The article considers organizational, pedagogical and substantive characteristics of training of medical personnel for rural health care system considering demographic, infrastructural and personnel imbalances. It is demonstrated, on the basis of international and Russian statistics, that shortage of medical personnel in rural areas is determined not only by general level of provision of physicians and paramedical personnel, but also by spatial inequality, labor conditions and limited accessibility of educational and professional trajectories. The evidence-based approaches to rural health care practice are summarized: targeted recruitment and distributed clinical training, simulation training, telementoring, inter-professional models and retention practices. The necessity of integrated ecosystem “education–clinic–community” based on regional requests and telemedicine infrastructure is grounded.

Project ECHO, rural health care, personnel shortage, medical education, distributed clinical training, telemedicine, Project ECHO, staff retention, inter-professional teams.