Physicians of all types are in short supply, with the shortage particularly acute in primary care and general surgery. As the site of the only surgery residency program in the state, Oregon Health & Science University's Department of Surgery has long been aware of the critical need for general surgeons to provide emergency and elective surgical care for those who live in remote areas and to support small rural hospitals whose survival depends on the presence of a surgeon. Based on our experience over the past 7 years, we believe that residents will benefit from a training program that provides extensive exposure to procedures unique to a rural practice. The objective of the training program is discussed in the article.