The notion of what constitutes a high-quality work-integrated learning experience has received increasing attention in the literature, particularly over the past decade. To date, the definitions of high-quality work-integrated learning have been broad and there remains a need to understand how elements of quality can be operationalized, particularly in niche settings. This paper describes an approach to developing a high-quality work-integrated learning program drawn from the experiences of a team of tertiary academics in the field of rural health. The design approach and quality assurance methods of a rural work-integrated learning program are discussed, including some of the preliminary outcomes. This paper demonstrates the complicated and complex nature of designing work-integrated learning programs in rural health environments. It is intended that this work will provide guidance to others seeking to create similar programs in rural contexts.