Preparing family physicians for rural practice requires a clear mission and passionate leadership, training residents in rural places, engaging community stakeholders, rightsizing a rural pathway or program to community assets and capacity, and surrounding rural faculty and program directors with a vibrant community of practice. The aims of rural training include placing family physicians in rural communities, assuring competence in all domains required for successful rural practice, meeting community needs, and promoting sustained joy in training and practice. Rural programs in family medicine are growing in number and appear positioned to continue that growth. This chapter describes the history and trajectory of training in and for rural practice; the requisite personal character domains of competence in practice for both faculty and residents; important and unique curricular design concepts pertinent to the context, content, and scope of rural training; and practical strategies in program development, implementation, and ongoing improvement. The best rural programs in both rural and urban locations are accountable to mission, strategically led by a passionate team, respectfully governed, financially enabled, committed to iterative improvement, and community engaged.