The Family Medicine Center (FMC) is a foundational component of family medicine residency training, but is also a uniquely challenging and complex environment with numerous difficulties in providing continuity, access, team-based care, and more. Many residency practices nationwide have created innovative strategies and solutions to meet the challenges of the FMC, and developed clinics that provide high-functioning care and engaging training experiences that model excellence in primary care and inspire learners to perpetuate this excellence in their future practices. This chapter will review basic logistics involved in running and practicing in a Family Medicine Center, and then use the 10 + 3 Building Blocks of High-Performing Teaching Clinics to take a deeper look at challenging areas and discuss best practices to help strategically address these challenges.