Introduction: Medical Residency Programs in Family and Community Medicine (PRM-MFC) are strategic for strengthening Primary Health Care (PHC) in Brazil, yet lack nationally applied validated tools to assess their implementation. Objective: To evaluate the implementation of PRM-MFCs in PHC based on the perceptions of residents, preceptors, coordinators, and managers, using a structured and validated instrument. Method: This was a cross-sectional study with data collection from November 2024 to April 2025, using a self-administered questionnaire composed of 11 evaluative items and two open-ended questions. The instrument was previously validated through a Delphi method with experts in Family and Community Medicine. A total of 219 responses were obtained from professionals linked to 78 different PRM-MFCs across all regions of Brazil. Analyses included descriptive statistics, program categorization, binary and ordinal logistic regression, and content analysis of open responses. Results: The overall average implementation score was classified as “satisfactory” (2.6 points), with variability across items. The lowest-rated aspects were preceptorship remuneration (1.4), procedural practice (1.7), non-assistance activities (1.7), and continuing education (1.9). Statistically significant differences were observed according to region, program type, time since implementation, and respondent role. Qualitative analysis revealed that disorganization within PHC was the main barrier to procedural training. Conclusion: The instrument proved to be effective in assessing PRM-MFC implementation and identifying critical areas for improvement. Results reveal structural and regional disparities, providing guidance for policies aimed at strengthening residency programs within PHC