This is fundable, with a lot of work, from certain foundations. See links to various resources above.
Local Funding Since you will be delivering services and possibly call, would make that a part of the negotiation process. Our rural rotations do this. We have second or third year residents (depending on the site availability) do rotations. We have 4 sites at a time for 3 years each. The sites are based on need, willingness to teach, and support of the training in terms of stipend, benefits, housing and travel. Sites wait for years on a list. Since sites can depend on a steady flow, they often hire an extra office nurse. Since we pick sites with 2-4 docs that are 1-2 docs short, the residents see 15-20 patients per day, building confidence and efficiency. They share call equally with the local docs, with a backup doc. If residents will commute out, the negotiation will depend on the need and your ability to deliver services on a regular basis. THE McLENNAN COUNTY PROGRAM, money saved vs money earned
RTT residents provide a fair amount of services for the clinic or for physicians during rotations. Resident services can provide funding directly. Specialty physicians also benefit from the assistance with patients at clinics or the hospital.
Some medical societies have acted as a funding and supervision resource (see McLennan Co. Med Ed and Rsrch). This is a possibility for the right community to build physician and financial support as well as work with the city, county, or other sources of funding and training experiences.
Rationale for Funding RME By the numbers: Rural Doctors and Rural Economies