Mark Deutchman, MD, shows off custom made Rural Program belt buckles, which he makes with students each year. Photo by Melissa Santorelli.

20 YEARS OF RURAL MEDICINE TRAINING

Mark Deutchman, MD, saw an opportunity for students and rural Colorado, and it’s paying off for the communities that need it most.

By Kara Mason

October 2025

It all amounts to a big difference for the communities where these students train and then settle, especially as strains on rural health care resources intensify. Rural areas in Colorado are more likely to have insufficient access to primary care, maternity care, and mental health care.

For rural and frontier communities that work with Deutchman and the CU School of Medicine, the Rural Program is a lifeline and a chance to prepare the next generation of healers serving small towns across Colorado and the nation.

THE BEGINNING

Prior to joining the CU School of Medicine, Deutchman took his first teaching job in Tennessee and before that he was a family medicine physician in rural Washington state. In academia, he started noticing there weren’t enough resources for training students to work in rural communities, just as he had done.

“The problem was that once a student gets to the academic health center, the focus is very urban and subspecialty, and so there really wasn't anything that would identify people who are interested in rural health and nurture that interest through their training. So, 20 years ago, we came up with this idea of starting a rural track in the CU School of Medicine as an elective.”

Deutchman and then-Associate Dean for Rural Health Jack Westfall, MD, MPH, wrote a grant to the Colorado Trust for funding that allowed extra time with students who were interested in rural medicine. The funding was granted, and the rural track was born, paving the way for other tracks, too.

Now, two decades later, the track is a full program with 68 students, comprising about 10% of each class of CU medical students. In 2025, the Rural Program matriculated 15 students into residency programs and accounted for 44% of CU’s overall family medicine match.

“We identify students  through the admissions process who are interested in pursuing a career in a rural area, and we  get together with them through their pre-clinical years. We talk about how health care is provided in rural places and bring a rural focus to what they  are learning in medical school,” Deutchman says. “We  work particularly on getting them additional rural clinical experience during their clinical time .”

“We're not trying to be for everybody, we're just looking for the people  who want us,” he adds. “Gradually, this idea grew in enthusiasm, and then when the School of Medicine changed to a new curriculum, we became a program rather than just a track.”

BEYOND THE CLINIC, INTO THE COMMUNITY

Rural program students have the same learning objectives as those based full-time on the CU Anschutz Medical Campus – “bread and butter medicine,” as Deutchman calls it. But the clinical focus set the program apart.

“Our students tell us that they get increased clinical responsibility because they're basically part of a smaller team,” he says. “Students have an opportunity to follow patients through transitions of care because they’re in a smaller system. If a patient comes into the clinic and gets sent to the hospital or is seen in the emergency department and is sent to the clinic or has surgical consultants involved in their care, our students can be involved in the continuum of care quite readily.”

With the program, students spend nine months in one of 20 rural communities where they get their core clinical experience. They work in hospitals and clinics from La Junta on the eastern plains to Cortez near the Four Corners, Wray in Eastern Colorado, and Craig in the Northwest.

Michael Nocek, who did his clinical training in Gunnison in 2024, is already dreaming of days when he gets to call mountain town medicine his full-time job.

“It’s my goal to come work somewhere on the Western Slope. I like orthopedics. I like sports medicine, so I’m just trying to set myself up for that path,” says Nocek, who is currently taking a research year in Vail.

Rural medicine often goes beyond the clinic or hospital. For Nocek, it led to new experiences, friends, sitting on a local nonprofit board, and becoming part of a community.

“In my first weeks, I went to a local football game with the pediatrician I was working with because I wanted to get involved in the community,” he says. “My fiancé was visiting and we were both just like, ‘Wow, I wish we could fast forward,’ because this is what it could be like when we’re done with training. That’s been the motivation. It was validating that I could see the end product and that it felt right.”

That enthusiasm from students is evident to community partners. Contagious, even.

Arlene Harms, CEO at Rio Grande Hospital and Clinics in Del Norte, says having Rural Program students takes away some of the recruiting burden, because they already want to be there.

“When we do general recruitment to bring a physician in, if they’re from a bigger town, rarely do they understand the difference in rural living. For us, it’s always harder to find that person that will be committed and as passionate about the community and that their spouse and family will be as comfortable living here, too,” she says. “So, it does become extremely difficult sometimes.”

Harms spent a year hiring for an emergency department physician and seven months recruiting for a position in South Fork, a small community about 16 miles from Del Norte. Rio Grande Hospital serves a population of about 30,000 in southern Colorado, which is three times the permanent population, because it counts people during peak season in the summer. The surrounding mountains in the San Luis Valley bring in tourists who also need medical care.

Today, there are four rural program graduates on staff at the hospital in Del Norte. For Deutchman, this is part of his legacy. Previous students are now becoming mentors in rural communities across Colorado and growing the Rural Program the way Deutchman always hoped for.

“When a physician moves from predominantly seeing patients to teaching, they lose the satisfaction of seeing patients and seeing their outcomes. For me, that was delivering babies and seeing the kids grow up. What replaced that is the students. I have students instead of patients. I'm seeing students grow up,” he says.

TACKLING CHALLENGES HEAD-ON

The Rural Program is often a bright light in an era of dim news for Harms and others who manage and work in small communities across Colorado.

The American Medical Association estimates that about 65% of rural areas have a shortage of primary care physicians. Financial constraints, low patient volume, and recruitment all make difficult circumstances even more challenging.

“Essentially, all rural and frontier counties are facing primary care shortages,” the State Office of Rural Health reported in 2024. “This is compounded by the difficulty of recruiting and retaining providers to practice in rural communities and a large portion of rural doctors nearing retirement.”

The communities face other challenges, too. Two-thirds of counties in Colorado are considered rural or frontier, based on population, and experience higher Medicaid and Medicare rates, fewer insurance options, higher drug overdose rates, more maternal care deserts, and a host of other challenges, like education and economic stability, that make it more difficult to obtain health care.

Colorado lawmakers have acknowledged these challenges. In 2022, the legislature passed the Colorado Rural Healthcare Workforce Initiative, legislation that Deutchman and his team wrote with the help of the CU legislative team. 

The Initiative shares the successful practices developed by the Rural Program with 14 other health professions training programs at public institutions across Colorado.  These include the PA program, public health, dental medicine, one behavioral health program and nine nursing programs. Lawmakers guaranteed $1.2 million annually to support the initiative, which is directed by the Rural Program team faculty and staff. The Rural Program also receives significant funding through the CU School of Medicine, the Department of Family Medicine, and has received  philanthropic gifts from organizations such as the Colorado Trust and Colorado Health Foundation, federal grants, and private supporters.   

Still, finding additional funding has become a top priority for Deutchman. When asked what his vision is for the future of the Rural Program, he says: “We have a terrific group of faculty and staff and support from the Department of Family Medicine and the CU School of Medicine to continue the educational work. The next step is to establish a center for rural health at CU to expand our advocacy, community engagement and research efforts.

Advocacy for rural healthcare is important. 

Urban areas depend on rural areas for food, air, water and recreation. Urban dwellers expect healthcare to be available to them when they visit a rural community.  Health care is always a significant economic driver in small communities and one of the biggest employers. The Colorado Rural Health Center estimates that one rural physician’s employment creates nearly $1.4 million in income from the clinic and hospital and creates approximately 26 additional jobs.

“Few people have been as committed as Mark to continuing access, and good access, in places like this,” Harms says of Deutchman. “These students give us hope for the future.”

“They’re committed and they know what they want, which is to be part of the community and to help. They jump in and learn,” she adds.

As Deutchman steps closer to a full retirement, the challenges that face rural Colorado don’t become any less – but he’s increasingly confident, as is Harms, that communities will be better off thanks to students who are preparing to be an integral part of their smaller communities.

“History has shown that frontier and rural hospitals will do everything they can to remain sustainable for their communities,” Harms says. “These places are seldom money over mission, and so when the money gets tight or the reimbursements get tight, we just have keep focusing on giving good care to our patients. I’m always proud that the students we receive from the Rural Program understand that and how well grounded they are when they get here.”