The success of these programs is enabled by the longitudinal relationship between faculty, medical students, and residency training programs at the training sites. Students learn about the residency program, while the residency team at the site learns about the students. If early on in the 3-year process a site change is required, depending on availability and capacity, opportunities will be explored. If this happens further into training or a site change cannot be accommodated, the student will need to “off ramp” and re-integrate into the traditional U of A College of Medicine – Phoenix 4-year MD curriculum. The student can continue to pursue their interest in a career in primary care in the 4-year MD program.