new rural residency programs that will ultimately be sustainable long-term through viable and stable funding mechanisms, such as, Medicare, Medicaid, and other public or private funding sources. For the purposes of this notice of funding opportunity, rural residencies are accredited allopathic and osteopathic physician residency programs that primarily train residents in rural training sites for greater than 50 percent of their total time in residency, and focus on producing physicians who will practice in rural communities. This includes ACGME RTP designation Types 1 and 2. There are two pathways for this program: General Primary Care and High Need Specialty Pathway and Maternal Health and Obstetrics Pathway. General Primary Care and High Need Specialty Pathway: This pathway supports the development of new rural residency training programs in family medicine, internal medicine, preventive medicine1, psychiatry, and general surgery. Maternal Health and Obstetrics Pathway: This pathway supports the development of new rural residency programs with a focus on obstetrical training to broaden residents’ training and scope of practice to provide high quality, evidence-based maternity care and obstetrical services in rural areas: (1) obstetrics- gynecology rural residency program or RTP, or (2) family medicine rural residency program or RTP with enhanced obstetrical training. Enhanced obstetrical residency training must provide family medicine residents with extensive clinical experience in comprehensive maternity care, including dedicated training on labor and delivery and operative obstetrics. These programs must have the faculty clinical expertise to prepare family medicine residents for the independent practice of obstetrics in rural communities.