Currently , residency training is neither detrimental nor helpful to the problems of rural health . Based on four generally accepted “ truths ” about rural health , medical schools should recruit students from rural areas , have them choose family practice as a career , and train them in rural settings . Given no substantial changes in residency training , the following recommendations are made . Develop a consensus definition of “ rural .” Educate rural communities to the purpose of residency training . Residency review committees should support rural rotations of at least six months ; consider the number of residencies at a site irrelevant for accreditation ; judge the quality of the product as the standard of accreditation ; and define teaching competency by other than specialty label . All medical school departments should be involved in seeking solutions to the problems of rural health . New opportunities for funding of rural residency training should be sought . If major changes in residency training are possible , internal medicine , family practice , and pediatrics should merge as a single primary care specialty and for residency training . Only this residency should be considered primary care for residency reimbursement purposes , and only its graduates should be reimbursed for primary care services .