This report provides the Kassenärztliche Bundesvereinigung (KBV) (national association of statutory health insurance physicians) in Germany with a study that seeks to help inform the further development of medical education and training in Germany. Specifically, we sought to understand how other countries are reforming their medical education and training system in order to better meet the needs of the changing healthcare environment and how they address shortages of doctors practising in primary or ambulatory care through reforming the education and training systems. We do so by means of an exploratory analysis of the experiences of three countries: England, France and the Netherlands, with Germany included for comparison. We describe the general context within which the medical education and training systems operate and provide an overview of the education and training pathways for general practice in each of the four countries. We place observed patterns into the overall governance of medical education and training, and analyse approaches to ensuring the provision and distribution of the primary care workforce nationally and regionally. We close with a presentation of options for medical education and training in Germany that arise from this study. This study will be of relevance for decisionmakers and practitioners concerned with ensuring a medical workforce that is prepared for the demands in a changing healthcare environment.RAND Europe is an independent not-for-profit policy research organisation that aims to improve policy and decisionmaking in the public interest, through rigorous research and analysis. RAND Europe's clients include European governments, institutions, NGOs and firms with a need for rigorous, independent, multidisciplinary analysis. This report has been peer-reviewed in accordance with RAND's quality assurance standards.