In the 4th year, students are involved in a 16 week rural preceptorship training. The preceptorship experience focuses on clinical skill development in a rural setting, implementation of a community oriented research or programming project, and a study of the rural community’s social, economic, cultural, organizational, and political structure. There are now 23 sites for this rural clerkship statewide. This element remains the most significant piece of the four-year curriculum, a capstone experience.

While clinical practice remains the focal point of medical education, service learning through community leadership and involvement continues to be a high priority for RMED. Community structure projects remain a requirement and the program is investigating ways that students can do some of this community assessment during their third year of medical training. This will allow the students to better define their Community-Oriented Primary Care (COPC) projects for the preceptorship. Students utilize the IPLAN database to help them identify community topics. During the preceptorship, many community leaders and organizations assist students with their community projects. The purpose of the COPC project is to provide students with an understanding of health care needs and resources in the rural community. It gives students the opportunity to work "hands-on" with healthcare professionals and rural residents in meeting community-defined needs.