Pierre Rural Family Medicine Residency is a three-year ACGME-accredited program born from the Governor's Primary Care Task Force — created to expand access to primary care across South Dakota's rural communities. We accept 2 new residents per year as a sister program to Sioux Falls Family Medicine Residency, affiliated with the USD Sanford School of Medicine.
Our mission
Evidence-based medicine. Real patient care. Community service. A curriculum built for rural and regional practice, not just any office in any city.
Our story
The Pierre Rural Family Medicine Residency was established to address a critical finding of the Governor's Primary Care Task Force: South Dakota's rural communities need more family physicians. State investment allowed the Center for Family Medicine to develop a second residency program focused on Pierre and the surrounding region.
Our sister program, Sioux Falls Family Medicine Residency, was established in 1973 and has graduated 400+ physicians — with 75% practicing in South Dakota and contiguous states. Year 1 residents train alongside Sioux Falls residents at the Center for Family Medicine in Sioux Falls; years 2 and 3 are in Pierre at Avera St. Mary's Hospital and Avera Medical Group Pierre – MAC Lane.
Research shows most physicians practice within 100 miles of where they train. That makes Pierre — the state capital on the Missouri River — an ideal place to build the rural practice skills South Dakota needs.
By the numbers
Our heritage
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What we focus on
Every rotation, every elective, and every faculty hire ladders up to these four commitments. They're not bullet points — they're the program.
Full-scope
Continuity OB
Residents serve as primary physicians for obstetric patients — from first prenatal visit through delivery and postnatal care — with faculty supervision at Avera St. Mary's and the Center for Family Medicine.
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Certifications covered
ATLS, ALSO, NRP, PALS, ACLS — all covered. You graduate able to do the procedures that rural family medicine requires, not just refer them out.
Rural
Mission-driven
The program was created to address South Dakota's rural physician shortage. Most graduates practice within 100 miles of where they train.
On-site
Part of curriculum
Mental health teaching is woven through the residency curriculum, preparing you for the behavioral health needs common in rural primary care.
Our objectives
Milestones over hour-counts. You progress when you've demonstrated the skill, not when the calendar says so.
Every rotation answers the question: will this prepare you to be the family physician your community needs?
Daily noon conferences and journal clubs build the habit of staying current after residency, not just during it.
Comprehensive care across the lifespan, grounded in current evidence, not just inherited practice patterns.
Newborns to geriatrics. Outpatient continuity, inpatient teams, OB, ED. A genuinely full-scope panel.
Compassionate, patient-centered care for the diverse communities of Pierre and rural South Dakota.
Life in the program
Two residents per class is a deliberate size. Faculty know who you are by the second week, and you're never lost in a crowd. Year 1 integrates with Sioux Falls residents; years 2 and 3 are a tight Pierre team.
Each year the program funds a three-day resident retreat at a nearby resort, selected by the residents themselves. Faculty are explicit about being available — autonomy is encouraged, but you're not figuring things out alone.
Outside the hospital, Pierre is South Dakota's capital on the Missouri River — affordable housing, Lake Oahe recreation, and a community that welcomes residents. South Dakota has no state income tax.
The best way to know the program
An afternoon shadow, a 1-week visit, or a full 4-week elective — we'll match the format to where you are in your training.