Further work is needed in identifying strategies to improve rural health services that are most appropriate and cost effective in regions with differing circumstances and needs. Substantial reform of payment systems favoring rural and primary care is essential to the effectiveness of educational reform. (Author/MSE)

The design, curricula, and financing of four existing medical schools' rural training track programs (University of Washington, University of Nebraska, State University of New York/Buffalo, University of Kentucky) are described. The programs are seen as having potential to decrease the shortage of physicians choosing careers in rural areas.…