The shortage of general practitioners (GPs) in rural areas is a growing challenge across Europe. In the XXX Republic, over 40% of GPs are older than 60 years, placing many rural practices at risk of closure. A national project was therefore launched to provide targeted education and structured rural clinical exposure.To identify motivations and barriers influencing early-career doctors interest in rural practice, and to assess whether immersive rural experience can positively shape career intentions.A three-year nationwide project Support for education in primary care for general practitioners, paediatric general practitioners, and support for regional accessibility of healthcare (Project registration number: XXX), co-financed by the European Social Fund through the Employment Plus Operational Programme and the state budget of the XXX Republic, was launched by the Institute for Postgraduate Medical Education in 2025. Key components include seminars at all eight XXX medical faculties, support for 26 rural teaching practices offering one-week clerkships for medical students and GP trainees, and a survey evaluating motivations, barriers and the impact of clerkships on career decisions. Regional seminars strengthen peer support and teaching quality.Across the project, 300 medical students and 150 GP trainees are expected to complete rural clerkships. Early findings indicate a positive shift in attitudes toward rural careers, particularly in perceived autonomy, community engagement and  mentorship. Immersive rural exposure appears to reduce concerns about isolation and limited career development. Participants frequently highlight meaningful patient contact and report increased understanding of rural primary care.Evidence supports the importance of early rural exposure in shaping career choices. The project’s model combining targeted education, mentorship and real-world experience helps counter misconceptions about rural practice among future GPs.This EU-funded initiative offers an innovative and scalable approach to rural GP recruitment. By integrating immersive clinical experience with sustained mentoring and evaluation, it reframes rural practice as an attractive and viable career path. The XXX model provides transferable strategies for countries facing similar workforce challenges.

In Germany, health care delivery is shifting toward ambulatory settings, while medical education remains oriented toward inpatient care. This structural mismatch threatens the sustainability of the German health care system. The challenge is pronounced in general practice (GP), where workforce projections indicate a shortage driven by demographic change, physician retirements, reduced working hours, and rising care demands. Without targeted reforms, comprehensive primary care provision—especially in rural regions—cannot be ensured.The project conceptualizes a decentralized medical degree program that places GP-care at the core of the curriculum. The project is designed as a medical program conducted at a rural site in Germany. From the first semester onward, students participate in longitudinal placements in GP, fostering professional identity formation, continuity of care and close integration into the local community. During the clinical phase, these experiences are complemented by structured block rotations in regional hospitals and ambulatory specialty practices, ensuring comprehensive clinical exposure while maintaining a focus on GP. To guarantee equivalence with established medical programs, students complete the national state examinations. Student selection within the project follows a predictor-based approach that considers academic performance alongside motivation for GP, rural affinity, and regional background.The curriculum addresses challenges of the German health system by integrating prevention, health promotion, public health, digital health, telemedicine, artificial intelligence and gender-sensitive medicine. Teaching formats are evidence-based, student-centered, with emphasis on problem-oriented learning and longitudinal integrated clerkships. These approaches enable students to follow patients across sectors and periods, gaining an understanding of coordination processes and constraints in rural care delivery.In the light of the current develompents in Germany, a dedicated medical education project has been initiated to realign undergraduate medical training in Germany with the realities of ambulatory and rural health care.By creating additional study places, strengthening regional training networks, and facilitating a seamless transition into postgraduate training, the project aims to make a sustainable contribution to securing high-quality primary care in Germany.

The decentralized structure of Germany’s final-year (PJ) general practice rotations often results in uneven teaching quality - especially in rural and remote settings. Departments frequently lack resources for full digital curricula. We developed PJ‑Teaching, an inter‑university online seminar series based on German National College (DEGAM) competencies. This supplements local teaching, ensures longitudinal learning regardless of location, and enables universities to share high-quality sessions - reducing workload while enriching the curriculum.Our goal is to ensure equitable, high-quality general practice education for all students, irrespective of their placement site, by fostering inter‑university collaboration. The approach especially enhances the feasibility and attractiveness of rural placements by pooling expertise, supporting small departments, and reducing isolation.The programme is coordinated through a shared online platform (website) by a student assistant and post doctorate staff. The participating universities (Marburg, Frankfurt, Hannover, Brandenburg, Jena, Münster, Dresden, Oldenburg, Mainz, Erlangen, Saarland, Charité Berlin, DEGAM) independently schedule interactive seminars featuring case studies and workshops. Teaching quality is measured through standardized student evaluations. Continuous improvement uses the ADDIE instructional‑design model, with feedback incorporated into ongoing refinement.Student engagement remains high; feedback is consistently positive. The format strengthens peer and faculty networking, elevates teaching quality, and broadens reach. Stakeholder inclusion proved to be essential in inter university collaboration. Experienced clinicians lead sessions that offer guidance and inspiration. The decentralized, student‑supported structure remains flexible and particularly well-suited remote placements and resource-limited settings. 2025 evaluation data - soon to be presented - demonstrates the model’s impact and educational quality.PJ-Teaching delivers accessible, practice-oriented training irrespective of location or institutional resources. It can be a showcase project how digital online teaching and can easily be transferred to an international context.  By sharing content and responsibilities, the programme benefits all participating universities and students, enabling sustainable, scalable rural placements.Our project relates to the core principles of WONCA Europe 2025 in Paris: Liberty: Flexible learning environment for students Equity: Independent from onsite university teaching Fraternity: Collaboration by sharing resources Humanism: Seminars aligning with Can-MED roles

Increasing student numbers and declining placement availability make our current attachment model for teaching general practice (GP), community health and rural medicine unsustainable at xxx. In 2024 we undertook an international study of medical schools (Phase 1), a literature review, and a series of interactive workshops to clarify our purpose, vision and mission, which provided a conceptual foundation and set of intended outcomes to guide curriculum redevelopment (Phase 2).To redesign our undergraduate curriculum in general practice, community health and rural medicine by addressing four key questions: What does the literature tell us about effective undergraduate GP teaching and learning? How can insights from our international study inform curriculum redevelopment? What can be learned from key stakeholders to strengthen the redesigned curriculum? How can these learnings be integrated within existing resource and structural constraints?International data from 44 medical schools were mapped to the EPIC‑GP (Modified SPICES) framework: Electives; Problem‑based; Integrated; Community‑based; GP‑focused; inter‑Professional education. EPIC‑GP scores were summed, hierarchical cluster analysis performed, and innovations and solutions subjected to content analysis. In 2025 a draft “strawman” curriculum was developed. Extensive stakeholder consultation is underway through surveys and semi‑structured interviews using pragmatic sampling of students, university staff, community general practitioners, primary care staff, and national primary care organisations. Data will undergo quantitative and reflexive thematic qualitative analyses.Three programme typographies emerged from the cluster analysis: hospital‑focused, GP‑focused and primary care‑focused. Five thematic areas of innovations and solutions were identified from content analysis: curriculum organisation; opportunities for student–patient conversations beyond consultations; strategies to provide authentic GP experience; early exposure to GPs as teachers; and use of simulation and information technology. Findings from stakeholder consultations will be presented.In 2026 data from Phases 1–3 will be triangulated to construct a refined draft curriculum which will then undergo a second round of stakeholder consultation, with implementation planned for 2027.The three phases will provide a coherent, evidence‑informed and stakeholder‑driven foundation for our curriculum redevelopment. The redesigned programme will align with international best practice, draw on Kern’s Six‑Step Model of educational theory, and reflect needs and expectations of learners, educators, clinicians and community partners.

The World Health Organization Regional Office for the Eastern Mediterranean (WHO-EMRO) has identified family practice as a cornerstone for strengthening primary health care and achieving Universal Health Coverage (UHC). Despite this priority, countries across the Eastern Mediterranean Region (EMR) face a critical shortage of trained family physicians. In 2016, only 3,225 certified family physicians were available, far below the estimated need of 185,497. Meanwhile, approximately 250,000 general practitioners (GPs) currently provide primary care services, most without formal postgraduate training in family medicine. Building the capacity of this workforce represents the most feasible short-term strategy to expand family practice competencies.In response to Regional Committee Resolution EM/RC63/R.2, WHO-EMRO and the Arab Board of Health Specializations (ABHS), in partnership with WONCA-EMR, collaboratively designed a two-year Regional Professional Diploma in Family Medicine (RPDFM). Using a blended learning model, the diploma combines online learning via the Moodle platform with structured face-to-face clinical training. The curriculum spans six thematic modules delivered over 16 instructional blocks. Program development involved stakeholder consultation, curriculum design workshops, competency mapping, and testing of the online learning environment. Implementation began in 2023 with 126 GPs from 10 EMR countries.Early experiences show that blended learning significantly enhances accessibility for GPs who cannot leave clinical practice for full-time training. Strong interagency collaboration and country-level support were critical enablers. Challenges included variable digital literacy, differences in national accreditation processes, and logistical constraints for clinical placements.The RPDFM demonstrates that regionally harmonized training can address workforce gaps in a sustainable, scalable manner. Its design accommodates national diversity while maintaining competency-based standards. Continued monitoring is needed to assess long-term impact on clinical practice and primary care quality.The regional diploma represents an innovative and practical solution to strengthening family medicine capacity across the EMR. Scaling and institutionalizing such programs can significantly accelerate progress toward UHC by equipping GPs to deliver high-quality, comprehensive primary care.

Neuroendocrine neoplasms (NENs) are complex tumors with an increasing global incidence. In 2019, in the Survey of Challenges in Access to Diagnostics and Treatments for NEN Patients (SCAN) there was a mean diagnostic delay of five years worldwide and 46% of patients (1077/2359) were diagnosed at an advanced stage. SCAN also demonstrated that in 19% of cases (456/2359) it was primary care physicians (PCPs) who undertook the initial diagnostic tests. These findings underscore the critical role of PCPs in early NEN detection.To lessen the diagnostic delay, a global team of NEN experts and PCPs, convened by the International Neuroendocrine Cancer Alliance (INCA) in partnership with WONCA Europee developed the Think NENs Global Educational Program, a free, UEMS-EACCME®-accredited e-course designed to equip PCPs with essential NEN knowledge, available in seven languages. The key objectives are to alert to the importance of distinguishing non-specific symptoms from those that require prompt referral for specific dedicated tests to rule out NEN and provide an international map of NEN-related expert groupsm for participants to reach out for specific help.The Think NENs Program was evaluated using descriptive statistics. Enrollment and geographical data, and the proportion of PCPs were assessed.The program consists of three 20-minute core videos covering NEN diagnosis and patient management, delivered through Q&A sessions between PCPs and NEN specialists. Additionally, 13 videos explore key topics. 467 HCPs have enrolled (43% of whom were PCPs) from 79 countries within the first year, with all feedback provided being excellent. This demonstrates considerable interest in the topic.Since no single diagnostic test exists for NENs, early diagnosis depends on PCPs suspecting NENs in patients with relevant unexplained and persisting symptoms. Early diagnosis is possible only if a PCP is aware and thinks about NENs. PCPs are instrumental to reducing time to diagnosis and optimizing care. The Think NENs Program aims to improve patient outcomes through increased PCP awareness of NENs.Delayed NEN diagnosis and subsequent care remain major challenges worldwide. This collaborative training program is essential for WONCA Europe and WONCA member organizations which may promote this course among their members: https://www.woncaeurope.org/news/view/think-neuroendocrine-neoplasms-nens-educational-program-for-primary-care-physicians

Chinese general practitioners (GPs) are key to primary healthcare. Continuing medical education (CME)/continuing professional development (CPD) is critical for performance improvement, but existing programs misalign with needs, lacking scientific assessment tools. The globally used Hennessy-Hicks Training Needs Analysis (HHTNA) has no validated Chinese version, with domestic studies relying on unrigorously validated self-designed scales.Translate and cross-culturally adapt the HHTNA to create the Chinese version (Ch-HHTNA); validate its psychometric properties among oriented GPs; provide a scientific tool for Chinese CME/CPD programs and a reference for other developing countries.The study was conducted in two phases. Phase 1: Cross-cultural adaptation of the HHTNA questionnaire was completed through forward translation, back-translation, focus group discussions, expert consultation, and pilot testing, following Beaton's guidelines and the modified Delphi method. Phase 2: A cross-sectional study was conducted among 385 oriented GPs in Chongqing. Psychometric properties were validated via item analysis, validity analysis (face validity, content validity, criterion validity, construct validity), and reliability analysis (Cronbach’s α coefficient, split-half reliability), with data analyzed using SPSS 29.0.Ch-HHTNA includes 37 items across 5 dimensions. Item analysis showed good discrimination (CR>3.0) and homogeneity (CITC≥0.3). Validity met standards: content validity (S-CVI≥0.99), criterion validity (positive correlation between research item scores and engagement), construct validity (5 factors explaining 75.25% variance). Reliability: Cronbach’s α 0.797-0.958, split-half reliability 0.932-0.953.The Ch-HHTNA was developed through a standardized process, maintaining the core framework of the original questionnaire while adapting to China’s healthcare context, with excellent reliability and validity. The modified Delphi method integrating focus groups and expert consultation enhanced the scientific rigor and efficiency of the adaptation. The results provide data support for targeted CME/CPD program design, but limitations exist: the sample only includes oriented GPs, requiring further validation of applicability; the cross-sectional design cannot track changes in training needs before and after training, and longitudinal studies are needed in the future.Ch-HHTNA has good reliability and validity, with a 5-factor structure adapting to Chinese GPs’ work context. It serves as a reliable tool for assessing oriented GPs’ training needs, providing a scientific basis for CME/CPD programs.