Our curriculum was designed to meet the needs of family physicians that practice in remote and isolated Alaskan communities. Alaskan bush communities differ greatly from many rural communities of the lower 48 states and our areas of emphasis reflect this. We encourage our residents to think freely so they will feel comfortable managing patients without rapid specialist access other than by telephone. Our faculty, who all have longstanding experience with the Alaskan rural and urban needs, continually revise and improve the curriculum based on the needs and input of the residents. The close faculty resident relationship has helped to maximize resident learning while minimizing those parts of the curriculum that are ineffective in meeting their goals.