Veterans Affairs Publishes Final Rule Confirming UIO Eligibility for Placement of Graduate Medical Students

On November 13, 2023, the Department of Veterans Affairs (VA) adopted as final, with changes, a proposed rule amending its medical regulations to establish a new pilot program on graduate medical education and residency (PPGMER), as required by the VA MISSION Act of 2018. The PPGMER is designed to help expand health care access for Veterans in rural, tribal, and underserved areas across the country. It will do so by funding physician residents’ clinical rotations in non-VA health care facilities, prioritizing facilities operated by Indian Tribes or tribal organizations, and the Indian Health Service. No fewer than 100 residents will be placed in these facilities as well as facilities located in communities that the VA Secretary has designated as underserved. The proposed rule provides a framework to establish additional medical residency positions at certain covered facilities. In issuing the final rule, VA stated that § 17.245(f) of the rule already allows VA to consider UIOs as covered facilities for the purposes of PPGMER. Placement of residents at UIOs would be in addition to those residents at IHS and Tribal facilities.

Please click here for the news release announcing the PPGMER.


For more information about the PPGMER, contact Andrea Bennett, Office of Academic Affiliations, Veterans Health Administration, Department of Veterans Affairs, at (202) 368–0324 or

Next Steps

VA will issue a request for proposals (RFP) in Summer 2024 to solicit the interest of graduate medical education (GME) sponsoring institutions and interested health care facilities to partner in establishing resident rotations beginning in July 2025. The Office of Academic Affiliations will hold information sessions for relevant stakeholders about the RFP process prior to its release. UIOs are urged to follow the development of this program closely for its potential to relieve workforce shortages through the placement of medical residents.

We will continue to monitor ongoing implementation of the VA PPGMER and provide updates on how the program impacts urban Indian communities.