Canada is a large country with a diverse and spread-out rural population. Compared to their urban counterparts, rural Canadians have fewer family doctors and dramatically fewer specialists, and they face other significant geographic barriers to accessing health care. This paper describes the milieu of the rural physician in Canada and reports on efforts to develop a postgraduate medical education model for rural family practice that will produce more physicians with the knowledge, skills and interest to practice in small and mid-sized communities. Key recommendations of the College of Family Physicians of Canada include: providing earlier and more extensive rural medicine experience for all undergraduate medical students, developing rural postgraduate training programs, providing third-year optional special and advanced rural family medicine skills training and making advanced family medicine skills training competency-based and nationally accredited.