There is great variation in the impact of rural rotations on the learner and the site.
Elective rotations are suitable for experiences. They are often used to explore practice sites. All programs should have them available but the quality can vary. Arrangements can be made by telephone, but in person arrangements are more likely to succeed. It's the rural way. Arrangements that are made less formally can result in problems. Preceptors have been known to shirk their duties or even leave for hunting trips when residents arrive, although this is happening less with each passing decade.
Required rotations allow more educational effort. Residents function more like rural physicians. Faculty should definitely visit sites and verify housing, call, and supervision. Initiating a site in a residency may be difficult at the start, but there are steps to take. See Working With Residents to Implement Rural Rotations Sites appreciate residents having billing numbers. Preceptors should document their efforts to avoid audit problems. Having a regular site means less surprises.
1 vs 2 month rotations - any one can isolate for a 2 or 3 week period, but a 2 month rotation forces residents to interact with the community and vice versa. 2 month rotations are also more community friendly as the residents contribute more to workforce as the orientation time is minimized.
Research studies show that the more rural months, the more likely a rural decision.
Community-Friendly rotations stack 6 residents over a 12 month period at a single site, preferably the same site for 3 years.
Getting Resident Acceptance - the key is getting residents out to a good site where they get to do procedures and function much like a "real doc". When they return, they will sell the program.