RRPD Program Funds Start-Up Costs for New Physician Residency Programs That Train Doctors for Rural Practice

HRSA's Federal Office of Rural Health Policy offers up to $750,000 over three years to organizations building new, accredited rural physician residency programs in six qualifying medical specialties: family medicine, internal medicine, preventive medicine, psychiatry, general surgery, and obstetrics and gynecology. Applications are due July 8, 2026. A Maternal Health and Obstetrics pathway provides a focused track for programs training physicians in rural obstetrical care, including family medicine programs with enhanced obstetrical training. Every funded program must achieve ACGME accreditation by the end of the three-year period of performance and must have a validated sustainability plan showing it can continue operating through Medicare Graduate Medical Education payments or other stable funding after federal support ends.

Assistance Listing Number: 93.746
Opportunity Identification Number: HRSA-26-047
Funding Agency: Health Resources and Services Administration, Federal Office of Rural Health Policy, Policy Research Division
Application Deadline: July 8, 2026

Eligible Institutional Structures and Geographic Priorities

All domestic organizations are eligible including state and local governments, tribal entities, nonprofit organizations, institutions of higher education, for-profit organizations, and faith-based providers. The programmatic requirement, rather than the entity type, defines true eligibility: the applicant must propose a new rural residency program that is either seeking Accreditation Council for Graduate Medical Education (ACGME) accreditation for the first time or that proposes a Rural Track Program expansion to new rural training sites. Existing accredited programs not proposing new RTP expansions are ineligible.

Greater than 50 percent of resident training time must occur at clinical sites physically located in HRSA-designated rural areas. Applicants must notify the State Office of Rural Health in any state where rural training is proposed and must include a copy of the notification letter with the application.

Financial Mechanics and Match Requirements

HRSA has committed $11.25 million for 15 awards capped at $750,000 per award, funded fully in Year 1 and distributed across three budget periods from September 1, 2026, through August 31, 2029. There is no cost-sharing or matching requirement. Resident salaries and benefits are explicitly unallowable costs. Ongoing operating costs of the residency program are unallowable. The award covers start-up activities: faculty recruitment and development, accreditation-related costs, curriculum development, and similar pre-opening expenses.

Administrative Compliance and Post Award Oversight

Awards operate under 2 CFR Part 200. The program has three required objectives with specific milestones: appointing a program director by end of Year 1 and achieving ACGME accreditation by end of Year 3; finalizing a detailed sustainability pro forma by end of Year 1; and finalizing a graduate outcome tracking plan by end of Year 2. Graduates must be tracked for at least five years after the first graduating class to assess rural retention.

Recipients must collaborate quarterly with the HRSA-funded RRPD Technical Assistance Center and attend an annual two-day program meeting. Sustainability documentation, including letters from hospital chief executives confirming Medicare GME eligibility based on review of cost reports since 1996, must accompany the application and is treated as a required responsiveness criterion. Annual performance reporting covers program milestones, accredited positions, admissions, faculty development, and resident characteristics.