Purpose
The Northern Medical Program (NMP) is developing a new blended clerkship, the Northern Regional Integrated Clerkship (NRIC). A recent update to the University of British Columbia MD Undergraduate Program’s (MDUP) social accountability statement, in response to a new accreditation requirement, emphasizes that rural and Indigenous peoples are priority populations for our program. The NMP is the most rural of the sites within the provincially distributed MDUP, and has a higher per capita population of rural and Indigenous peoples within its region. We have both a need, and an opportunity, to provide better training in rural generalist medicine.

Methods
NRIC combines a 6-month longitudinal integrated clerkship in rural communities across the north, with a 6-month hospital rotational clerkship, to provide the best possible training of physicians for the needs of the north. This includes ensuring our learners are taught rural generalist medicine and experience longitudinal care in northern communities.

Results
To ensure the success of this new model we’ve conducted extensive community consultation, and our first pilot occurred during the 2024-25 year. Feedback from students to date indicates they see benefits to the program, but are somewhat reluctant to be in a small town without connection to their classmates. We’re studying the learning and community immersion experiences of the first pilot with the support of our Evaluation Studies Unit, and we’re also conducting research into the students’ experiences of learning how to navigate overlapping relationships.

Conclusion
A lack of skill in setting boundaries within overlapping relationships contributes to retention issues. Through the development and implementation of NRIC, we hope to produce more physicians with the skills and interest to succeed as rural generalists, serving rural and Indigenous populations in the north. In addition, we hope to gain insight into how to best prepare our learners for success in such experiences.