Since the 2000 health system reform that established general practitioners (GPs) as gatekeepers, Bulgaria has faced a persistent decline in the primary care workforce. National data show a drop from approximately 4,200 GPs in 2000 to 3,700 in 2025, combined with marked ageing of the profession (73.2% over age 55). Fluctuations in the number of new GP trainees raise further concerns regarding long-term sustainability. Understanding which contractual and organisational reforms may enhance GP retention is therefore essential for strengthening primary care capacity.To identify feasible contractual and organisational strategies, particularly within the National Framework Contract (NFC), that could support GP retention and improve the long-term sustainability of primary care in Bulgaria.This qualitative study was part of a broader investigation on career development in general practice. Semi-structured, vignette-based interviews were conducted with 62 GP trainees. Participants were asked to reflect on two central questions: (1) Which contractual and organisational changes could help retain GPs? and (2) How could modifications to the National Framework Contract improve long-term sustainability? Responses were provided in writing during organised training sessions. Data were analysed using qualitative content analysis to identify recurrent themes and proposed interventions.Participants (xx males, xx females; mean age xx years) proposed several near-term contractual improvements: additional remuneration for extended or atypical activities (e.g. home visits), financial mechanisms to ensure locum coverage during leave or illness, and substantial reduction of administrative burden through simplified reporting and automated electronic systems. For long-term sustainability, trainees emphasised the importance of clear reimbursement rules for telemedicine, the establishment of standards for digital health services, and stronger data-protection frameworks.Trainees viewed the NFC as a central policy instrument that strongly shapes working conditions, workload, and professional motivation. Their proposed changes align with broader European trends aiming to modernise primary care through digital tools, streamlined administration, and supportive workforce policies.Targeted revisions to the National Framework Contract could enhance the economic and organisational attractiveness of general practice, influence career decision-making, and strengthen the long-term sustainability of primary care in Bulgaria. Implementing these measures may contribute meaningfully to mitigating the country’s critical GP workforce shortage.