Family Medicine residency programs must change substantially to prepare for new family physicians a model of practice for the 21st century. This article describes 10 essential skills that are part of a new model of family medicine and the educational changes and resources needed to obtain them. These skills include management of a population of patients, patient-centered care, personal medical home, best knowledge at the point of care, continuous access to multimodal communication, a new platform of care, time intensive visits, group visits, teamwork and interpersonal skills, and financial practice management.