Context: Primary care physician shortage in the United States is especially problematic in tribal, rural, and underserved communities. Resourcing innovative medical school programs designed to recruit, prepare, and encourage medical students (MS) to choose residencies and careers in primary care (PC) is an upstream strategy. Objective: Describe a federally-funded 4-year program to pipeline MS including those from Tribal, Rural, and medically Underserved communities in Oklahoma (TRU-OK) to PC careers. Study Design: Qualitative program evaluation of Year 1 progress. Setting: 4-year medical school (University of Oklahoma) with two campuses each with accredited tracks: College of Medicine Oklahoma City (COM) and Tulsa School of Community Medicine (SCM). Established partnerships with health systems serving TRU-OK communities. Population: 660 MS at COM (n=540) and SCM (n=120) campuses; multiple community partner organizations (e.g. several tribal health systems, FQHCs). Intervention: The three program goals are: 1) recruit, admit, and retain TRU-OK MS; 2) create innovative and early educational experiences focused on PC for all MS; 3) support the PC Pathways Network (PCPN) to promote pipelining from/into TRU-OK communities. Activities are being developed and implemented at COM and SCM with key community partners. Six core pedagogical topics are of focus: 1) interprofessional education, 2) behavioral health integration, 3) social determinants of health, 4) cultural and linguistic competency, 5) practice transformation, and 6) telehealth technology. Outcome Measures: A narrative summary of project operations, objectives, accomplishments, barriers, and resolutions. Results: Goal 1: conducting new types of outreach and recruitment focused on TRU-OK communities. Goal 2: adapting and developing curricular changes at COM and SCM, focusing on six core topics, and TRU-OK community-based training; and creating SCM-specific longitudinal integrated clerkship and accelerated pathway. Goal 3: establishing the Pathways Community Collaborative to provide expertise and oversight, and developing infrastructure and resources to establish the PCPN. The effects of COVID-19 on the program will be discussed. Next Steps: Enact continued TRU-OK targeted outreach and recruitment, progress in campus-spanning curricular changes, and operationalization of the PCPN, with adaptations as necessitated by COVID-19. This program can inform other efforts directed at PC workforce development.