BackgroundGP practices deliver vital medical student teaching in the face of increasingly challenging circumstancesAimTo understand the nature and scale of threats to medical student teaching capacity in primary careDesign & settingAn electronic survey of a pre-defined population of 120 East of England GP practices who host medical student placements.MethodThe survey was completed on behalf of the practice by the GP lead for medical student teaching. They were asked to pick (from a list of sixteen) the four main challenges they faced delivering medical student teaching placements, then explain their selection and suggest solutions. Thematic analysis of free text responses was undertaken from an activity theory perspective.ResultsResponses were received from 114 of the 120 practices in the study population (95% response rate). After clinical/practice workload (picked by 92 practices), lack of space in the practice was by far the most commonly selected challenge to delivering placements (picked by 63 practices). Thematic analysis produced a model whereby a practice’s decision to continue hosting students was influenced by level of motivation and burden of teaching, but only if a certain level of resource enablement is present. Analysis of free text responses suggested that space pressures were perceived as being exacerbated by the need to accommodate more clinicians – especially advanced practitioners employed by primary care networks under the additional roles reimbursement scheme (ARRS).ConclusionThis study provides much needed quantitative evidence to support the view that lack of space in GP premises is a major threat to the future of undergraduate general practice.