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Building a Rural LIC in an Accelerated Curriculum: Hubs, Spokes, Flat Tires, and 
Hovercraft 
Jacob Prunuske MD, MSPH; Heather Roth; Ellen M. Schumann, MD, MS; Lisa Dodson, MD 

z.umn.edu/JRMC
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Jacob Prunuske MD, MSPH; Assistant Dean for Clinical Learning, Associate Professor of Family & Community Medicine, Medical 
College of Wisconsin – Central Wisconsin; jprunuske@mcw.edu 
Heather Roth; Education Program Manager, Medical College of Wisconsin – Central Wisconsin; hroth@mcw.edu 
Ellen M. Schumann, MD, MS; Central Wisconsin Integrated Clerkship Director, Medical College of Wisconsin – Central Wisconsin; 
eschumann@mcw.edu 
Lisa Dodson, MD; Campus Dean, Professor of Family & Community Medicine, Medical College of Wisconsin – Central Wisconsin; 
ldodson@mcw.edu 
 
All work in JRMC is licensed under CC BY-NC  

Volume 2, Issue 3 (2019)             Journal of Regional Medical Campuses         Abstract 

Building a Rural LIC in an Accelerated Curriculum: Hubs, 
Spokes, Flat Tires, and Hovercraft 
Jacob Prunuske MD, MSPH; Heather Roth; Ellen M. Schumann, MD, MS; Lisa Dodson, MD 
 
Topic:  
 
Across the country there are geographic maldistributions of physicians. Many regional campuses have a mission to meet local 
workforce needs. Regional campuses must balance comparability with the institution’s main campus curriculum with sufficient 
innovation to meet the regional campus mission.  Clinical training in a rural environment has many challenges, including limited 
access to specialty physicians, a greater proportion of health care delivered in the outpatient setting, lower patient volumes, fewer 
preceptors, increased travel time, and communication challenges for academic and administrative aspects of clinical experiences. 
The Medical College of Wisconsin – Central Wisconsin (MCW-CW) offers an accelerated curriculum that allows progression from 
matriculation to graduation in 3 years, includes a 4-year option, and has a distributed model for clinical training. In this session, we 
presented the challenges of development and implementation of a rural longitudinal integrated curriculum at an accelerated 
regional campus, described how these challenges are being addressed, and discussed future plans and implications for other 
institutions. 
 
Short Description:  
 
Across the country there are geographic maldistributions of physicians. Many regional campuses have a mission to meet local 
workforce needs. Regional campuses must balance comparability with the institution’s main campus curriculum with sufficient 
innovation to meet the regional campus mission.  Clinical training in a rural environment has many challenges, including limited 
access to specialty physicians, a greater proportion of health care delivered in the outpatient setting, lower patient volumes, fewer 
preceptors, increased travel time, and communication challenges for academic and administrative aspects of clinical experiences. 
The Medical College of Wisconsin – Central Wisconsin (MCW-CW) offers an accelerated curriculum that allows progression from 
matriculation to graduation in 3 years, includes a 4-year option, and has a distributed model for clinical training. In this session, we 
presented the challenges of development and implementation of a rural longitudinal integrated curriculum at an accelerated 
regional campus, described how these challenges are being addressed, and discussed future plans and implications for other 
institutions. 
 
Four questions that were posed to/considered by session participants: 
 

1) What unique challenges are associated with an accelerated curriculum? 
2) What are common challenges of clinical training in rural settings? 
3) What are the advantages and disadvantages of a longitudinal integrated clerkship in an accelerated curriculum? 
4) How might other institutions benefit from lessons learned in creating a rural longitudinal integrated clerkship in the context 

of an accelerated curriculum? 
 
Three take home points from our session: 
 

1) Developing, nurturing, and sustaining relationships at all levels between campus and community partners, preceptors, 
institutions, and communities is essential. 

2) Each training site is unique, and schools should seek to identify and respond to local needs and take advantage of local 
strengths.  

3) Flexibility in scheduling and an emphasis on competency achievement, rather than time, helps ensure comparable 
educational experiences across sites