Teaching Health Center Graduate Medical Education Program - Recruiting, training, and retaining Family Medicine physicians that are dedicated to serving medically underserved and vulnerable populations in the San Joaquin Valley is the primary purpose of the Valley Health Team Family Medicine Residency Program (VHTFMRP). The sponsoring institution, Valley Health Team (VHT), is a Joint Commission-accredited, private, non-profit Federally Qualified Health Center which is recognized as a Level 3 Patient Centered Medical Home. VHT delivers comprehensive, culturally competent, high quality primary health care services through a network of twelve federally funded community health centers, two mobile medical units and one mobile dental clinic, all of which are located in underserved communities in the counties of Fresno, Inyo and Tulare. In 2020, VHT served as a “Health Home” for 34,156 patients providing 146,662 visits: 90% of patients lived below 200% of the FPL, 70% were of Hispanic descent, 17% were uninsured, 62% were covered by Medi-Cal, 46% were dependent on the agricultural workforce, and 24% were best served in a non-English language. The VHTFMRP is an existing THCGME Family Medicine residency program which was funded in 2017-18 as a carryover from a consortium-run THCGME funded residency. In June of 2016, when one of the key consortium members, Clinica Sierra Vista, withdrew its support of the existing THC residency program, VHT immediately stepped in to fill the gap. VHT received Sponsoring Institution Accreditation from the Accreditation Council for Graduate Medical Education (ACGME) in July 2016, and in April 2017 the VHTFMRP was accredited and approved for a 4-4-4 training program (www.vhtfmrp.org). While VHTFMRP agreed to retain the residents from the previous Family Medicine residency program, VHT became an independent sponsoring institution. Since then the program has graduated 3 cohorts of residents with a 100% board pass rate and received full continued accreditation status. The program focuses on producing the type of physicians that the region requires, encouraging locating in areas of high need in the region. This is accomplished by recruiting diverse trainees who mirror the overall population, providing robust GME training in community settings, and ensuring newly trained physicians possess the skills essential for everyday full-scope primary care practice. Residents train across multidisciplinary settings serving medical, surgical, pediatric, OBGyn, and mental health patients. This provides experiential learning in both in and outpatient settings, supplemented by lectures, workshops, self-directed learning, and panel management. The VHTFMRP is able to deliver comprehensive, high-quality training through partnerships with key stakeholders in the regional health care safety net system, including two hospitals: Community Regional Medical Center and Valley Children’s Hospital; two regional FQHCs: United Health Centers and Family HealthCare Network; and the University of California, San Francisco-Fresno. All 15 training sites are located in underserved areas designated as Health Professional Shortage Areas. Under this expansion application, VHT is requesting funding to expand from a 4-4-4 program of 12 residents each academic year to a 6-6-6 program with a complement of 18 residents over the course of 3 years. This will be a phased expansion, with a complement of 6-4-4 enrolled for AY 2022-23, a 6-6-4 complement for AY 2023-24 and a 6-6-6 complement in AY 2024-25. VHTFMRP is requesting funding support for an additional two resident FTE per year for a total of 6 expanded resident FTE in Year 3 and Year 4. By awarding funding for this expansion, HRSA will ensure that VHTFMRP is able to support an increased number of resident FTE positions at its existing HRSA THCGME Program, growing the number of culturally-competent family medicine physicians in the region, which spans multiple counties and includes learning environments in a multitude of HPSA, NHSC and safety-net sites.