BoatCommonly referred to as the "WWAMI experience," rural-community training sites in Washington, Wyoming, Alaska, Montana and Idaho have been a unique part of University of Washington School of Medicine medical education since 1971.

In the second year, residents spend two months at one of five WWAMI practice sites, learning from community pediatricians about primary care in a more rural setting. These practices are located in Port Angeles, Yakima and Bellingham, Washington, as well as in Sandpoint and Pocatello, Idaho. Some residents have also had the opportunity to do this rotation at sites such as Missoula, Montana, and Bethel, Alaska.

Because of the impressive size of the WWAMI region, primary-care pediatricians are widely dispersed, often in sparsely populated areas that do not have easy access to subspecialty pediatric consultative services.

In addition to their primary-care responsibilities, these physicians must frequently provide emergency stabilization and hospitalization of sick children and facilitate occasional transport of children to tertiary centers such as Seattle Children's Hospital.

Other demands on these physicians range from coordinating the input of multiple consultants in the care of chronically ill and physically disabled children to helping design community health services geared toward children.

As an integrated member of a rural clinic, residents have an opportunity to work with these experienced physicians in managing simple to complex pediatric patients.

This unique opportunity provides residents with a firsthand understanding of what it's like to be a practicing community physician away from the resources of a tertiary care center.