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Substance use disorders are debilitating disorders with far reaching effects. However, many healthcare providers do not receive sufficient training on how to identify or respond to individuals who are at risk for SUDs. Because of this, residents of rural communities, who are served by fewer healthcare providers, are unlikely to encounter providers who are trained to respond effectively to SUDs. SBIRT is a tool used to intervene among patients engaging in risky substance use. Although numerous SBIRT training programs exist across the country, most have focused on relatively small groups of trainees, and have prioritized the training of mental health professionals. In response to this finding, we implemented a large-scale SBIRT training program designed to prepare approximately 540 medical students to meet the needs of patients at risk for or suffering from SUDs in West Texas. In this paper, we focused on medical student perceptions of the quality and utility of our SBIRT educational initiative. Student evaluations of the SBIRT training remained high across three cohorts of second-year medical students. The goal of this report is to provide recommendations to help enable any group to develop, adapt, and implement large-scale SBIRT training programs in other locations. [ABSTRACT FROM AUTHOR]