BACKGROUND AND OBJECTIVES: This article describes the development of the first training program in family medicine in Ethiopia that was launched on February 4, 2013, at Addis Ababa University (AAU). The postgraduate program will prepare highly trained doctors for all parts of the country who choose generalism for their lifelong career. The paper describes a series of strategies that were used from 2008 to 2013 to take the Ethiopian family medicine program from vision to reality. There is no single model for the development of family medicine in a country where it does not yet exist. In this case the strategies included Continuing Medical Education events, discussions with stakeholders, international collaboration, needs assessment, curriculum design, and faculty development. The article also reviews both the potential for a new program in family medicine to contribute to the country’s health system plus the challenges that are expected in the early stages of establishing a new specialty. The challenges include the ambiguous roles of the family physician in the Ethiopian health care system, uncertainty about career opportunities, adaptation of the curriculum to address local needs, expansion of the training programs to produce larger numbers of family physicians, development of Ethiopian faculty who will be teachers of family medicine, and internal and external brain drain. Family physicians will need to maintain a respectful relationship with other specialist physicians as well as nonphysician primary care providers. The development of this AAU family medicine residency is an example of a successful inter- institutional relationship between local and international partners to create a sustainable, Ethiopian-led training program. Insights from this article may guide development of similar training programs…..more