A nonexperiemental design was used to evaluate the quality of new rural-based clinical training sites. Academic performance measures were used to compare RMT participants with their respective non-RMT OSU-COM student population cohorts. Baseline performance was established using medical school admission measures, including undergraduate overall grade point average (GPA), undergraduate science GPA, and Medical College Admission Test (MCAT) scores. At key points in training, RMT participants were compared with their non-RMT peers during preclinical training on the performance of 7 required Comprehensive Osteopathic Medical Achievement Test (COMAT) scores. Mean differences between the 2 groups were assessed using the Mann-Whitney U test. Although the data met the assumption of normality, there was a violation of the homogeneity of variance assumption for at least 2 COMAT comparisons. Additionally, the sample sizes were markedly unequal, so the more conservative Mann-Whitney U offered protection against a type 1 error (ie, rejected the null hypothesis when no effect exists). A P value of .05 or less indicated statistical significance. Effect sizes were computed using the Cohen r and interpreted using the common criteria: small=0.1, medium=0.3, and large=0.5.