Five Years of Family Medicine Education in Zambia: Challenges, Milestones, and Lessons Learned.

Over the past 2 decades, the growing need to strengthen primary care in southern Africa has fueled a rising interest in the specialty of family medicine. Given the region's heavy burden of both communicable and noncommunicable diseases, along with restricted health care resources and limited access to care, family physicians may play a key role in improving health care access and quality in these settings. The development of family medicine in Zambia began in 2013 as a working group of committed clinical and public health academics, and progressed to the launch of that country's first family medicine residency in 2019. Despite enormous challenges, the program has flourished since that time, growing rapidly from the inaugural two residents in 2019 to 45 residents and recent graduates by 2025. While this growth has allowed the residency to become a leader in family medicine education in the region, it also has brought a new set of challenges. In this narrative, we describe the health care context of Zambia, the introduction of family medicine as a specialty to a new health care landscape, and the launch of that country's first ever and rapidly growing family medicine residency, as well as unique challenges, strategies employed, and lessons learned along the way. We conclude the article by looking ahead at new challenges and recommendations for the program's continued growth. The experiences and lessons learned may be used by future family medicine residency start-ups throughout sub-Saharan Africa.