Administering a Rural Longitudinal Integrated Clerkship Across 5 US States

Abstract

This article illustrates the administrative structure that has evolved to support a multistate longitudinal inte- grated clinical clerkship (LICC) experience. In 1996 the University of Washington School of Medicine created the WWAMI Rural Integrated Training Experience (WRITE), a five-month rural continuity based LICC experience. WRITE students spend five months in a rural immersion experience with a primary care preceptor. During this time students form continuity based relationships with patients and preceptors, which allows students to develop skills and knowledge re- quired to treat the broad range of medical, surgical, and psychosocial problems found in rural communities. Administration of 21 rural sites across five states is based on a strong partnership between rural practice sites, regional clinical deans'offices, and the departments and dean's office in an academic medical center.We explore the key aspects of the multi-layered administration that has evolved to support the WRITE program. A review of the year-long calendar of the WRITE program illustrates the complexity, detail and components necessary for the administration of this successful program.Rural LICC experiences like WRITE offer a useful approach to meeting rural physician workforce needs. A brief review of the WRITE outcome data will be explored. Administration of a multistate LICC experience requires synchroni- zation of many components, especially a strong regional administrative presence that connects the rural practice sites with the academic medical center.