Abstract
Family medicine is vital in Japan as its society ages, especially in rural areas. However, the implementation of family medicine educational systems has an impact on medical institutions and requires effective communication with stakeholders. This research-based on a mixed-method study-clarifies the changes in a rural hospital and its medical trainees achieved by implementing the family medicine educational curriculum. The quantitative aspect measured the scope of practice and the change in the clinical performance of family medicine trainees through their experience of cases-categorized according to the 10th revision of the International Statistical Classification of Disease and Related Health Problems. During the one-year training program, the trainees' scope of practice expanded significantly in both outpatient and inpatient departments. The qualitative aspect used the grounded theory approach-observations, a focus group, and one-on-one interviews. Three themes emerged during the analysis-conflicts with the past, driving unlearning, and organizational change. Implementing family medicine education in rural community hospitals can improve trainees' experiences as family physicians. To ensure the continuity of family medicine education, and to overcome conflicts caused by system and culture changes, methods for the moderation of conflicts and effective unlearning should be promoted in community hospitals.