Rural regions face emergency medicine (EM) physician shortages. Most training programs are located in cities and lack rural clinical experiences, didactics, and mentorship to excite and prepare residents for rural EM practice. There is limited data on optimal training methods for preparing residents for rural practice. To address this need for rural EM training and workforce, we developed a rural EM curriculum. We began with a two-year case review from critical access emergency departments.  Rural EM skills were defined and taught using lectures, simulation cases, and clinical rotations. We obtained quantitative and qualitative feedback from the first ten residents participating in the curriculum. Qualitatively, 10/10 residents gained new skills and found these experiences valuable to their training and career choice, with 100% expressing interest in rural practice and 75% choosing a rural practice. Quantitatively, residents managed a greater variability in patient acuity and volume and performed a greater variety of procedures compared to their academic center rotations, all while gaining unique skills from the challenges of a rural environment. Focused rural emergency medicine clinical experience and didactic training during residency are a promising approach to bridge the gap between urban tertiary care training programs and rural emergency care needs.