States involved in the program are Washington, Alaska, Montana, Idaho, and, most recently, Wyoming.
T he program began in the 1970s in response to the then-critical shortage of physicians, especially physicians practicing in rural areas. The Northwest states had a unique problem. These states account for one-fourth of United States land mass, but their populations were inadequate to build medical schools. Medical school dean Robert Van Citters worked with other administrators and legislators to pioneer an experiment in which the University of Washington School of Medicine was to serve as the focus of medical training for the four-state region. They would complete their first year of basic studies at their state institution, come to the UW for their second year, and then have the option of spending much of their clinical third and fourth years in rural community settings.