to create new rural residency programs that will 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 (NOFO), rural residency programs are accredited physician residency programs that 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 programs that meet ACGME RTP Designation, including both new programs and permanent complement increases for new rural training site(s) for existing programs. 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 that focus on training to meet significant rural health needs. The eligible specialties in this pathway are 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 training to provide high quality, evidence-based maternity care and obstetrical services in rural areas. The eligible specialties in this pathway are obstetrics-gynecology and family medicine with enhanced obstetrical training. Enhanced obstetrical residency training must provide family medicine residents with extensive clinical experience in comprehensive maternity care, as outlined in ACGME’s program requirements, including dedicated training on labor and delivery and operative obstetrics. These programs must have faculty with clinical expertise to prepare family medicine residents for the independent practice of obstetrics in rural communities.