Family Medicine Residency Research Articles

Nutrition Training in Medical Education Among Family Medicine Residents in North Carolina

Background This study surveyed family medicine residents in North Carolina regarding the state of nutrition education in their residency training. In addition, the survey explored comfort levels with, and attitudes about, discussing nutrition with patients. Methods We administered an online questionnaire to family medicine residents in North Carolina (n = 384) asking about their history of nutrition training and their current attitudes about nutrition. The 24-item survey included both Yes and No and Likert-scale responses. Results All but one resident had received formal or informal nutrition training during their medical education. Residents overwhelmingly considered nutrition to be an important component of health care, although a majority felt physicians are inadequately trained in nutrition. Feeling comfortable discussing nutrition with patients regarding specific health conditions varied from 45% (gastrointestinal concerns) to 94% (cardiovascular disease) or 95% (diabetes) among residents. Limitations The volunteer sampling method used in the study may limit generalizability of the study findings to a broader population of family medicine residents. In addition, precisely defining “formal” and “informal” nutrition training on the survey questionnaire would help to clarify the role of nutrition education in shaping resident attitudes and practices. Conclusion This study shows that family medicine residents recognize the importance of nutrition education but do not feel adequately trained to provide it to patients. Given the abundance of evidence linking nutrition and health as well as an apparent interest among family medicine residents in nutrition education, this study supports the integration of nutrition training in medical education. Suggestions for how to accomplish this objective are provided.

Evaluating the Effectiveness of Basic Life Support (BLS) and Advanced Cardiovascular Life Support (ACLS) Training for Family Medicine Residents in Saudi Arabia

Evaluating the Effectiveness of Basic Life Support (BLS) and Advanced Cardiovascular Life Support (ACLS) Training for Family Medicine Residents in Saudi Arabia

Scope of Practice Intentions Among Family Medicine Residents for Integrated Care of HIV and Hepatitis C Infection in People With Opioid Use Disorder

Background and Objectives: Because deaths from opioid overdoses have increased in the United States, family physicians are needed who can provide integrated care for a patient with HIV, hepatitis C, and opioid use disorder. We sought to describe the individual and residency characteristics of graduating family medicine residents who intend to practice such integrated care. Methods: We used 2017–2021 data from the American Board of Family Medicine Initial Certification Questionnaire. Our primary outcomes were individual and residency characteristics of resident graduates who intended to provide integrated care. We used logistic regression to assess independent associations with providing integrated care. Results: The response rate was 100% with 18,479 total respondents. After exclusions, our final sample size was 10,660 (57.7%) respondents. Of those, 782 (7.3%) respondents intended to practice integrated care. Using regression analyses, we found that resident graduates who intended to provide integrated care were more likely to be male, non-Hispanic or Latinx. After residency, they were more likely to intend to practice at a federally qualified health center, Indian Health Service, or nonfederal government clinic. Conclusions: Only 7% of residency graduates reported their intention to provide integrated care for people with opioid use disorder after residency. In response to a surging opioid crisis, policymakers, residency educators, and residency funders/sponsors should increase the workforce of family physicians who can provide this integrated care.

A REALIZAÇÃO DO PROGRAMA SAÚDE NA ESCOLA COMO FERRAMENTA PARA PROMOÇÃO DE EDUCAÇÃO EM SAÚDE DURANTE A FORMAÇÃO EM MEDICINA DE FAMÍLIA E COMUNIDADE: UM RELATO DE EXPERIÊNCIA

Introduction: The School Health Program (PSE), announced by the Ministry of Health in 2007, aims to promote health in partnership with educational institutions to improve the quality of life of the population, specifically school-aged children. This involves collaboration between health and education professionals, providing appropriate knowledge to reduce vulnerabilities that may compromise the development and the future of children and adolescents. Objective: To report the experience of a family medicine resident, part of a family health team (eSF) in the Federal District (DF), primarily promoting sexual education for children and adolescents in two public schools within the team's area of coverage. Methodology: This is a descriptive and qualitative study, of the experience report type, conducted during the two years of residency in Family and Community Medicine, from 2023 to 2024, in the satellite city of Sobradinho, Federal District. Results: The students involved, aged between 9 and 12 years, showed great interest in the topics addressed regarding sexuality and hygiene habits, adopting a participatory attitude, engaging in the exchange of experiences, raising questions, and discussing the subjects covered in the meeting and topics detailed in the adolescent health booklet. Conclusion: The necessity of partnership between health teams and education professionals was evident to provide health promotion, especially focused on sexual education, aiming to reduce negative outcomes and minimize future social and health damages in the vulnerable population of the DF.

Family physicians have greater ambiguity tolerance in the clinical context: A nationwide cross‐sectional study

AbstractBackgroundAmbiguity tolerance in the clinical context is increasingly recognized as essential for physicians to work as professionals. However, the relationship between specialty and ambiguity tolerance in the clinical context has been understudied. Here, we investigated the association between specialty and ambiguity tolerance in the clinical context, focusing on differences between family physicians (FPs) and non‐FPs.MethodsWe performed a nationwide cross‐sectional study in Japan. We asked FPs from 14 family medicine residency programs across Japan and non‐FPs from monitors of an internet survey company in Japan to participate in the study. We assessed their tolerance for ambiguity using the Japanese version of the Tolerance for Ambiguity in Medical Students and Doctors (J‐TAMSAD) scale.ResultsIn total, 388 physicians (178 FPs and 210 non‐FPs) completed our anonymous online survey and were included in the analysis. After adjustment for possible confounders (gender and postgraduate years), FPs had higher J‐TAMSAD scale scores than internists/pediatricians, surgeons, and physicians with other specialties, meaning that FPs had greater ambiguity tolerance.ConclusionsThis study reveals that FPs had greater tolerance for ambiguity in the clinical context than non‐FPs. Our findings suggest that there may be a need to increase non‐FP's tolerance for ambiguity specific to the clinical context through educational interventions, since ambiguity is inherent and growing in medicine today. FPs and non‐FPs should work together to complement each other's strengths, rather than simply improving the training of non‐FPs.

Impact of an Inpatient Family Medicine Exposure: Changing Student Perception

Introduction: Currently there is a primary care physician shortage in the United States, and this shortage is expected to worsen into the foreseeable future. In 2023, only 7.5 % of US allopathic graduates entered family medicine (FM) residencies. Opportunities to create increased interest in family medicine as a career choice and address hidden curriculum messages in career choice must be explored to address shortages in family medicine. Methods: A 5-day inpatient experience with family medicine residents on a family medicine inpatient service was implemented during a required third-year core medical student clerkship in family medicine. Students who participated in this clerkship change were invited to complete a survey on how this experience altered their perceptions on the roles of family medicine physicians in inpatient medical care, intrapartum care, and care of the newborn, and how it affected their view of FM as a career choice. Results: Of the eligible students, 34% completed the survey. Participating in the FM inpatient experience significantly enhanced students’ perceptions about the depth of knowledge and skill needed for the specialty, increased students’ respect for the specialty, and contradicted students’ perceptions about the complexity of cases treated in the specialty. Conclusion: Adding an inpatient component to a third-year FM clerkship experience can significantly change the perceptions of medical students about the specialty of FM. Brief inpatient exposure to medical students has an impact on hidden curriculum messaging about family medicine.

Competency of Family Medicine Residents in Performing Skin Cancer Examination.

Early recognition of skin cancer reduces associated morbidity and improves survival. Most patients with suspicious skin lesions present to family medicine physicians. We aimed to evaluate the self-reported competency of family medicine residents in performing skin cancer examination (SCE) and assess the impact of different factors on their competency. All family medicine residents completed a previously validated questionnaire aimed at evaluating their skin cancer examination competency in this cross-sectional study. In total, 250 residents participated in this study. More than half of the residents never had a rotation in dermatology or received training under the supervision of a dermatologist. Approximately 70%, 72%, and 77% of residents had not observed SCE, received SCE training, and performed SCE, respectively. Although most residents were aware of the risk factors for skin cancer and the ABCD acronym for melanoma, only one out of ten residents screened their patients for these factors, enquired about changes in skin lesions, and personally practiced SCE. Only 16% of family medicine residents consider themselves competent in performing SCE. Training under the guidance of a dermatologist, SCE training, evaluating patients for cancer risk factors and any changes in moles, and SCE practice on personal level were associated with SCE competency. Multivariate analysis showed a significant association between the frequency of observing SCE and competency in performing SCE. Only 16% of family medicine residents considered themselves competent in performing SCE. The frequency of observation of SCE during residency was a significant predictor of self-reported competency in performing SCE.

Medical learner perspectives on elements of an educational rural generalist pathway: survey outcomes

IntroductionThe Northern Ontario School of Medicine University (NOSM U) continues to be challenged in meeting its social accountability mandate of addressing the rural health human resource crises in its catchment of Northern Ontario. Its new educational initiative, the Rural Generalist Pathway (RGP) aims to graduate family physicians specifically prepared for rural practice. This study elicits the perspective of NOSM U learners on the various components being considered for this educational pathway.MethodsA mixed methods survey was created for each of two medical learner groups, undergraduate NOSM U students and its family medicine residents. Quantitative data was analyzed for frequencies and percentages and qualitative data underwent thematic analysis.ResultsWith a response rate of 24.6% for undergraduates and 37.9% for residents, the survey discovered undergraduates consider rural clinical rotations as the most valuable experiences in rural medicine. Among the findings, both the majority of medical students and residents (87.3% and 87.9% respectively) agreed that support for a resident’s family well-being and community integration was the element of the pathway most likely to influence them in pursuing the RGP. Mentorship by a practicing rural physician was an element highly supported by 81% of undergraduate and 81.8% of postgraduate learners as likely to influence them to take the RGP.DiscussionIncorporating learner perceptions into the development of the RGP could help focus institutional resources and enhance learner participation in this pathway, producing more rural family doctors to serve Northern Ontario.

Timely radiographic detection of developmental dysplasia of the hip in family medicine residents. Educative intervention

Timely radiographic detection of developmental dysplasia of the hip in family medicine residents. Educative intervention

Three Types of Uncertainty: A Qualitative Study of Family Medicine Residents.

Many past studies have focused on uncertainty in medical practice, yet it is still not well understood in the field of family medicine, especially among residents. The aim of this study was to examine situations in which residents experience uncertainty and the coping strategies they use to deal with it. The results may have implications for advanced training programs and the specialist training in family medicine. We conducted semistandardized interviews with 15 residents and young family doctors from Hesse, Germany and asked them to describe cases in which they experienced uncertainty. In total, 40 cases were reported. Using established methods, we derived a coding system with different categories. Uncertainty occurred in a broad and heterogenous range of cases, and it often involved complex interaction of biomedical, interpersonal, and psychosocial factors. The participants described various strategies that were helpful in dealing with the three different types of uncertainty. To deal with biomedical uncertainty, the residents primarily found information-seeking and consulting more experienced colleagues to be useful. In dealing with interpersonal and psychosocial uncertainty, they applied reflective strategies. Participants suggested open communication and honest dialogue about uncertainty and the thematization of the topic at much earlier stages (eg, during medical studies). Family medicine residents experience uncertainty as an important part of their daily work. They do not necessarily interpret it as a negative phenomenon. Instead, uncertain situations often accompany learning effectiveness and an increase of self-confidence.

Burnout among Nurses, Midwives, and Physicians in Maternity Care Exposed to Traumatic Childbirth Events

Abstract Purpose: To describe the relationship between experiencing traumatic childbirth events and burnout. Study Designs and Methods: This descriptive cross-sectional study used an anonymous online survey to assess traumatic childbirth event exposure and the three independent constructs of burnout: emotional exhaustion, depersonalization, and personal accomplishment. Participants were a convenience sample of registered nurses, obstetric residents, family medicine residents, and attending obstetricians across five hospitals from December 2020 through June 2021. The traumatic childbirth event questionnaire measured the frequency of traumatic childbirth event exposure, perception of severity, and perceived influence on the participant's professional practice and personal life. Results: Data were analyzed from 150 participants. Registered nurses represented the largest percentage of participants (66%). Components of burnout varied according to race and occupation. Asian/Pacific Islanders had significantly higher mean depersonalization scores at 10.1 (SD = 6.0). Resident physicians had the highest emotional exhaustion scores (M = 34.6, SD = 8.8). Traumatic childbirth events perceived influence on practice correlates with personal accomplishments. Yet, no relationship was observed between traumatic childbirth events, emotional exhaustion, and depersonalization. Linear mixed analysis revealed that hospitals account for 7.5% of the variance in emotional exhaustion scores, 11.1% in depersonalization scores, and 1.3% in personal accomplishments scores. Clinical Implications: Maternity clinicians experience burnout at similar rates to those in other specialties. Although traumatic childbirth events are infrequent and not strongly correlated with emotional exhaustion and depersonalization, hospitals should implement effective strategies to support clinicians after such events. Educational interventions can enhance knowledge and resilience, whereas specialized training effectively alleviates burnout. Development of evidence-based strategies that prioritize the wellbeing of clinicians and patients is crucial.

The future of AI clinicians: assessing the modern standard of chatbots and their approach to diagnostic uncertainty

BackgroundArtificial intelligence (AI) chatbots have demonstrated proficiency in structured knowledge assessments; however, there is limited research on their performance in scenarios involving diagnostic uncertainty, which requires careful interpretation and complex decision-making. This study aims to evaluate the efficacy of AI chatbots, GPT-4o and Claude-3, in addressing medical scenarios characterized by diagnostic uncertainty relative to Family Medicine residents.MethodsQuestions with diagnostic uncertainty were extracted from the Progress Tests administered by the Department of Family and Community Medicine at the University of Toronto between 2022 and 2023. Diagnostic uncertainty questions were defined as those presenting clinical scenarios where symptoms, clinical findings, and patient histories do not converge on a definitive diagnosis, necessitating nuanced diagnostic reasoning and differential diagnosis. These questions were administered to a cohort of 320 Family Medicine residents in their first (PGY-1) and second (PGY-2) postgraduate years and inputted into GPT-4o and Claude-3. Errors were categorized into statistical, information, and logical errors. Statistical analyses were conducted using a binomial generalized estimating equation model, paired t-tests, and chi-squared tests.ResultsCompared to the residents, both chatbots scored lower on diagnostic uncertainty questions (p < 0.01). PGY-1 residents achieved a correctness rate of 61.1% (95% CI: 58.4–63.7), and PGY-2 residents achieved 63.3% (95% CI: 60.7–66.1). In contrast, Claude-3 correctly answered 57.7% (n = 52/90) of questions, and GPT-4o correctly answered 53.3% (n = 48/90). Claude-3 had a longer mean response time (24.0 s, 95% CI: 21.0-32.5 vs. 12.4 s, 95% CI: 9.3–15.3; p < 0.01) and produced longer answers (2001 characters, 95% CI: 1845–2212 vs. 1596 characters, 95% CI: 1395–1705; p < 0.01) compared to GPT-4o. Most errors by GPT-4o were logical errors (62.5%).ConclusionsWhile AI chatbots like GPT-4o and Claude-3 demonstrate potential in handling structured medical knowledge, their performance in scenarios involving diagnostic uncertainty remains suboptimal compared to human residents.

6631 A Week With Diabetes: Using Real-Time Continuous Glucose Monitoring In A Simulation Activity With Residents And Fellows

Abstract Disclosure: T. Gallagher: None. C. Donelly: None. R.E. Amori: None. Background: Continuous glucose monitor (CGM) use in managing diabetes mellitus is increasing rapidly. Fellows and residents often prescribe these devices, but most do not themselves have diabetes mellitus and do not use these devices personally. A real-time simulation activity can help physicians in training learn about using the technology in diabetes management and the patient experience living with diabetes mellitus. Objective: Assessing learner’s experiences using a one week real-time CGM simulation. Methods: A real-time simulation using CGM and elements of role playing can enhance knowledge of CGM use and overall diabetes care. Voluntary participants included endocrinology fellows, internal and family medicine residents, and one health professions student. One common structured learning task per day was assigned to all participants over a single seven day period of use in academic year 2022-23. Assessment of each task occurred via personal observations and reflections. Data was collected in an anonymous form and in a group debrief. Results: Eight of 10 participants completed the deidentified post simulation survey and 8/10 participated in the live debrief. Participants reported ease of CGM placement and use. They reported improved insight into the impacts of diabetes on daily activities and increased awareness of diet and exercise impact on glucose levels. Insulin dose calculations were largely correct but errors were seen. All felt the activity was beneficial to their learning. Conclusions: Real-time CGM simulation improves student, resident, and fellow knowledge of the technology and allows the learner to gain insight into a patient’s diabetes self-management. Presentation: 6/3/2024

Orthopedic Injections: A Longitudinal Musculoskeletal Curriculum in a Family Medicine Residency.

Musculoskeletal (MSK) complaints comprise more than 20% of all visits to health care providers each year. Despite required experiences in MSK care, family physicians report low confidence in diagnosing and treating MSK conditions. The purpose of this study was to analyze the effects of early and longitudinal exposure to MSK education on residents' confidence in and likelihood of performing MSK physical exams and injections in future practice. From 2017 to 2019, residents completed an annual survey assessing confidence in, frequency of, and future intentions to perform exams and injections for MSK conditions. We compared responses between family medicine residents who completed a 176-hour longitudinal sports medicine (LSM) curriculum distributed over all 3 years of residency and a comparable cohort of family medicine residents who completed a 188-hour concentrated MSK curriculum primarily in the final year of residency. We made comparisons using the Fisher exact test for categorical variables and an independent samples t test for numeric variables. We analyzed the 98 total responses from 50 residents. The proportion of residents reporting high ratings of their residency MSK education (26% to 60%), performing &gt;5 injections (38% to 73%), reporting confidence in performing injections (12% to 40%), and indicating likelihood to perform MSK injections in the future (52% to 65%) were all greater in the LSM versus concentrated MSK curriculum cohorts (P&lt;.05 for all). Early and longitudinal exposure to MSK care and sports medicine in family medicine residency led to both an increase in MSK injections during residency training and a greater desire to perform these injections in postresidency practice.

Learning Networks: How Family Medicine Departments Are Meeting the Requirement.

In 2023, the Accreditation Council for Graduate Medical Education added participation within a "learning collaborative" or "learning network" (LN)as a requirement for family medicine residencies. The structure and scope of what makes an acceptable LN was only vaguely defined. The purpose of this study was to learn how many family medicine residencies associated with departments already belong to LNs, the purpose and funding of these existing LNs, and barriers to entering LNs. An online survey was sent to family medicine department chairs through a Council of Academic Family Medicine Educational Research Alliance omnibus study from August to September 2023. Survey questions explored the purpose, structure, and funding of LNs that associated residency programs already belonged to as well as the chairs' beliefs and knowledge about LNs. Of the 227 chairs, 119 completed the survey (50.2%). About 53% reported that their department was part of an LN, with more than one-third belonging for 5 years or less; 47% had a low understanding of what an LN is; and 71% had little to no concern that collaborating in an LN would negatively affect residency recruitment. The purpose of most LNs was a mix of research, education, and clinical activities. Faculty's lack of knowledge about LNs and lack of time were the top barriers identified to joining an LN. Funding was varied, and departmental funding was positively associated with administrative control of the LN. About half of the residency programs associated with family medicine departments already belong to LNs. Wide variation among existing LNs may lead to significantly disparate outcomes for residents and residencies as they navigate this new requirement.

Skin Biopsies and Diagnostic Outcomes at a Multisite Family Medicine Residency Network.

Physicians other than dermatologists evaluate nearly 60% of all skin diseases, and 22% of these physicians are family physicians. Dermatology education is therefore an important aspect of Family Medicine training. Dermatologic procedural training in Family Medicine residency is not standardized, however, so family physicians graduate with highly variable skills. This study describes the scope and diagnostic outcomes of skin biopsies performed by residents at a multisite Family Medicine residency network in comparison with those performed by attendings at a Family Medicine faculty community practice. We performed a retrospective chart review of patients evaluated at eight Family Medicine residency training sites and one Family Medicine faculty community practice within a regional academic health system between January 2020 and October 2022. Patients with a skin finding who underwent at least one skin biopsy during their visit were included in the study. Among all of the skin findings, the incidence of skin biopsy was 3.6% (258/7104) for residents and 1.8% (175/9917) for attendings (P < 0.001). Family Medicine residents performed fewer shave biopsies (57.8% vs 77.7%, P < 0.001) and more punch biopsies (25.6% vs 11.4%, P < 0.001) compared with attendings. Most biopsies performed by residents and attendings were benign, although residents biopsied significantly more benign (79.1% vs 64.6%, P < 0.001) and malignant lesions (11.2% vs 5.7%, P = 0.049). Attendings biopsied significantly more low-to-moderate-grade dysplastic (22.3% vs 5.0%, P < 0.001) and high-grade atypical lesions (4.0% vs 0.8%, P = 0.034). Family Medicine residents at this residency network receive training in a variety of skin biopsy types. Distinct skin biopsy practices and outcomes between residents and attendings may reflect differences in patient populations, clinical expertise, and dermatology referral patterns.

Factors Affecting the Career Choice of Intern Physicians and Their Perspectives on Family Medicine Residency

Factors Affecting the Career Choice of Intern Physicians and Their Perspectives on Family Medicine Residency

Family Physician Education and Barriers to Promoting Smoking Cessation: A Multiservice Investigation.

Cigarette smoking remains the leading cause of preventable disease and death in the United States. Brief discussions with doctors increase cessation rates by two-thirds, and physicians trained in smoking cessation are more likely to perform counseling. Multiple organizations also recommend connecting counseling with lung cancer screening (LCS), yet physicians and patients report a lack of such integration. We sought to characterize the education received and the barriers to providing smoking cessation counseling, and to determine its integration with LCS among military Family Medicine physicians. This is a cross-sectional study of registered attendees of 2022 Uniformed Services Academy of Family Physicians Annual Conference. Our study aimed to: (1) Assess the amount of formal smoking cessation education during and after residency; (2) assess barriers to providing smoking cessation within the military health care system; and (3) assess if physicians connect smoking cessation counseling and LCS. Descriptive statistics with chi-squared analysis were used to analyze the survey results. With a response rate of 61% (n = 323/487), most participants reported receiving <3 sessions of formal education during residency (72.9%) and <3 h after residency (76.2%). Forty-eight percent cited their health care system never or rarely provided resources on smoking cessation. Time was the largest barrier to promoting smoking cessation (62.6%) and to integrating it with LCS (56.7%), although a considerable percentage also cited lack of supporting staff (34.3%). Furthermore, only 50.6% of respondents always reported counseling on smoking cessation with LCS. Smoking cessation education is provided in family medicine residencies but rarely offered afterwards. Time and lack of support staff and resources are recognized as notable barriers within the military health care system. A large proportion of uniformed Family Medicine physicians also do not link LCS guidelines with patient education on tobacco cessation and resources. Further research is needed to guide interventions to overcome these challenges within the military health care system.

Implementation of a Labor Dystocia Checklist to Reduce NTSV C-Section Rates.

Cesarean section (c-section) rates among nulliparous, term, singleton, and vertex (NTSV) pregnancies are increasing, posing risk to the infant and birthing parent. To reach the Healthy People 2030 goal of an NTSV c-section rate below 23.6%, teams must remain aware of their NTSV c-section rate and implement mechanisms to reduce it. This project was conducted to assess the impact of quality improvement interventions implemented by family medicine residents to reduce a hospital's NTSV rate. From 2021 to 2023, family medicine residents were educated on evidenced-based diagnosis of labor dystocia, failed induction of labor, arrest of dilation, and arrest of descent in first-time birthing parents. Learning was reinforced by implementing the Colorado Perinatal Care Quality Collaborative's labor dystocia checklist. Quarterly assessment of the hospital's NTSV rate and checklist utilization were monitored and widely reported. After the implementation of a standard checklist, the NTSV c-section rate at the tertiary care center declined from 35.6% in 2020 to a sustained rate below the 2030 Healthy People goal of 23.6%. Notably, patients with public insurance saw the greatest reduction in NTSV c-section rates. Hospital staff highlighted the benefits of using the checklist, including more effective electronic documentation of labor progression, improvement in team dynamics, and increased team communication. Using a labor dystocia checklist is a successful method for teams to reduce NTSV c-section rates and can be used as a training tool for family medicine and obstetrics and gynecology residency programs that care for laboring persons.

Pioneering family medicine: A collaborative global health education partnership in Ethiopia.

In 2013, Ethiopia launched its first Family Medicine (FM) residency programme at Addis Ababa University (AAU). The University of Toronto's Department of Family and Community Medicine (DFCM) was invited to support Addis Ababa University's Department of Family Medicine's (AAU-FM) educational programme activities forming the Toronto Addis Ababa Academic Collaboration in Family Medicine (TAAAC-FM). This paper describes the TAAAC-FM partnership, a capacity-strengthening initiative that focuses on four key levers of academic engagement and transformation: education offerings for AAU-FM trainees, partnership preparation of DFCM faculty, fostering AAU-FM faculty development and leadership, and lastly scholarship, knowledge sharing and mentorship. Toronto Addis Ababa Academic Collaboration in Family Medicine operates on principles of respect, flexibility and cultural sensitivity. Monthly virtual meetings and annual in-person faculty visits fostered curriculum support, teaching and leadership training, ensuring that the programme remained responsive to evolving needs. The partnership has contributed to a Community of Practice (CoP) to advance FM in Ethiopia, promoting shared learning. Addis Ababa University's Department of Family Medicine faculty leads in various roles, engages with global FM communities, and contributes to policy development, demonstrating significant progress in FM education and leadership. Looking ahead, TAAAC-FM aims to adapt its efforts based on the capacity built with AAU-FM, continue faculty development, and strengthen linkages within the global healthcare community. The partnership's success underscores the importance of collaborative, culturally informed high-low resource setting approaches to FM training and healthcare system strengthening, offering valuable insights for similar initiatives.